Making social care social again

by
05 May 2017

Frustrated with the dehumanising ten-minute slots that she was allocated, Sarah Kydd, a care worker, developed a not-for-profit model that puts caring for people first, Hattie Williams discovers

 

Grimsby Telegraph

Person-centred: left to right: the KCC volunteer co-ordinator, John Spowage; the domiciliary care-manager, Sarah Kydd; and the Revd Philip Stevens, a trustee

Person-centred: left to right: the KCC volunteer co-ordinator, John Spowage; the domiciliary care-manager, Sarah Kydd; and the Revd Philip Stevens, a...

SARAH KYDD wanted to put the love of God into action by caring for elderly and disabled people in her community, within their own homes. But fulfilling this sense of calling was a long and painful journey.

She began working as a domiciliary carer for a commercial care-group in the village of Keelby, Lincolnshire, eight years ago, having moved with her two young children to be closer to her sister, a cleric in the parish. But, within a few months, Ms Kydd felt underpaid, undervalued, tired, and frustrated.

“They were long days, and I was run ragged,” she said. “The company would ring me up on my day off, and ask if I could go here or there, because so and so was off sick. I would be out in all hours, in all weathers, to make sure people were OK.”

 

THERE are currently more than 1.3 million people employed in the adult social-care sector in England, data from the charity Social Care Skills, published earlier this month, suggests. And, like Ms Kydd, the average full-time carer earns just over the minimum wage: £7.69 an hour, or £14,800 a year. (The average full-time UK salary last year was about £27,600.)

“Caring is an incredibly important job, and it saddens me that, as in child-care, people pay the worse rates: they entrust their parents and children to people and don’t want to pay them,” she said. “Carers work better, and their lives are more fulfilled, if they feel cared for and valued themselves.

“I worked with people who didn’t have time to care; they were overwhelmed with the number of clients, because of the way commissioning works. It was endless.”

Ms Kydd was required to drive all over Lincolnshire to tend to clients, but the long journeys and impractical schedule left her out of pocket, without expenses to cover the cost of petrol. They also left her out of time, which she wanted to spend caring for her clients; she was allocated just a ten-minute window to tend to all their needs. She would set off before 6 a.m., and was late home to her children most days.

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“One day, I had 20 calls, back to back, and at the end of the day they gave me ten minutes to go to a lady in the village,” she said. “That was the final straw. I complained: how was I supposed to do my job in ten minutes, and treat this lady like a person? It is disrespectful to the client and to the carer. I wanted to do the job properly; so any talking I did was in my own time, when I should have been at home having tea with my children.”

Her parish priest, the Revd Philip Stevens, who is Vicar of the Wolds Gateway Group, serving the villages in Grimsby, said that Ms Kydd, who is on the PCC, would often arrive late at church during that time, exhausted, and dressed in her uniform, and would have to leave the service early to visit her next client. “She wanted everything she did to reflect the respect she felt for the dignity and value of each person.”

Analysis, by the BBC, of data from the charity Skills for Care, suggests that more than 900 adult social-care workers a day quit their job last year — 60 per cent of whom left the sector altogether.

Ms Kydd was in the minority. In 2012, she decided to go it alone and offer person-centred care, working flexibly with people to fulfil all their needs, including attending GP appointments, helping to entertain friends and family, or giving them a lift to the hairdressers.

“Self-employment is quite scary if you have a family to feed; so I thought and prayed for a long time before deciding to go ahead. I handed in my notice, and they worked me like a dog for that month. But I did it, and set up with ten hours a week of caring.

“Three days after I started, the local Methodist church representative asked if I would like 15 hours a week working in their café, which kept me going for the first six months. I thanked God for answering my prayers.”

 

HER client base and reputation grew, and, in two years, she had five independent part-time carers supporting eight clients. But their self-employed business model was holding the group back: tax returns became more complicated, and they were not registered with the Care Quality Commission (CQC), making it difficult to win contracts for commission.

Ms Kydd was also tending to her father during this time, who was living in a care home ten miles away. He died after a prolonged illness, while her children were doing GCSE and A-levels. “I had no time for myself,” she said. “I felt I could not keep going.”

It was then that Mr Stevens stepped in to help. “I felt that it would be a real shame if this enterprise were to fold,” he said. “To begin with, I tried to recommend that they set up a company and employ someone to carry the administrative burden on behalf of them all, but their eyes glazed over. They wanted to receive a decent wage, and were keen to register and comply with CQC requirements if someone could take the lead, but [they] had no interest in making a huge profit.”

In 2015, the group settled on becoming a registered charity, and Keelby Community Cares (KCC) was born. Today, it offers private domiciliary care-services for over-65s and adults with dementia, physical disabilities, or sensory impairments. KCC currently employs 12 care workers, supporting 12 clients.

Half of these pay for their care using their social-services allowance, provided by the Government under the Care Act 2014; the rest pay privately, directly to KCC, either because they choose not to receive social care, or because they do not meet the national minimum requirement. The group charges about £2 more an hour than social services, but their care provision is more flexible, because they are not under the commission of the local council.

Ms Kydd, who is now doing a degree in social care, is a manager, but continues to “fill in the gaps” as a carer. “I still go to see clients, because, as a manager, you need to have eyes and ears on your care provision.”

Mr Stevens is now a trustee, garnering support from other churches and community organisations to keep the charity afloat. Any profits are ploughed back into KCC, to improve the quality and quantity of care.

 

THERE are currently just under 19,000 registered residential and nursing care-homes in the UK. More than 3000 of these are voluntary non-profit care homes, of which more than a third are in the south of England (1203). Many of these voluntary organisations are also church- or Christian-led.

“Churches often try to set up voluntary pastoral-care and befriending schemes,” Mr Stevens said. “There was a history of the local churches in Keelby doing just that — both Church of England and Methodists.”

But even the most well-organised schemes often fizzle out after a few years, he said. “Too often, within a couple of years, a few churchgoers persist, out of a sense of duty, in having tea with one or two housebound elderly ladies once a fortnight or so. What began as an exciting new opportunity to respond to the needs of isolated people in the community with faith and hope, is reduced to an unchanging chore for those who stick with it.

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“By contrast, there are some community-based volunteering programmes which are so ambitious they exhaust themselves with practical jobs on behalf of elderly residents.”

KCC did not want to fall into either extreme. It set up a volunteering scheme, led by John Spowage, to fulfil some of the extra needs of elderly and disabled clients, such as reading aloud, and writing Christmas cards, and giving lifts to appointments, family weddings, or other occasions. It was partly funded by a £100,000 National Lottery Grant, which also helped to address some of the challenges of caring for people with dementia. Volunteers are properly recruited, trained, vetted, and supervised, Mr Stevens said.

KCC also received a £14,000 grant from the diocese of Lincoln Mission Initiatives Fund, and a further £5000 from the Cornish Trust, to set up the charity and gain CQC registration. Its first inspection was not without criticism, however, and, while the report stated that the care and responsiveness of the group was “good”, “overall improvement” was required with regard to its safeguards, effectiveness, and management.

Mr Stevens was not alarmed. “The inspection took place just a few months after we started, and we were delighted with the outcome. They were positive and open throughout the process; our quality of care was praised; and we agreed with their assessment of our weaknesses.”

One client of KCC, who has a degenerative condition, said that he had chosen the group because it was a local, not-for-profit company. “They help me in all aspects of my personal care, from getting me dressed, bathing, continence care, ensuring skin integrity and muscle toning through physiotherapy, to assisting me to eat and drink, and helping with my TV,” he said. “I have a very good level of care and a detailed care-plan, which is updated as my condition deteriorates. I have no complaints.

“My independence is very important, as there are no residential homes suitable for me in the area. Even so, I would still choose to stay at home as long as I can be provided for at the level I am currently.”

Hattie Sleight and her sisters live outside Lincolnshire, but wanted their parents, in their nineties, to be cared for in their own home. “We were looking for the security of professional care and support on an occasional basis. This has now grown to several visits every day.”

They chose KCC, which her parents pay for with the help of the Carer’s Allowance. “The carers are very kind, professional, and willing to help with anything,” she said. “My sisters and I are in constant touch with the carers, who always let us know of any problems. We all feel very comfortable with KCC managing their care.”

 

A REPORT from Age UK in February, Health and Care of Older People in England, warned that the state of social care in England is at risk of complete collapse, after a £160-million cut in total spending in real terms on elderly social care in the five years to 2016.

It suggests that, by 2036, just one in seven people in their early eighties will be free of any diagnosed long-term health conditions, and that 80 per cent will be living with at least two by the age of 85. This is reflected by an increase in care needs, it says.

There were more than nine million carers in the UK in 2015, including non-professional carers such as family, friends, and volunteers, Age UK says. Two million carers last year were aged 65 and over, and 417,000 were aged 80 and over. They warned that, currently, more than 1.1 million people over 65 do not receive the help they need.

Sue Davenport, who joined KCC as a full-time carer in June, said: “I love my work, but it is a stressful job and I don’t think people always realise that. Helping people with dementia [and] palliative care can be a challenge, especially if you haven’t been through that before.”

The negative press surrounding the social-care system is partly the result of large companies’ taking on too many clients, she says. “In my last job, I had a list of 13 clients in one shift who I had never met. There were more than 200 carers; so you just had to get your head down and get on with your own part. Working for KCC is totally different: I work with the same clients every day, whom I know well.”

Ms Kydd said that she is frustrated at the reports, which can affect the reputation of carers: “In my experience, each individual carer is excellent. And, if you interview people well, making sure they fit your organisation, you can find people who are enthused about what you do.

“Our model works because it is small. As long as it can get help with external funding, or be able to self-sustain, you could create other hubs elsewhere.”

Mr Stevens said: “Setting up a new care-venture is certainly not for the faint-hearted: it needs a clear vision and determination, which took us more than a year to achieve. But there is certainly a need for this kind of service, and the demand is likely to grow over time.

“It flows directly from ‘Love your neighbour as yourself,’ and, in a climate in which the quality of care is so varied, and so many people are left with inappropriate solutions, the Church may find an opportunity for service here.”

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