Care at home:where the system is falling down

It is now nearly a year since my mother died, so there has been some time to reflect. I believe that the system of care companies which look after older people in their own homes is at breaking point, and reforms to it are urgently needed.

The need to bring some support first occurred four years ago, when Mum felt she wanted help with getting up and washed. She had too much in savings (that is, more than £23,000) to qualify for Local Authority carers, but social services provide families with information about the various companies that are available. We went for a small family-run operation. This worked well for the next two-and-a-half years, Mum having an excellent rapport with her carer, Marie.

As her requirements grew, however, she was in and out of hospital, and needed more frequent visits. Eventually, there was only one company that could provide the level of cover required: the element of choice had gone. The idea that the client can mix and match from a range of options is a long way from reality. And this was in a part of the south coast of England where there is a large concentration of elderly people.

I met one of Mum’s former carers, Sue (not her real name) recently. She looked exhausted. Working for the care company for the past 14 months, on a zero-hours contract, had taken its toll.

She could have a day packed with back-to-back calls, or the office manager might give her a couple of hours of work in the morning, then a gap of four hours, and later on, calls stacked up into the evening. Often, she said, she wanted to stay longer to get the job done properly, but there was pressure to get in and out as quickly as possible.

Most companies have a system whereby the carers ring their office on arrival at the client’s house, and again before they leave. This gives an accurate record of the time spent with each client. It has to come from the client’s phone, to confirm that the carer is there, and not elsewhere with a mobile phone.

There has been much talk recently about 15-minute calls as not being sufficient for care needs. This can, of course, be the case, but sometimes, 15 minutes could be more than is needed. If you are paying for the call, you want the visit to last as little time as necessary. It is one of the more distressing elements of private care that you have to judge whether genuine compassion is being shown, or whether it is really about the care company’s getting paid.

The company needs to be monitored by the client’s family or a friend. In our case, Mum was loath to lose Marie, with whom she had struck up a friendship. In the case of a company that we used later, however, I was constantly seeking to have one person lead the operation, to ensure that the routine was done the same way; that things were put away when the carer left; and that the team dealing with Mum should consist of a small, stable number of faces. This was not always the case, which caused great distress.

A number of lessons can be drawn from our family’s experiences. The first is the need for the vulnerable person to have someone acting as an advocate, to stand up for him or her when dealing with the care company, and with social and medical services.

A distinction needs to be drawn between people who fund themselves, and those for whom the local authority picks up the bill. The amounts can be horrendous. The final four-visits-a-day bill was £800 per week. Recent recommendations suggesting a cap on care spending by individuals would be welcomed by many.

There should also be more concern for the carers. Relatives often say that they feel unsupported, and overwhelmed by the pressure of looking after a member of their family, particularly, if they are trying to keep a job going at the same time — often, such people have to give up their jobs. Research conducted by YouGov for Carers UK in February 2013 found that 2.3 million people had given up work to care for elderly parent, or a disabled or ill family member. This is said to have cost the exchequer £5.3 billion in lost tax revenues, on top of the additional benefit costs.

One of the problems is that the ability of families to provide voluntary support is taken for granted. The Generation Strain, a report published by the Institute for Public Policy Research in April, argued that soon (by 2017 was the estimate), there will not be enough family members to deal with all those who require support.

Professional care workers do vital, skilled work, which should be valued by society. They should not be on the minimum wage and casual contracts: they should be salaried, with decent pay and conditions of employment, such as holidays and sick pay. This would change the care sector overnight. The present system of bringing in people, giving them a little training, and exploiting them to the point pf burn-out is no way to run a system.

A wider question must be whether care can ever properly be conducted by private-sector companies, whose concern at the end of the day is profit and return to shareholders. The ethos of caring does not sit easily with their bottom-line economics. A state-run system is unlikely to prove popular with the current Government, however, especially against the background of continuing cuts in public spending. More non-profit organisations and charities operating in the sector would help.

As a whole, there needs to be a more accurate assessment of what the care requirements of an ageing population are, and what systems could be put in place to cope with this.

What is certain is that the present system is not working.

 

*Church Times - 27/6/2014

Bruce Kent getting hard of hearing at 85

A throng of the good and great from the human rights world gathered to celebrate the 85th birthday of Bruce Kent. Among the assembled throng were former Unison general secretary Rodney Bickerstaff and former Guardian foreign editor Victoria Brittain. The veteran campaigner, who recently completed a walk across the country in protest against Trident, admitted to failing hearing after all these years. Bruce told how he remarked to his wife Valerie Flessati how rude a man had been saying Bruce Kent your getting obese, when it turned out he had said Bruce Kent it is good to see you are still working for peace. Another, remarked on knowing him when he was someone important. The old ones are the best ones as they say.

*Guardian diary - 24/6/2014

Death of Gerry Conlon marks shameful period for British justice

The death of Gerry Conlon at the age of 60 marks a sad day for the British justice system.
Conlon was one of four people unjustly convicted for the Guildford pub bombings in 1974, which killed five people and injured 65.
In the febrile atmosphere of the time, as the IRA bombing campaign extended to England, the police were on alert for any possible atrocity. Anti-Irish Catholic hostility was at its height.
When the Guildford and later Birmingham pub bombings happened, the police were quick to move, grabbing as it turned out the nearest Irish person.
Conlon was one of those unfortunately convicted. It took 15 years for the four individuals known as the Guildford Four to attain justice.
Many people helped over the years in the justice campaign, not least solicitor Gareth Peirce and the late Sister Sarah Clarke who supported the families.
The families themselves played huge roles in establishing the innocence of their loved ones. Gerry’s father Giuseppe came to London to fight for his son’s innocence, only to get caught up in the whole terrible business himself. He was arrested together with members of the Maguire family and convicted of terrorist offences.
Giuseppe played by Pete Poselthwaite in the film about the Guildford Four,  In the Name of the Father,  was to die in prison in 1980. The Maguires and Guiseppe (posthumously) were also later cleared of their convictions.
Gerry Conlon’s mother and sisters were to continue to steadfastly support him throughout the long years in prison. Sister Sarah Clarke played a major role in supporting the family and men over this period.
At the time of Gerry’s untimely death, new reports included the clips from that triumphant day back in 1989 when the Guildford Four were finally cleared of murder. The iconic picture of Gerry together with family, arm raised aloft in defiance. What few would realise is that whilst he had won a triumph over the justice system this was just the beginning of another struggle.
The general public believe that once an individual has been cleared of such crimes, they get compensation and life resumes. The reality could not be further from the truth. Innocent prisoners are actually treated worse than those who have actually done the crimes. No preparation for release, accomodation arranged or resettlement courses. Most are just kicked onto the street with a bag for their belongings and a payment of £40 or so to be getting on with. It is as though the justice system is having its final vengeance for having been found at fault for incarcerating innocent people in the first place.
Yet most of these victims of miscarriages of justice need a lot of support. Gerry Conlon had two breakdowns, suffered with drug and alcohol addiction and attempted suicide. He received some treatment for Post Traumatic Stress Disorder.
Nor was Gerry’s situation isolated. Billy Power of the Birmingham Six told of his difficulties in resettling into life outside. A door with a handle that can be turned and opened from the inside. The busy streets and way life had changed over the 16 years away. Billy told how he was used to battling the Home Office and justice system but found it much more difficult to deal with rows in the family. The Birmingham Six were found to have psychological problems.
Few of the high profile miscarriage of justice victims ever work again. Some put a lot of effort into working for the justice of others. Gerry Conlon became involved with several cases over the years and played an important role in the work of the excellent Miscarriage of Justice Organisation (MOJO).
Gerry also notably spoke out over the miscarriages of justice of the present day, with people being put under control orders and detained for years on end without ever being brought before a properly constituted court of law.
Paddy Hill of the Birmingham Six is another who has played an active role working for justice. He has been involved in several campaigns and was a founder member of MOJO.
Billy Power of the Birmingham Six campaigned for fellow Irish prisoner Frank Johnson , who was finally cleared of murder in 2002 afteer serving 26 years.
Frank was another turned onto the street with £40. He lived his first few months of freedom at Billy’s house. He died in 2008.
The death of Gerry Conlon should be a time for society to reflect on a justice system that still convicts innocent people. It should also be a time to examine just how these damaged individuals are treated when released. They require support and help, not simply to be chucked on the criminal justice scrap heap.

Eric Pickles fight over council papers distracts from a bigger crisis in local media

Eric Pickles has had a bee in his bonnet about local council run newspapers or as he prefers to call them “town hall Pravda’s” for some time.

Pickles recently declared "It is scandalous that bloggers have been handcuffed for tweeting from council meetings, while propaganda on the rates drives the free press out of business. Only Putin would be proud of a record like that.”

The anger of the secretary of state recently resulted in five Labour run council papers in London being threatened with legal action for failure to comply with the publicity code for local authorities, part of the Local Audit and Accountability Act passed in January.

Formal letters calling for the closure of the publications were sent to Greenwich (GreenwichTime), Hackney (HackneyToday),Newham ( the Newham Mag), Waltham Forest (Waltham Forest News) and Tower Hamlets (East End Life).

Pickles has been supported in his crusade by the independent local papers and the Newspaper Society, which feel the pressure when a council paper opens in the area drawing away advertising and public notices from their publications.

The NUJ take an opposing view, claiming that the 2010 Audit Commission report had “debunked” the idea that council newspapers represented unfair competition for the local press. (The Audit Commission found that the money spent by councils was not unreasonable, that few council publications were published sufficiently frequently to be a viable media for most local advertising, and that the current accountability framework would ensure that any misuse of public money could be dealt with.)

The dilemmas of the independent versus council publication came home to me four years ago when working on the start up of the Barking and Dagenham Council paper the News.

One occasion that really brought home the conflict was when the police had set up an interview opportunity for the local press with the new borough commander.

When the interview had finished the Commander was interested to know how the local press operated, particularly the relationship between the council run local paper and the Archant title the Barking and Dagenham Post.

The problems of council run versus independently owned papers was immediately obvious with the council distributing the News free to 90,000 outlets across the borough, while the local paper sold around 10,000.

My involvement with the local council run paper only lasted a few months; however, it was enough time to gauge the issues at stake in the local paper versus council run paper argument.

The News was a substantial product, not just a news sheet. Distributed fortnightly, it included local news, features, events, entertainment and sport. I had the joy of trying to get interesting comments out of Essex cricketers and Dagenham and Redbridge footballers, though interviews with sporting legends Trevor Brooking and Graham Gooch proved more fulfilling.

No doubt the News did not help the fortunes of the local paper, nor was it likely to run stories that were embarrassing to its town hall paymasters. However, it was pretty cost effective, at that time, paying most of the costs of running the paper out of what was being saved in advertising and notices.

The concerns about the threat posed to free speech by council run papers no doubt has some validity. They do tend to be council good news sheets.

However, the local papers can hardly argue that they have been performing the role of being the guardians of democracy for some years now.

In the internet age, where the bean counters rule, the local papers have been stripped down to the absolute minimum. Many papers these days operate on very few staff, most of whom rarely leave the office.

The days when local papers reported council meetings and courts are a long distant memory. The local papers have become a shell of their former selves, often reflecting very little about what is going on in the local area. They certainly, in the majority of cases, can hardly be said to be doing a great job for democracy or free speech.

One noticeable development over recent years has been a growing trend for local newspapers journalists to migrate into local council press offices. Once they have mastered the basics of journalism, these individuals cannot then survive on the poor wages on offer at local titles. The local council offer more secure, better paid jobs, often without the same pressure of turning out a weekly publication on ever depleting resources.

The same attraction regarding pay, terms and conditions apply regarding working for a council run paper. The journalists are put on council contracts with decent pay, pensions and other benefits. Indeed, it was a better option because the journalists were still doing a sort of pseudo-journalism, almost straddling the fence between journalism and PR, rather than jumping right over from one side to the other.

So my feelings after my short sojourn at the News was that council papers were probably bad for journalism but good for journalists.

That said, the News was closed by Barking and Dagenham Council on 29 March 2013, as part of the council cuts being made at the time.

What could happen in the five boroughs being targeted by Pickles can be seen looking at Hammersmith and Fulham. It had a fortnighly council publication which came under pressure from the local Trinity run newspaper the Fulham and Hammersmith Chronicle. This led to the council shutting down its paper.

Now, the Fulham and Hammersmith  Chronicle has shut down, leaving the council without any paper at all in which to place its statutory notices.

The response of the Communities and Local Government department was that these notices can be put in the Evening Standard. The council has argued that Standard’s advertising rates make this far too expensive.

The local councils that run the papers are certainly putting up a strong fight, refusing to roll over in the face of the Pickles onslaught. Mayor of Newham Robin Wales claims that approval rating for his magazine, the Newham Mag, has risen from 41 to 70 per cent.

Where things go from here remains to be seen. Council run papers no doubt have an impact on the independent locally run newspapers, however, such publications have also contributed to their own demise in other ways. What does seem unquestionable is that there has been a vacuum created at local level by the decline of local independent media. There is a democratic deficit, which needs to be rectified. Council run papers will not meet that need; however, commercially run independent titles seem unlikely to change what they are doing either. No doubt there are those among the independent titles that will argue if you want some of these accountability issues addressed maybe there should be a subsidy for them. This ofcourse could arguably be another check on independence and accountability. The probability is that there is room for independent and council run publications, just that there needs to clear parameters to stop one from putting the other out of existence.

Whatever happens there are certainly important issues that need to be addressed at the level of local media, which stretch way beyond the present feud between Pickles and local councils over their newspapers.

 

published -  British Journalism Review - June 2014

Beach Head chaplaincy rescue service set to close due to lack of funding

The Beachy Head Chaplaincy team (BHCT), which prevented 364 people committing suicide at the Sussex beauty spot last year, is set to stop operating due to lack of funding.

The BHCT gave redundancy notices to four of its six permanent staff last week, with £50,000 by the end of the month to keep the operation going.

The BHCT has saved more than 2,000 lives since it began operations in 2004, with 364 saved last year. The demand for the service though continues to grow with 865 searches on the cliff top last year compared to 771 for the previous 12 months - when 305 people were saved

The number who actually die as a result of jumping has remained steady over the years with 33 dying last year, compared to 29 and 32 for the preceding two years. If the service were to end then this number would undoubtedly increase.

Mark Pybus, director of the chaplaincy team, lamented the lack of funding on a day when the charity received the Queens Award for voluntary services.

He underlined the urgency of the situation, saying that if the money cannot be raised then he will have to sell the vehicles needed to do the work, thereby bringing the service provided to an end. "We're not crying wolf. My accountant said that unless the situation changes by the end of June we have to act and that means winding down," said Mr Pybus.

In order to continue operating, the BHCT needs first to secure £50,000 to meet existing bills, then obtain a regular income of £15,000 a month to support the six permanent staff and 14 volunteers who undertake the work.

At the moment, the BHCT receives around £4,000 a month but the income is very haphazard, being dependent almost entirely on individual donations. "There are a number of ways the funding could be obtained, half a dozen trusts could give £2,500 a month or 1500 people could give £10 a month or 150 could give £100 a month," said Mr Pybus, who also pointed out that there are 1500 churches that he writes to in Sussex, Kent and Surrey. "If they all gave £100 a year that would cover the costs," said Mr Pybus, who pointed out that the amount is a pittance when compared to the cost of end of life care.

* see: www.bhct.org.uk or 01323 301200