Bill,

Excellent blog. I totally agree with your check-list. I also think providers have a duty to support people receiving support to connect with their local community - so others, beyond family and paid staff are watching out for an individual's welfare. Organisations, such as Certitude, that are actively supporting people with profound learning disabilities to connect with their community reflect a culture of openness and transparency which is one where shocking abuse of the kind we have seen at Winterbourne View, or in this most recent Panorama programme, is less likely to occur.

I wholeheartedly agree with the above comments. The film made me think about when staff don't get verbal feedback from users of a service, it is so tempting to talk between themselves, sometimes moaning about conditions or checking on social diaries. Is it easier for people to be dehumanised and excluded when they are not speaking? (Thankfully this is not inevitable!) Not an excuse for poor or inhuman practice but understanding what is going on helps us to make changes.

The Check List above is not useable by the many users of care services in their own home. Direct Payments means being an employer and buying the care services needed. After ten years experience as such, I am usually able to spot the potential problem employees and by problem I mean their attitude to me and their trustworthiness. But I bring to this process years of experience in employment law, local government practice and counsellor training and despite physical, sensory and cognitive dis-abilities feel, so far, able to cope with those who apply to work for me. However, many interviewees think home care is a soft option, when they have experienced being unemployable or unable to commit to regular employment. I don't use the local Job Centre since they sent for interview a woman whose CRB form listed convictions for fraud and violence ! Even those with spotless CRBs are still a potential problem.

Many interviewees expect home care work to be a way of having their emotional needs satisfied, or an outlet for their need to feel superior to the cared for person. When interviewing I question very closely interviewees' understanding of my requirement of respect for my autonomy and my privacy. Even those who profess appreciation of those conditions of employment, do not understand that those terms mean I set the rules. The good ones stay with me for years - the majority last just days, or at most weeks. Its hard work. For me !

Now I have to get back to the numerous annual assessments and audits required of me by social services departments and various sections of the NHS, in order that I may continue to be cared for in my own home. And there is no retirement for me from that work - until I am no longer economically able to be cared for at home (hopefully never) ... then I will have to be strong enough to deal with care home staff (see above !) who may not be as well interviewed and trained as my own !!!

That's Life in Disabilityshire.

Thanks Sally for taking the time and trouble to comment and pointing out the important differences between support services purchased via a DP in non-registered settings - compared with other settings.

The annual assessments and audits (form filling) sounds a nightmare and I suspect is largely a waste of time, effort and money. Later this year the DH is launching the 'red tape challenge'(this is an attempt to reduce bureaucracy goes across the whole of government, and being carried-out dept by dept). Look out for it on the DH website... and perhaps comment.

Thanks Sally - we should love you to do a personal checklist from your experience of recruiting Personal Assistants - what would be your five questions or pieces of advice that others receiving home support should consider? If you were willing then we could help you construct a blog post. Skills for Care are increasing their support for people using Direct Payments and I am sure they would like to hear more too.

My email is: bill.mumford@macintyrecharity.org

Thank you John and Bill for responding and apols for delayed acknowledgement - this week's energy has been spent warning, sacking and then protecting myself against a bad employee. Both your comments are of interest but alas, not possible for me ... In the last fourteen years of ill health and resulting impairments, two years were spent too ill to cope, ten years were spent volunteering, blogging, campaigning, fighting the good fight ... and now I am two years into not having the spare capacity to do that anymore - but there are many more up and coming campaigners out there ... so please visit the world of Blogging Against Disablism Day

I have been a home carer since 97, started with the council. (care in the community should have stayed with the council) we were put into a trust then passed onto a private company the other year. Over the years I have noticed many of the carers employed since leaving the council do not have the same caring nature. not sure what it is, but pay and conditions do affect carers.

I have seen and heard evidence of that with my own eyes- carers being sharp and rough with a client because they are only getting so many minutes, they are not paid travel time and other reasons, I would never be like that myself its wrong we all know that even management know it but it is going on like crazy out here. Even if this carer is reported. management never seem to do anything- must be because it is harder for them to employ staff on the low pay and conditions, people like that should not be in the job. carers or managers.

I think care in the community should go back to being managed by the council- we were told we were put into a trust then private agency because it was costing the council to much, but looking at it all now -because of the mess and the need for the council to make new posts and employ more to over see it all on higher wages it must be costing us all more than in the past when the council employed us carers, as it is now less is spent on us and the client.

Agencies need to make a profit, even the company I work for who say they are a not for profit charity is a bit misleading, they make a profit but it all goes back on things not really needed or important and over staffing the head office with very high paid people behind a desk.

Us Carers are only paid for the time we are in the clients home and you can be given no hours a day or even just 15mins or an hour or as many hours as they can give you all over the borough, so management need to employ people that do not need to earn a full wage or can afford to be out longer than they are paid for. We have many that only need to work the 16hours (it may have gone up - not sure)to get the social. so many are just doing the work for that reason, they may not like the work or be right for the job but they can get the few hours they need to claim benefits.

Other than pay and conditions affecting some carers attitude to the work and clients, is the importance of the work it seems to go to some peoples heads :( and yes some people/carers like to abuse the vulnerable

The client is most important and then us carers, we do some work of the nurses and social workers along with the usual hard care work. It is a very important job, the frail and elderly need and rely on us we are there with them every day- but over the years I have noticed the power of that all goes to many carers heads. They act as though they are important (if you know what I mean) being sharp, rude and bossy to the clients even to other carers, in our company that type of person seems to get on and get the work they want.

Management needs to be trained to be able to stop that type of person not encourage it as many do now.

Also management need to run the office for us out here doing the actual work, there are some days we out here have important problem that need to be dealt with, we phone our office and there is no one there for us, because they are on training courses or in workshops - this has to stop it is more important we have management and back up there all the time no off on training courses or work shops and they are for ever having meeting when you phone.

I am a good carer and I can see what is/has gone wrong but not got the words to really get my point across to make a difference so im just writing in places like this and tweeting links hoping you out there with the words and important voices can help sort it all out. Because as I have said before, no amount of cameras spying on people, no amount of training will make a rotten carer decent. Care in the community and the carers that do the work need to be treated with the importance they deserve, and paid a good wage and managers need to be trained in the importance of employing the right type of person for that work, and keeping them not just employing anyone that can work for less hours and pay.

Thanks very much indeed for leaving your comment Vicky. It must be almost impossible for you and your colleagues to carry out home care well if you're only allowed a 15 minute visit.

But I'm not sure that it's the type of organisation delivering the care and support that is the thing that really matters. The fact is there is a funding crisis in social care which has been horribly exacerbated by the huge cuts to councils – from central government (and we probably haven't seen anything yet!): which means they are trying to do more and more, for less and less money.

Some people call this a 'race to the bottom' meaning that some councils look for the lowest price available ... which in turn will eventually mean that the quality of the support being delivered suffers. (It must do – mustn't it?) It's like this because no government has ever treated social care as a priority – Tony Blair said his government would sort out the funding but he never did – and that was before the financial crisis. Abuse, bullying, rough handling, being verbally aggressive is always wrong – carers are in a position of trust and they have a duty of care ... but if the price keeps going down and down, the frail and vulnerable will suffer and eventually the system will collapse.

Hiya
I did see the programme on-line the other day it had Fiona Philips presenting. And yes it's shocking, when people older or otherwise are palmed off to people i.e private companies who only see pounds and pence signs what do you expect. And to add to it they pay peanuts to staff. So the people who some say (as I have meet some carers who do a very nice job) just do the bear minimum as they treat the people who they care for as product on a supermarket shelf rather than a real person. If carers get paid more will staff be motivated more, they might be?

Will it change it, might do, but not in my lifetime. But we must keep on at the government and local councils to do better for the people we all care for, no matter the age of the person.

Thanks

I am now 60. Do I dread getting too old to care for myself, of course I do. If the system is bad now what is it going to be like in years to come?

The elderly and the disabled have always been bottom of the pile with governments and the general public.

How can we expect our communities to behave in a civilised way when government ministers 'fiddle' the books, prime ministers are called to rights over wars, newspaper goings on etc? The state of the country is awful, lots of people only care about how much money they have.

A country should be judged by the way it treats the more vulnerable in our society.

I think our care system says it all