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Probe into domiciliary care highlights need for staff training

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Some home care staff are unable to perform the most basic of tasks such as boiling an egg or making a bed, according to a report, which highlights the need for more training and closer collaboration with community nurses and other professionals.

The report on domiciliary care encompasses the views of more than 3,400 service users, families and frontline staff. It stated that the majority of people were positive about the care they receive.

“People feel that staff demonstrate real dedication to their work, and do a difficult job under significant pressure,” said the report, published today by the body Healthwatch England.

“Poor quality home care is leaving too many people with dementia spending the day in soiled clothing”

Rob Burley

However, it goes on to highlight areas where there is room for improvement, including when it comes to staff training and integrated working.

Where carers lack experience and basic skills, such as being able to wash someone or make them breakfast, “this can result in very poor care”, warned the report.

“One local resident in her 80s told Healthwatch Bradford that her carers were unable to boil an egg or make the bed, while another said care workers needed to be taught ‘home care common sense’,” noted the report titled Home care services: what people told Healthwatch about their experiences.

The document brings together the findings of 52 local Healthwatch bodies between August 2015 and June 2017.

“There are significant workforce pressures facing the sector at the moment”

Healthwatch England report

Commenting on the findings, Rob Burley, director of policy at the Alzheimer’s Society, said staff often lacked the skills needed to look after people with dementia who make up around 60% of home care users and have complex needs.

“We have heard of cases where poor quality home care is leaving too many people with dementia spending the day in soiled clothing, going without food or water, or ending up in costly hospital or care home admissions,” he said.

Meanwhile, lack of investment in staff training and development were often cited as one of the main reasons for high turnover, said the report, which highlighted the pressures on the home care and wider social care sector.

“There are significant workforce pressures facing the sector at the moment, so recruiting and retaining staff has to be a priority,” it said.

“Investing in training can help staff feel proud of their profession and build a positive approach to service delivery and development,” it added.

“While most people report that their services are good, there is a need to improve services”

Izzi Seccombe

Healthwatch England is among bodies to sign up to the Quality Matters partnership initiative launched in July, which includes a focus on developing both managers and frontline staff.

Another issue highlighted in the report, was the “real problems” created when services do not communicate with each other effectively.

Examples gathered by Healthwatch Dorset included GPs changing medication without informing care providers and district nurses not updating plans after a visit.

“Even when information was shared, simple things like a client’s new medication having to be taken four times a day, yet the care package only allowing for two visits, created very practical problems that could have been avoided through better communication,” said the report.

It also found care staff were frequently unfamiliar with clients’ care plans and that on first visits not enough time was allowed to enable them to read plans.

Lack of understanding of care plans could lead to “some very serious problems” including medication being missed. It could also mean people’s preferences being ignored and care being delivered in way they did not want.

Izzi Seccombe

Izzi Seccombe

Izzi Seccombe

The Local Government Association, which is also part of the Quality Matters project, said councils were committed to driving up standards of care, working with providers.

However, it went on to highlight the strain caused by “continuing under-funding of adult social care” and increased demand from an ageing population.

“This report shows that, while most people report that their services are good, there is a need to improve services,” said Izzi Seccombe, chair of the LGA’s community wellbeing board.

“The financial pressure facing services is having an impact and even the very best efforts of councils are not enough to avert the real and growing crisis we are facing in ensuring older people receive the care they deserve,” she warned.

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