The slow death of Britains home care system After we revealed the terrifying chaos and lack of compassion blighting care for the elderly you told us your stories Theyre alarming reading

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Recently The Mail ran Fran Abrams' devastating account of home care
Hundreds of readers came forward to share their own experiences
From mismanagement of medication to being left without the heating on
The following stories show what it's like for some in the home care system

Published: 20:42 EST, 18 February 2015 | Updated: 02:42 EST, 19 February 2015

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The Mail ran a devastating account by Fran Abrams of how chaos and a dearth of compassion are destroying home care for the elderly two weeks ago. Hundreds of readers were moved to get in touch, each with their own tales to tell. From carers to home care business owners, to the families of patients, their stories are deeply worrying . . .

THEY GAVE MUM TWO DAYS' DRUGS IN THREE HOURS

Julie Bevan, 52, a retired nurse from Broadstairs, Kent, lost her mother Lilian Turner, 90, in April last year. She believes that poor home care blighted the final years of her mother’s life. Julie says:

Julie Bevan from Broadstairs, Kent (pictured), had a very poor experience of care workers with her late mother Lilian Turner

In the early days when my elderly mother was first being visited by home carers, one of them made a comment that haunts me to this day. ‘Mrs Bevan, you must take a step back and let us take over,’ she said.

Thank goodness I didn’t — because if I had, my mum would have died a month later from sheer neglect. As it was, mismanagement of her medication on more than one occasion led to a deterioration in her physical health and her mental state, too.

My mother first started getting care services at the age of 86, in early 2010, after being diagnosed with vascular dementia. I visited every day, but as I was also battling liver cancer myself I had to manage that alongside my own hospital appointments.

The carers’ job was to visit Mum mornings and evenings to supervise her medication and ‘remind’ her to eat her prepared food. Within a month, I arrived one lunchtime to find her weak and dizzy, and established that she had been given two days’ dosage of her medication within three hours. Had she not had a pacemaker fitted she could have died.

A new care agency was appointed, with assurances this wouldn’t happen again, yet within weeks Mum had been given another overdose, this time of the blood thinner warfarin. Some days her medication was missed altogether — yet when I phoned the agency to complain, the response was to say ‘it’s better to under-dose than overdose’.

Julie, pictured here with her late mother Lilian Turner, on her mother's 90th birthday. Julie says that although the carers were nice people, they were incapable of doing the job

Unsurprisingly, all this was taking a huge toll on Mum’s mental health. By the end of the year, she was moved into residential care, where she died just over two years later. At no point, despite endless meetings, has anyone ever said sorry.

The awful truth is that while the carers were nice enough, and not generally unkind, they weren’t fit for purpose. I could train a child to open a pill box labelled with days of the week, but they couldn’t manage it — despite being ‘senior carers’.

Had any of this happened to a child there would have been an outcry and justifiably so — but because it’s an elderly person, people say: ‘Oh well, she would have died anyway.’ I accept people make mistakes — we are all human — but this is systemic and something has to change.

HALF AN HOUR? THEY STAYED FIVE MINUTES

Dr Julie Wileman, 63, from Tolworth, Surrey, is a visiting fellow at the University of Winchester. Her 92-year-old mother Joan has experienced a litany of problems with home care. Julie says:

Arriving home one day at the end of last year, I found my mother very distressed. Her carer had just left, although you wouldn’t know it — the house was freezing and she hadn’t been given her breakfast or her medication. All the carer had done was take her to the bathroom, all the while shouting at her because she was in a hurry and my mother couldn’t move quickly enough.

Sadly, upsetting as this was, it wasn’t untypical: in the few months since Mum had started using home care services last summer after a bad fall and a subsequently diagnosed heart problem, care had been, at best, patchy and, at worst, atrocious.

Mum’s agency was a pretty ropey set-up. She got three daily half-hour visits, to which I contributed £400 a month of the cost.

From the start there was no consistency: she rarely saw the same person twice in succession, while some of the carers spoke little or no English. They regularly forgot about her medication, didn’t bother to wash her properly, and she was frequently left without the heating on, a hot drink or hot food until I came home from work.

The carers were supposed to spend half-an-hour at a time with Mum, but some were in and out in little more than five minutes, partly because they had an impossible schedule. Many of them were nice enough — two were lovely — but some were actively unpleasant: one pushed my mother around like she was a sack of coal.

I watched as her health deteriorated before my eyes, but although my endless complaints to the agency management were met with promises and excuses, they never resulted in any changes.

Finally, three weeks ago and after endless campaigning, we were given the services of a new, much better agency. We have the same two girls coming in every day, which means they have got to know my mum and her needs.

As a result, in just that short time my mum’s health has noticeably improved — as well as her spirits. It’s a sobering reminder of how vital good care is — but it only happened because of the endless hours I spent on the phone, fighting Mum’s corner.

What happens to the ones who don’t have anyone to speak up for them? They are left to just put up with it. It breaks my heart.

I TRIED MY BEST BUT IT WAS HOPELESS

Farida Young, 60, worked for two years as a carer for a local agency in her Oxfordshire town, resigning last year, exhausted by the demands of the job. She recalls:

Lunging towards me, the elderly lady was anxious, confused and lashing out. It was all I could do to calm her down.

It wasn’t her fault — she had Alzheimer’s, and I wasn’t her usual carer, whose car had broken down. I had 15 minutes to calm her down, get her a hot drink, warm up a meal and give her medication.

Former care worker Farida Young (pictured), resignined last year, exhausted by the demands of the job

It was the kind of scene I encountered fairly frequently during my two years as a carer, in which lack of time was a constant obstacle to doing my job properly.

In a typical morning visit, I would have 30 minutes to log in my arrival by telephone, check the communication book for information from the last visit, assist the client out of bed, wash and apply creams, dress the client, make them breakfast and give them their medication before leaving everything clean and tidy, and filling in the communication book before logging out.

That would be no mean feat at the best of times, and when you are dealing with the frail and elderly, some of them with mental health issues, then it is a huge challenge.

Farida (pictured) described the job of looking after the frail and elderly as a 'huge challenge'

Most days I started work at 7am and finished at 9pm with short morning and afternoon breaks —but, despite my 12-hour days, I was only paid for eight or nine as travelling time isn’t counted. I was always running late and driving like a lunatic. Yet despite the frenzied timetable I got very close to most of my clients and it was upsetting not being able to give them the emotional support they deserved.

Sometimes even just doing one extra little thing would earn me a reprimand from my employers: I remember taking a minute to rinse limescale out a lady’s kettle and being told by my agency that my standards of cleanliness were too high and I was a carer not a cleaner. It sounds awful but the irony is that, as care agencies go, mine was one of the better ones.

In the end, it just became too much and I handed in my notice last year. My experience opened my eyes to what is really going on — and I know for sure that our elderly deserve better.

I RAN A CARE FIRM BUT PRAY I NEVER NEED IT

Bob Mackenzie, 65, ran a home care agency for ten years in a small market town before selling it in 2011 because he no longer felt able to provide a decent quality of care while making a living.

‘I set up my agency in 2001 after signing up to a national franchise, starting out with four carers on my books. By the time I sold the business, ten years later, I had more than a hundred.

On the surface that looks like a success story — but behind the scenes it was anything but. Because the reality behind those burgeoning figures was a paper trail of bureaucracy and micro-management — most of it down to the local authority, which gave us 80 per cent of our business and which was incredibly prescriptive and inflexible.

Bob Mackenzie, 65 (pictured), ran a home care agency for ten years but sold it in 2011 when he no longer felt able to provide a decent quality of care while making a living

They paid us by the minute for each client visited. When a carer arrived or left someone’s home, he or she would have to phone a number to electronically log them in and out.

If they went over the allocated call time by more than five minutes they were not paid for it, or for their travelling time and expenses.

Then there were the care plans, which were often not remotely realistic or catered to the client’s needs. Meanwhile, the local authority were paying about £13.50 an hour per client — at least £2 less than I would charge my private clients to ensure their basic needs could be met.

Bob said the care plans were not 'remotely realistic' and did not cater to the needs of the client

In the end, it got harder and harder to pay my staff, provide a decent service, and make anything approaching a living. We were having to cut corners and that’s why, in 2011, I made the decision to sell up.

I accept that providing care is a complex problem — but it’s one that won’t be solved by more layers of bureaucracy.

Many care staff are doing a brilliant job within the constraints they have to work under, but that doesn’t change the fact that things are in a pretty dire state.

After seeing the way it’s going, I can only pray that if I need care services in future I have enough money to pay for them myself.

OUR STAFF DO CARE - UNLIKE TOO MANY SELFISH FAMILIES

Sue Garrett, 59, has run the privately owned Mansion House domiciliary care agency in Althorne, Essex, for the past seven years. She believes care workers often go the extra mile with very little recognition. Sue says:

Being a small agency, with 20 carers, means we can really get to know our clients. We build relationships, which in turn means that all my carers go above and beyond what is expected of them, whether it is staying on for an extra ten minutes for a chat, or taking a small birthday gift.

For many of the lonely and vulnerable elderly we work with, this makes all the difference.

Sue Garrett (pictured) is a Manger at Mansion House Domiciliary Care Agency in Althorne, Essex. Sue says that because they are a small agency, they take the time to get to know their clients

Earlier this week, I received a call from one of my carers to say she was going to be late to her next appointment. She’d arrived at the home of her client — an elderly lady with very limited mobility — and found, that on top of her helping the lady get bathed and dressed, giving her medication, cleaning her commode and preparing her breakfast, there was a sink full of washing-up left over from a family gathering the night before. It’s a problem we face regularly. Sometimes it can feel like we are a hybrid of a fourth emergency service, a cleaning service and a home help.

Sadly, a number of people who receive care have families who could assist more but aren’t willing to and who, once they know their loved one is receiving their two half-hour daily visits, back off altogether — even if that means leaving them with a bare fridge. It’s not uncommon for my staff to buy bread and milk for clients out of their own pocket, even though a family member lives close by.

Often it feels like we don’t just take someone on as a client, we effectively adopt them. We liaise with hospitals, we book plumbers and electricians, sometimes we even bring them clothes.

Sue says her staff are extensively trained for six weeks and mentored by other carers before they go out visiting clients

This is all on top of our actual caring duties, and we don’t get paid for it. Yet none of my staff complains. Sadly, the commitment of our care team is rarely recognised by the world at large.

I believe passionately that care work should be vocational. I worked in the advertising business, but when I lost my father in my late 30s it started to feel meaningless. That’s when I took the decision to give something back. I got a job as a carer in a residential care home. It meant a massive pay cut, but the money wasn’t important: you can make a real difference to people’s lives.

Sadly, a lot of people don’t see it that way. I’ve had people turning up saying: ‘Tesco isn’t recruiting at the moment so I thought I would give you a try.’

That attitude — that it’s just a job — applies to employers, too. I know of a number of agencies where carers turn up with a job application one day, and the next day are out visiting clients. We don’t do that — our staff are extensively trained for six weeks and are then mentored by another carer.