Berwickshire posing home care challenges

HOME care services in Berwickshire are still being provided predominantly by Scottish Borders Council despite efforts to move to a 50-50 split with independent providers.

By The Newsroom
Wednesday, 7th July 2010, 11:43 am
Updated Wednesday, 7th July 2010, 11:43 am

A report before the council's executive last week revealed that while the council has been successful in handing over home care services to the private sector across the rest of the Borders, over 78 per cent of the care provided in Berwickshire is still being carried out by the council's own home care staff.

Following a review of home care services between 2003 and 2005 it was agreed that in order to meet the growing demand and greater expectations for more flexible and personalised care at home the council would need to purchase such care from independent providers.

A tendering process resulted in Choices Care being awarded the contract for Berwickshire, Teviot and Cheviot, and Independent Living Services being awarded the contract for Eildon and Tweeddale area.

Sign up to our daily Berwickshire News Today newsletter

However, a number of clients opted to stay with their original provider, such as Nightingales, rather than being transferred to one of the contracted care companies and Choices has found it difficult to recruit staff in Berwickshire.

In 2005/06 home care hours paid for by direct payments, where the client chose their own carer and they were paid directly, stood at 11 per cent, but had jumped to 22 per cent in 2009/10 as more clients took control of who cared for them.

Jane Douglas, of SBC's social work services, said: "Direct payments by a client is a way forward for people to have more control over their care.

"We have spoken with the provider in the Duns area, Choices, and they are doing work on it. One of the issues, they are telling us, is that unemployment isn't high and those who are unemployed are male and used to different types of jobs. It's also a very rural area which also creates challenges.

"We still provide care in the area. We have grown the hours we provide compared to what it was but we are still looking at a 78-22 split rather than a 50-50 split."

The report before councillors confirmed: "We are currently in discussion about how best to address the particular issues that Berwickshire poses."

Agreeing that there had been issues when the council introduced new contracts for home care staff in May last year, Ms Douglas added: "Everything seems to have settled down. We have worked with providers and service users.

"At the time of transition there were problems but over the last four or five months things have settled down and we haven't had any major issues of late."

The report before councillors also highlighted the problems encountered.

"Inevitably during the change some concerns were expressed by service users and carers about the impact of the changes on their service, particularly due to the impact on rota changes," it said in the report.

"In some areas a small number of staff have found the new arrangements difficult to adjust to and the new rotas have taken some time to implement fully."

This time last year the council's social services team heard a string a complaints from carers and clients' families and friends about the changes made to Scottish Borders Council's home care packages when they held public meetings to garner views about their Transforming Older People's Services programme, of which home care was one part.

Last May SBC home carers started working set shifts in teams of four, designed to provide continuity of care for the elderly clients and a guarantee of set hours for staff. However, staff told of working ten hours one week and over fifty the next, and families related tales of individual clients having so many different carers they didn't know who was coming into the house.

One family member said at a meeting in Coldstream last August: "When the changes came in, letters were sent to say it was going to change, then who the carers were going to be. But carers didn't know what duties they had to do and sometimes they couldn't even get into the house.

" You had a 93 year old woman letting strangers into the house.

"There has been no communication.

"It has been very unfair, especially when you are dealing with elderly people who get very confused."

Borders Voluntary Community Care Forum recently carried out a survey of those receiving home care services, sending out 900 questionnaires, 50 per cent of which were returned, indicating that things seemed to be improving.

Although the official results are not yet known SBC say that "early indications suggest that 96 per cent of those who responded to the survey are satisfied or very satisfied with their current home care service and 84 per cent feel the quality of the service they receive has stayed the same or improved since the transfer of hours in June 2009.

In the social work report on home care, it states: "The overall aim of the modernisation of home care implementation remains the same - to ensure that the right care at home services are delivered to the right people for the right price."

And to achieve this they are: introducing a time monitoring system for home care staff; looking at home care's role in out of hours services; reviewing the standard of home care by all providers; re-desigining the shopping service to aim it at those most in need and at best value; and paying home care staff monthly rather than weekly.