Life as a Domiciliary Carer

When I went to bed last night, my rota said a 7am start time. Taking this for granted I set my alarm for 5.30am. I had a text at 10.43pm telling my rota had changed and I was starting a half hour earlier, I did not get the text until I woke up and consequently, I had half the time to sort myself out in the morning. I thankfully had prepped a packed lunch the night before using the kid’s dinner leftovers. I had my shower, got dressed, took my meds and after calming my 3-year-old down because he doesn’t like me going to work, I didn’t have time for breakfast and I have no spare money to buy any.

The first call was now a different person. It’s a former medical professional who is now severely disabled. On arrival, I discovered that, despite the continence underwear and special bed sheet, they were laying in soaking wet bedclothes. My colleague arrived as the call requires two of us. We stripped the client down and hoisted them onto the commode/shower chair so that we could wash them effectively. Having given the client a few minutes to open their bowels, one of us then had to clean up the commode and wipe the clients bottom. This can be a seriously awful job if the client has diarrhoea or soft stools. Many clients have laxatives and this can make the movement very smelly indeed.

Whilst one of us showered the client, the other stripped the bed and renewed the bedding. Then it was time to dry, cream, pro-shield and dress the client. Using the hoist again the client was taken to the bed and then onto the wheelchair. Already the sweat is running off of us.

Despite the heatwave, we have been having, some clients still have their central heating switched onto maximum, some do not open windows either. This is one such client. The smell of urine is sometimes overpowering. I leave the house after the client is comfortable in the lounge with breakfast and drinks left for them. I’m so glad I remembered my bottle of water.

The second call is a single person call and is pretty much the same but without the hoist. This person can shift from chair to chair but has little mobility. This person is also elderly and is showing signs of dementia. This is so sad. They have no family locally, very little mobility. For some clients, carers may be the only people/ person that they see all day long. You often find as well, that in affluent areas elderly people often live in an adapted room or annex on a family member’s property, if it’s not their own property. They have little interaction with the outside world and most are grateful for the time you give them.

Some people are resistant to needing care and struggle to accept they are no longer capable, these people are mentally and physically exhausting. I’d love to compare some clients to a child but being a mother of 4, I cannot. Not all of these clients are small and fragile. Sometimes you get verbal abuse, sometimes physical resistance. Often you get all the unsavoury tasks without the more joyful ones. You get to change incontinence pads and soiled pants, you get to wash soiled hoist slings and changed soiled beds, you get pood on, phlegmed on, spat on but you don’t get to go to the birthday parties, so to speak.

I won’t bore you with describing each call, in detail but rather the way in which the industry works. Most care companies pay £8 to £10 per hour, which a lot of people think is good money. It isn’t. The higher the hourly rate the less you get as you’re often then paid per job. Take the company I work for, I am contracted from 7am until 2pm but this changes at the drop of a hat, as described above. Most days I often work until 2.30pm too.

My contract stipulates £8 per hour, however, if I went to zero hours I would be eligible for up to £11 per hour. Here’s how it works. Zero Hours means bank staff, means you’re not always called in to work which means no money. It also means no holiday pay, no sick pay, no guarantee of being able to pay some of your bills or feed your family at month end.

Most companies give you mileage allowance too. However, unlike the tax office which allows 45p per mile, most companies offer just 25p per mile, which housing benefit has, in the past, taken into consideration as income because it is on the payslip as an incoming amount. You can wait until the end of the tax year to claim the rest back on a P80. I know many pay their travel to work but my average travel between client’s homes is 30 miles per day and I have to pay that out of my pocket until the end of the year. I am not just travelling to and from a single place of work. Also I may start one day with the first call just 4 miles from home and have my final call 14 miles from home, there is no allowance for this difference in start and finish mileage.

With the contracted hours on a lower rate, I am guaranteed work and pay on any given day. This way the employer makes sure I can be booked for back to back jobs, for example:

  • 7am Sandhurst 45 minute call
  • 7.45am Yateley 45 minute call
  • 8.45am Bracknell 30 minute call
  • 9.20 Sandhurst 30 minute call
  • 10am Farnborough 1hr call
  • 11am Camberley 30 minute call
  • 11.30am Sandhurst 30 minute call
  • 12 noon College Town 30 minute call
  • 12.45pm Yateley 45minute call
  • 1.30pm Owlsmoor 30 minute call
  • 2pm College Town 30 minute call.

On rarer days the rota can look like this:

  • 6.30am Sandhurst 45 minute call
  • 7.15am Sandhurst 45 minute call
  • 8.30am Owlsmoor 45 minute call
  • 9.30am Ascot 1 hour call
  • 11am Camberley 30 minute call
  • 12 noon Lightwater 30 minute call
  • 1.30pm Sandhurst 30 minute call

There is little consistency with the rounds, as you can be sent anywhere. This affects continuity of care, especially with dementia clients. This adversely affects their behaviour and they can be very resistant to all help as you are effectively a stranger every time you walk through the door. I have noticed that the more I visit a dementia client the easier the call becomes as I am recognisable, even if it is just a hazy familiarity they have of me.

Calls often include toileting, hoisting, dressing, washing, domestic duties, meeting with nurses, applying creams and handing out medication, keeping very stringent records and lots of paperwork, constant risk assessments and much more. Very much like looking after a child except this is a full-sized adult that is either elderly, senile or disabled or a combination of these.

Not only is the role of carer physically demanding in houses of smokers and non-smokers, the heat on full blast where sometimes the house is so dirty and cluttered you can barely walk on the floor without sticking to it or the smell is so bad you gag as you try to breathe but also in extended family homes where the people are so lonely that you feel guilty leaving them because you know the family is too busy paying mortgages to bother with dear old dad who is in his 90s and cannot use the toilet without supervision and assistance, so he is just placed in the converted dining room and the carers are his only interaction throughout the day.

Days are also mentally draining, I have walked in and found people having strokes in the lounge, having fallen out of bed and bumped their heads and unable to get up and rarely but twice, I walked in and someone had died in their sleep, once someone died on the floor. It is distressing and never gets easier. Not to mention there is no real psychological support or training for carers and £8 per hour to see the horrors of strokes, heart attacks and dead bodies. Unlike hospital nurses, we do not have a great deal of support in those situations, we may be the only person in the house with the deceased. We have to press a call button, IF the client can afford to subscribe to the call-service, explain everything through a little wall mounted speaker box and then wait for paramedics. With the NHS as cash starved as it is, sometimes you wait a good while for help. All the time feeling guilty about being late to everybody else on your call sheet, as well as dealing with the upsetting situation that has unfolded in front of you.

In terms of turnover, like nursing, this industry has workers where this is a vocation, even fewer see this work as a viable career. Many agencies are advertising constantly because many leave the industry after a couple of years through injury or because of mental stress, there is only so much neglect or trauma that one person can witness before it becomes demoralising and depression sets in. I will not be in this industry long because despite the wage, I am having trouble feeding my children on these wages and so am constantly looking for a better paid position, with better conditions and more support. I have had to go to foodbanks this past month and I am working full time! The people in charge have no idea what that feels like! Its horrendously shameful that I am working full time and cannot afford to live. I worry if my car breaks down I will not have enough money to repair it and then I will be unable to work.

The care industry, like the NHS is hugely undervalued and workers are not paid in line with the duties they have to perform, this must change and soon, I am worried for when I am elderly that I will be unable to afford this service, that by all rights should be covered by my national insurance contributions but will not be, should this current government remain in control of the country. The private companies charge a fortune for its services and pay it is workers very little. The balance needs addressing. This is one industry that should be nationalised and very firmly under public ownership if it is to be linked as under one minister as Health and Social Care!

Tom Neill

Posted by:

Tom Neill
Campaign Coordinator (North Bracknell)

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