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The Scandal of 'Flying Care'

There has been much in the press recently about the provision of care in the home for those who are disabled or elderly.  The Care Bill, currently making its way through parliament, is intended to allow those who need it most access good quality care in their own home.

However, the Leonard Cheshire Foundation recently published its findings on investigations into Local Authority care provided to the disabled and elderly.

Shockingly, it found that some Local Authorities provide more than three-quarters of their home care in visits of less than 15 minutes, so called “flying visits”, and the proportion is increasing.  More and more councils are providing care in these very short timescales, even where they have a legal duty to provide care and have assessed the person as being in need.

Care visits are meant to provide personal care, which can include help with dressing, bathing, toileting and also ensuring medication is taken appropriately.  Leonard Cheshire carried out some research by asking over 2,000 adults to time how long it takes to make a cup of tea and a simple meal, go to the toilet, dress and wash, then make the bed – the average was over 40 minutes.

Just to carry out the essential tasks of going to the toilet, washing and dressing took an average of over 17 minutes for the able bodied, and even longer for the disabled.

For the care worker, therefore, it can lead to some agonising decisions.  Which is more important, going to the loo or having a cup of tea?  If they run over their time this may have an impact on the next appointment, or the carer will stay to carry out the necessary work effectively in their own time – in other words without pay.

In rural and sparsely populated areas like Shropshire, things become even more difficult.  Care workers have to travel between appointments (often this time is unpaid) which can lead to even more difficulty fitting everything in to the working day.  Difficult though it is to believe, statistics from Age UK reveal that 20% of people aged over 65 in the county have to live alone with no transport.  For these people, the carer’s visit is more than just physical support; it may also be the only human contact for an isolated person with restricted mobility.

Living alone in a rural area with no personal transport and poor public transport inevitably leads to chronic loneliness.  The World Health Organization has stated that loneliness is as damaging to health as smoking 15 cigarettes a day.  Right now in Shropshire & Herefordshire there are over 9,000 older people who are desperately and heartbreakingly lonely.  The “flying visit” format then leads to a false economy as good-quality care reduces long-term illness and pressure on hospital facilities.  Care workers trying to carry out many tasks in such a short space of time are more likely to make mistakes or have accidents, which in turn will lead to claims or judicial review of care provision.

The Care Bill is a real opportunity for the government to overhaul the care and social system in the UK.  Government Health Minister Norman Lamb stated the new bill will concentrate on the individual’s well-being – rather than providing “care by the minute”, but he insisted there would be no ban on the flying visit.  There are also plans to ensure the NHS and Local Authorities work together to provide health and social care.