I think in a sense we . Re probably at the point of near failure. The Llyn Peninsula in north wales. Its eight oclock in the morning, and home carer amanda is beginning her working day. Her first call is in pwllheli. Good morning have you got your bleeper on . My bleeper, why . What bleeping time do you call this . Amandas one of the uks 800,000 Home Care Workers, helping the elderly and disabled live independent lives at home. Today, shes with former Teacher William williams, who has multiple sclerosis. Its just nice knowing that i could go out there and help other people and make sure that theyre safe in their own home, and that they can actually stay home, and live at home in their own house, and dont have to go into care or anything like that. Im 72, remember. I havent got much time left we have many years to go again the girls, i have to admit, are terrific. Absolutely terrific. Theyre caring, theyre understanding and theyre full of fun. Like many carers, amanda struggles to make ends meet. Shes paid £7. 55 an hour, just above the National Living wage, but shes on a zero hours contract, which means the hours she works are not guaranteed. I did look into buying a house four years ago, but because i didnt have a contract they wouldnt allow me to buy a house, or anything like that. Its hard, it is hard. You see your friends out every weekend, going for supper with each other. Itsjust like no, i cant come. Try and be a little earlier than this morning, will you . Ill be sat in the car, waiting ta ra, will its really a hard days work really. With working out in the community. You could work from 7. 30am straight through to 10pm but you do get breaks in that time. But i could see up to about 10, 11 people a day. Amanda is one of 200 staff at a Family Run Care company near bangor in gwynedd. Hello. Cymorth llaw. Cymorth llaw, which means helping hand, is paid by local councils to provide home care. Im just concerned about her safety and welfare, really. Menna is one of the managers at the company, and has worked here for 11 years. The change in that time, the sense of recruiting for the last two years recruitment has been phenomenally hard out there. Have you got blank rotas i can have, please . Mennas trying to juggle the staff rota. There are gaps that need covering. Shes also trying to find carers for new clients. Due to staffing availability, and the hours of care that they require, we physically cannot fit them in on the carers . Rotas, u nfortu nately. And thats part of the job i do not like to do, and how does it make you feel in those situations . I have sleepless nights because i worry. Across the water in liverpool, and the pressures are the same. A shortage of care workers means its difficult to get people whove been in hospital back home. This way . Yes. Bad leg up . Yes. Bad leg up. 86 year old anastasia 0leary was transferred to the Granby Rehabilitation Unit from the citys Royal Liverpool University Hospital last november. I was very sorry to hear about your fall, and you were on the floor for five days . Five days i was on the floor, love, for five days, and it was a really dark night. All me nose was bleeding and me mouth was bleeding. I had terrible scars on me hands trying to grab hold of the cabinet to get meself up off the floor, but i couldnt. Ijust had to lie there and i was only banging on the walls for five days but nobody heard me, but, on the fifth day, somebody must have just heard me, and the next thing i knew the fire brigade had to smash all me door down and get me out. I was in a pretty bad way, wasnt i, love . You was, and look at you now. I was, love, in a bad way. Anastasias been well enough to go home since january. Shell need four visits a day from carers. But finding that care package is proving difficult. Theres currently about five people. Anastasia is one, that are still with us now. Theyve been here more than the 28 days, is on average the amount of time people spend with us. Some patients have been with us 12 and 14 weeks because all the therapy is complete but unfortunately theres no care package available at the end of it. Back at the Home Care Company in north wales, theres a crisis looming. Is there a possibility please that you could help us out this evening at all . You cant . Right. 0k. Thank you. A member of staff is sick and theres no one to visit an elderly client this evening. Weve been trying to cover this shift since monday morning and were having great Difficulty Due to lack of staff in area. Could you please get back to me once youve had this message . Times running out to fill the shift but, after some frantic phone calls, they eventually find a member of staff to step in. We are caring for peoples lives here. Its not just. You know, anybody. Its important that we do provide that professional care for them out in the community. Home Care Companies across the uk say one of the biggest problems they face is recruiting and keeping carers. Staff at cymordd llaw are receiving training. The company says its an important area to invest in, but sometimes that can back fire. When theyve attained such qualifications, they can quite easily walk into the local hospital as health care assistants. Yes, they are staying in care and, yes, they are doing a valuable job in the local hospitals but, of course, that leaves us short in the community. And the pay and conditions working for the health board are far, far better than what we can offer. Carers at the company where there are around 30 Staff Vacancies arent just leaving to work in hospitals. We know the local supermarkets are paying considerably more in wages than what we can pay and of course when you work in a supermarket youre not putting 50, or 100 miles a week on your car travelling from village to village to see clients. You just go to the one venue, do your shift, and go home. Single Mum Kirstiejones worked as a carer for five years in the prestatyn area of north wales. Sometimes we were the only people they actually saw in day to talk to. You do become close to them i dont think youre human if you dont. It was hard work, but it was fulfilling. After gaining qualifications while working as a home carer, she got a job as a Healthcare Assistant at her local hospital. The pay was better, the hours were better. No wear and tear on my car. Dont get me wrong, i do miss the clients, but i definitely dont miss the hours. For carers still in the job, like anne marie, they continue to do their best despite the many demands they face. Its eight oclock starting and got four calls this morning. After three visits in gwynedd, anne marie is already behind schedule and calls the office. Hi, teresa. Its anne marie. All right . Can you give my 10am client a ring and let them know im running late for about 20 minutes . You got to do the personal care, got to do the breakfast, prepare lunch, sometimes just need to talk to you five minutes of your time but youve got to rush, in and out, in and out with them. So you feel a bit rude. Like her colleagues, anne marie is on a zero hours contract. Have you seen this, ken . The companys been in business since 2000 but its seen its profits fall over the last few years. What they do make, they plough back into the Family Business but say its still not enough to increase wages. We pay as much as we possibly can and weve always paid above what was the National Minimum wage and the National Living wage. They get a mileage allowance, they get paid travelling time between their clients. As a company we are legally obliged to pay, you know, i pension, 13. 8 National Insurance and of course training and all the other things that go to employing a person. It doesnt leave a great deal. The company used to provide care for three councils in north wales. But last year it stopped working with one conwy which initially paid £14. 20 an hour for care. They then offered to raise that to £15. 00 but the company decided that still wasnt enough, so they handed back the contract. We didnt think we could provide this level of service for that amount of money that conwy were offreing. We were very reluctant to leave, but we had to leave. It was as simple as that. Conwy council says its committed to supporting Vulnerable People in communities, despite facing financial challenges. Conwys not alone. Our Research Reveals that, across the uk, almost 100 councils have had home care contracts handed back to them. £12. 60 in the north east, £12. 95 in the north west. These are the average figures some councils Pay Companies per hour to provide home care, according to the industrys trade body. It says Many Companies are really struggling. We have some really desperate providers, who really do not know whether theyre going to be able to continue in business, um, beyond the next year. That means theyre really having to make some hard, commercial decisions, whether they might need to cease trading or indeed just hand back work to local councils. Home care company mears is the second biggest in the industry. It used to have a contract with Liverpool City Council but handed it back lastjuly, saying the £13. 10 an hour paid simply wasnt enough to cover their costs. That was a terrible thing to do both for Service Users and for care staff. We absolutely did not take that lightly but frankly what choice did we have . Mears says it needed at least £15 an hour to provide the care expected of them, and like home Care Companies across the uk, claims its costs are often greater than the amount councils are prepared to pay. We just cannot do the two most basic things that you need to do in homecare one, pay staff the absolute minimum of living wage and, two, be able to recruit people, enough people to deliver the service that Liverpool Council actually expected from us. Mears has also handed back contracts to two other English Councils, with more in the pipeline. Over the last seven years, Liverpool City Councils budget has been cut by £330 million. Now it has to find a further £90 million over the next three years. Samih kalekache is the outgoing director of adult social services. When mears pulled out of the city, other providers managed to pick up the work but the pressure remains. It is concerning when the Care Provider is saying, we cant maintain this level of care. Absolutely we could see that, and thats why ourselves, and all the directors nationally, are looking to address it. But, frankly, how could you address it when there are no resources coming from elsewhere . Most home care across the uk is provided by the private sector. Panorama has commissioned analysis of the financial state of britains 2,500 home Care Companies. The Research Suggests that more than one in four of them are at risk of insolvency. The analysis also reveals growing numbers of home Care Companies simply shutting up shop and walking away 69 in the last three months alone. Weve had 25 years of the Market Economy and i think everybody recognises the word often used is, were in crisis. I struggle to find a word thats one higher than crisis, i think, in a sense, were probably at the point of near failure in the market. 0h, hi. Itsjo from Care Brokerage here. I wasjust wondering if you could let me know if youve got any capacity today, and if so in which postcode areas . If you could have a little look at it for me . Like many councils, liverpool has a busy team constantly searching for carers. Nothing at all . All right then. Thank you. Bye. Theyre trying to find Care Packages for people at home and those in hospital waiting to leave. Were really desperate to get him out of hospital. But its not easy. Its the staffing isnt it, basically. Theres quick turnaround with that job, i think people do it and then they leave and then theyre stuck. Yeah, like yesterday where a Care Provider had picked up a hospital case. It all been agreed. The gentleman was discharged from hospital at 9. 30am yesterday, and then Care Provider got in touch called at 11am to say due to two staff resigning night before, they werent able to provide the care. So its a bit of a crisis situation. This gentleman was now at home. Family were there for now, werent they . Yeah. They were going to try and organise a home visit. Weve got a provisional offerfrom one provider, whos going to get back to us later today. So, fingers crossed. That provisional offer fell through. It took another two days to find a company able to take the case on. If theyve got capacity, then obviously they want the work. Theres too many people need care and not enough carers. Its the same picture in north wales. Lovely, ta ra, ta ra, ta ra. Mennasjust got off the phone to gwynedd council. Its social Services Team is trying to find Care Packages for people waiting to leave hospital. Theres a client at home here, waiting for care. Theres another one still in hospital, waiting discharge. I requested an updated list of clients that are waiting to come out of hospital or are at home already that need care. Ive given them availability of the hours that we can give them. Unfortunately, we cannot offer them the times that they request, as theres just no capacity at that time slot for any more clients. Menna recognises one of the patients, the same person was also on the Waiting List For Care Last week. So whats happened to that person now, where is he or she . Still in hospital. That client will remain in hospital until a suitable time comes available. Bed blocking. There are more than 6,500 people across britain stuck in an acute hospital bed, despite being well enough to leave. In england, a third of these are waiting for a home care package. Hello. Im back again. 82 year old Shirley Haughie has dementia. Her daughter yvonne has come to visit. You dont think so . Thats ok then, isnt it . Shirley was taken to liverpools royal University Hospital suffering from dehydration in early january, then transferred here to Broadgreen Hospital shortly afterwards. I am doing everything to get you home. She doesnt know where she is. Its a strange place. The confusion is just devastating. Its hard to sleep when youre in hospital, isnt it. Yeah, yeah. Yvonnes getting her mums house ready for her return. Shirleys been well enough to leave hospital for nearly nine weeks. But difficulties finding her a care package are delaying the process. Hi, its yvonne here. You rang me earlier about the care package were hoping to get in place for my mum. Shes medically fit to come home and they want her to go home. She has been assessed by a social worker. Everything has been approved, the care she needs, what she requires. Thats all been approved. Direct payments have been approved, now its basically finding somebody who can provide that care, which is not as easy as it sounds. Were finding it really, really ha rd. You know, you think theres loads out there. It should be dead easy, but it isnt. It wont be long now. Yeah. 0k . Pressure on councils social Services Departments across the uk is growing each year, as Life Expectancy increases. There are more than five Million People over the age of 75 at the moment. Therell be two million more in ten years time. The granby Rehabilitation Centre in liverpool is run by the city council, to relieve pressure on the areas larger acute hospitals, but it too is full. Weve had four referrals this morning and weve only two beds. Were still under tremendous pressure to get as many patients home as possible from the patients at the royal across to ourselves and get them reassessed. I think this week, the bed crisis, a e was just chock a block. For liverpools director of adult social services, its a familiar story. Chris, whats the status today . Today weve got 28 people in aintree hospital, who are awaiting Care Packages or placements in care homes, or short term care. Weve got 45 people in the royal hospital. Most of it is because theres quite lot of people waiting for Care Packages and beds in intermediate care or care homes. Its just a matter of trying to source those packages. Is there a crisis in the Homecare Services . Id say yes, there is. And its notjust money. Its the sheer volume of demographics. Weve got an ageing population, which we welcome, but we dont have enough people coming into the industry. Its estimated well need at least two million more carers in england alone, in both domiciliary care and care homes, to cope with the growing demand by 2025. Last october, the regulator in england, the care quality commission, warned the Home Care Sector was at a tipping point. Six months on, it says nothing has changed. The Homecare Sector continues to be a fragile sector. It continues to need to have a long term, sustainable solution to the problems that its got. Weve carried out our own research that shows that one in four companies are at risk of insolvency. In some parts of england, its as high as one in three. Does that surprise you . Im afraid it does not surprise me that there are a number of services that are at risk. And we need those services to survive. We need those services to continue to provide good care. It is a real worry that the Smaller Services that are focusing on providing high quality person centred care are finding it difficult. As pressure builds on the hospitals in liverpool, carers employed by a Council Initiative called homefirst are working flat out to free up beds, but even this service is under strain. Hiya, you alright . Yes. Homefirst carer Gail Bainbridge is helping 79 year old violet hill, whos back home after a stay in hospital. Is it cold out . Yes, its going cold now. Hospitals can discharge patients like violet, if they know a homefirst carer is free to help them regain their independence at home. What do you fancy for tea tonight . Chicken casserole. You go and do it then come on. Shall we go now then . Yes. No peace for the wicked, you know. Homefirst gives the council a Breathing Space to find a private care package. And the more independent violet is, the less help shell need. Sometimes im already dressed, sometimes they give me a hand at getting dressed or having a shower. Ive gotta be have someone in the shower room with me, because im terrified in case i slip. Cant grumble with them at all. Theyre lovely girls, honestly. We have a laugh, yes. I wish they could stay longer. Hello homefirst team, can i help you . Demand from the local hospitals is overwhelming. Right, well be able to take it, but wouldnt be able to start till monday. We havent got that in that area, im afraid, jen, no. But liverpools latest effort to free up Hospital Beds is again hindered by the shortage of Home Care Workers in the private sector. No capacity, sorry. The longer it takes to find private home care for people like violet, the less Space Homefirst has to take on someone new. Violet has been with us since october, and she is on our list of long term people, you know. She requires a long term package of care, and it cant be sourced. So we keep them. Of course, that blocks us then, because we cant take anybody else on. No, i didnt like that at all, gail. Do you want anything else instead . No, not at the moment, might have something later on. Have a bit of toast later on, yeah . Yeah, bit of cake or something hello, cymorth llaw. Back in north wales, and with the demands on her carers increasing, menna feels theyre not always valued by society. These carers work long hours, unsociable hours. They go out in all weathers, whether its snow, hurricane wind. Theyre out in it. How are you, maggie . I dont think care is a recognised profession. I think oh, somebodys got to do it. That career has got the right to be respected. Just like any otherjob out there. We need to make sure that we are valuing and recognising that these are difficult jobs, but they are incredibly rewarding and fulfilling jobs as well. But we cantjust rely on peoples commitment and dedication. We have to make sure that were supporting them properly and were rewarding them appropriately. The uk government has announced £2 billion extra for social care for English Councils over the next three years. Scotland, Northern Ireland and wales will decide themselves how they spend their extra funding. But the industry says that with an increasingly ageing population, its just not enough to keep pace with demand. I dont think that the people who make these decisions actually realise what goes on in the community. For instance, has the Minister Of Health ever been out on a wet, windy night in the middle of anglesea with a home career at 9pm knocking on somebodys door to go in to put them to bed . I dont think so. The uk government declined an interview, but in a statement, said it has given English Councils a total of £9. 25 billion to fund social care. It says it will be bringing forward proposals later this year to ensure a more financially sustainable social care system. Liverpool city council will receive an extra £27 million, following this months budget announcement, but like many struggling councils, they say its too little, too late. Ive been given a sticking plaster, after two to three years, if the system doesnt change, i dont think well be able to maintain the services the way they are. It makes me feel very angry, that we cannot provide the care which should be available. Instead, were having to prioritise. Is that a service which i want . Definitely not. But what else can i do . For anastasia in liverpool, the waiting is at an end. Well meet again some sunny day. After being here since november, carers have finally been found to help her at home. For shirley, until a care package can be put in place, the wait goes on in hospital. And in north wales, its the end of the working day for amanda. And shes back at William Williams house to get him ready for bed. Hello. How are we . Still here. Still here, well thats a good. Her day began at 8am, over 12 hours ago. I like myjob and i feel good about myself, when ive given them that care as well. I know ive done everything right and that theyre tucked up in bed and the doors locked. And there we go until the next morning. With more of us living longer and a growing shortage of care workers, is time running out to find a solution to britains home care crisis . Welcome to bbc news, broadcasting to viewers in North America and around the globe. Im mike embley. Our top stories the westminster attacker is identified, a british muslim convert with a history of violent crime. Tributes have been paid to those killed. One was celebrating his 25th wedding anniversary. A vigilfor the victims in trafalgar square, and londons mayor says the attack wont divide the city. Those evil and twisted individuals who try to destroy our shared way of life will never succeed. And a key vote on president trumps replacement for 0bamacare is delayed, as republicans in Congress Fail to agree
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