Would UK care workers be so badly paid if most of them were men?

Just a thought that used to occur to me during my many years working in front-line care and support work. At the very least, all care workers should be paid the Real Living Wage – currently £9.00 per hour and £10.55 per hour in London.

Due in April 2019, the recently announced increase of the government’s Living Wage (which is not actually based on what employees and their families need to live, former chancellor George Osborne pulled a dishonest fast one there) to £8.21 per hour (which excludes workers under 25, age 21-24 workers will go up to £7.70 per hour) is NOT GOOD ENOUGH!

Care work is important and often very tough work. The people doing it need to be able to afford to live. Seems reasonable?

Newcrosshealthcare employee review – £50 fine for being ill?

Mostly good, too corporate. A very “mixed” four years.

When I first joined, the Brighton branch was run by a very good manager. For the likes of me (healthcare assistant and support worker, on and off for twenty years, including a great deal of agency experience) and qualified RGNs, there was plenty of work available (mostly in care homes) and we were very well supported. After the manager suddenly left, things went slowly downhill. They’ve recently closed the Brighton branch, running any remaining business from Eastbourne.

Pros and cons

Holiday pay is included in the hourly rate. Pay is not bad but they pull a bit of a fast one by including “holiday pay” in the hourly rates. It may look as though you are being paid more than other care agencies – often around £8.00 for day shifts (below a real living wage), more for nights and weekends – it’s actually about the same or slightly less than other agencies.

Variable management. At least at the branch where I was. One stand-in manager was extremely insensitive during an annual staff review and I made my feelings clear to her and to the regional manager at the time. Newcross can be overly corporate, the word care in Newcrosshealthcare is sometimes overlooked – I had to stand up to them a few times.

The £50 fine “cancellation fee”, including if you are ill! What on earth are they on about!? It may discourage people from phoning in sick last minute but it really upsets and undermines staff. Fortunately, I’m in good health so this outrageous policy only affected me a couple of times. On more than one occasion, I worked with Newcross staff who had come into work with stinking flu in a care home, rather than go through the hassle of the £50 cancellation process i.e. getting a refund after a doctor’s note.

The call centre in Devon is sometimes at odds with the local branch. At one stage I put in a complaint about an incredibly rude and unprofessional call worker. At other times I would ring in to register my availability (Newcross tend to be a bit obsessed with this) and would later find out that it hadn’t been put on the system. On the whole though, most staff were doing a good job, some were lovely people.

Continually recruiting new staff when there aren’t enough shifts for existing staff. Newcross regularly sent me enthusiastic text messages, reminding me how I can earn a bonus for recommending people to work locally. Fair enough if there was plenty of work to go round but this was often far from the case!

Mostly good but too corporate. Newcross sometimes seem a bit too concerned with their self-described corporate mission “to dominate the market”, rather than respecting their staff at all levels. Despite that, thank you to them for helping me pay the bills for the last four years, I made some good friends and enjoyed much of the work particularly the many regular homes and clients. I know from experience that some agencies are worse. I’m now at a smaller, more local agency which is generally a bit more human.

A shortened version of the above has been posted on indeed.co.uk, the job website.

January 2019 update: Thank you to The Guardian newspaper for exposing this dodgy company.

The front page of the printed edition on Christmas Eve, no less! Although my time with Newcrosshealthcare was not all bad, everything in The Guardian is consistent with both my experience and everything I heard (or suspected) as I gradually found out more about them. Thank you to the journalists and whistleblowers involved.

https://www.theguardian.com/society/2018/dec/23/british-care-company-fines-workers-50-for-calling-in-sick

Justice for Ernest John Coles – the crimes of Sanctuary Care?

This document has been received and signed for in the following offices:

Devon County Council, The Police, The Doctor involved, Sanctuary Care and CQC head office.
House of Commons and NHSLA, pending, not yet signed for…

Letter of Notification of a Pre-Action Protocol for the Resolution of Clinical Disputes
Date of claim: 20th October 2015.
Copied to the NHS Litigation Authority
Associated bodies
Rachel Chalmers, DC for vulnerable adults Rachel Doyle, CQC Inspector
CQC Enquiry Number – 2186209966
Claim
Failure to comply with the Health and social care Act 2008 Regulation 20 Breach of duty of care to both Mr and Mrs Coles
Claimant:
Ernest John Coles of 7 Lichfield Road, Redhills, Exwick, EX4 2EU
on behalf of his late wife Marguerite Coles who passed away in Greenslades Nursing home on the 9th of December 2013
Defendants:
Responsible for the care of his late wife and failing to provide information.
Mark Mc Carthy, Head of Sanctuary Care
Natasha Knowles, business manager for Sanctuary Care
David Berenski previous Manager of Greenslades nursing home Alison Robertson Previous manageress of Greensalades Nursing home Dr.Carl Bracey, responsible doctor for Greenslades Nursing home, Foxhayes Surgery
Phil Norrey, CEO Devon County Council
…………………………….


Ernest John Coles

On the 25th of August 2015 a letter was sent to Mark McCarthy, head of Sanctuary Care requesting an explanation to why the care plan of the late Marguerite Coles states that it has been “rewritten.”
The letter was received in their Worcester office and the signature documented by the post office is “Gormley.”
It was also acknowledged by email to myself but not to Mr Coles. Email content :

Dear Ms Wakefield,
Thank you for your email dated 25 September.
I am emailing to confirm receipt and to assure you that Mr Coles’ letter of 25 August is being dealt with professionally and that a response will be sent within the 30 days that was requested.
Kind regards, Natasha

Natasha Knowles BA (Hons), PGCE, CPE – Law
Business Manager
Sanctuary Care Limited
Cameo House, Chamber Court, Castle Street, Worcester, WR1 3ZQ.
Tel: 01905 334243 (Internal: 34243)
Fax: 01905 21019
Email: Natasha.Knowles@sanctuary-housing.co.uk
“Keeping kindness at the heart of our care.”
Sanctuary Care is part of Sanctuary Group

Unfortunately they have failed to act professionally and failed to deliver an explanation on the deadline given. I have followed them up with a phone call and I was informed that the lady dealing with this matter is on annual leave and that no one is covering her duties.
This case is as Im sure you are aware, a matter of public interest and grave concern.
In order to restore faith in the public services provided by all of the organizations involved in this matter there needs to be a thorough investigation in to this case. If the handling of this case is a reflection of the standard of care given to the vulnerable people that you are all responsible for protecting then it sheds huge concern over the services provided.

Mr Coles is seeking further specialist legal advice in this matter as he is the legal representative of his late wife and has a grant of probate in safekeeping. As it is a crime to falsify medical notes and care plans we expect your professional response in this investigation of serious concern and provide us with a satisfactory outcome in order to restore the trust of the public who pay for the system in place.

We look forward to resolving this matter as quickly as possible as you are already responsible for the mistreatment of Mr. Coles as he is in his own right a vulnerable adult. I would also like to remind you that both Mr and Mrs Coles both gave up their retirement to work voluntarily for the NHS and to be repaid by society in this way is unforgivable and will not be forgotten.

A response from this pre-action letter is required within the standard time frame of 20 days by all involved without exception.

Samantha Wakefield

Facebook page Justice for Ernest John Coles

Healthcare assistants do the care, nurses do the paperwork

Healthcare assistants, not nurses, often do most of the actual care in the UK

In nearly twenty years of part-time and full-time work as an agency healthcare assistant (HCA), I have worked with many qualified nurses in care homes and hospitals who do an excellent job caring for residents and patients. In many situations however, it is the regular staff HCAs who are doing the hard work.

Due to increasing awareness of an ageing population, it is only now being acknowledged that much of the nitty-gritty hands-on caring for the elderly (be it in their own homes, nursing homes or hospitals), is actually done by “unskilled” HCAs and carers on little more than the minimum wage. Drastic cuts in social care budgets and other political problems are not helping the system as a whole.

The Tory government have made a belated but predictably inadequate attempt to improve the general low pay situation in the last budget but there is still a long way to go. £9.00 per hour by 2020, excluding those under 25? Not good enough, not nearly good enough. In the meantime, most carers struggle on with around £7.00 per hour. Due to existing financial pressures, many local trusts, councils and care providers are not happy about having to give carers any kind of pay rise at all. However, as they are such caring folk, the many Chief Executives of organizations profiting from care will of course be taking cuts in their six figure salaries. Of course!

What does a healthcare assistant actually do? The underpaid, undervalued and “unskilled” work of caring for your parents, your grandparents and possibly YOU one day

The infamous Bristol Stool Chart

As anyone who has worked in care and nursing knows, the supposedly unskilled work of an HCA can be physically, mentally, emotionally and even spiritually demanding in the extreme. During a 12 hour care home or hospital shift, particularly early shifts, there can be a massive amount of practical multitasking…

Waking the patient or resident gently (“We have to get this lady up because her family insists on it, even though she hates getting up at this time.”), moving of heavy hoists in restricted spaces (“Why can’t they do something about these flipping leads in the way under the bed?”), toileting (“Here we go… nice and tall… ouch there goes my back again!”), wiping bottoms (“Excellent bowel action, 3 on the Bristol Stool Chart!”), washing (“There’s no soap again…”), shaving (“Gunged up blunt razor blade, I’ll have a hunt round for a new one…”), dressing (“Mind she doesn’t get another skin tear. Why hasn’t this lady got any clean knickers?”), helping with eating and drinking (“Thickened fluids… Thick and Easy? That’s just the staff!”) and so on.

All the time you try to remain friendly and supportive to everyone around you, in an often extremely stressful environment.

In the meantime, the qualified nurses on a much better wage are usually getting on with dispensing medication, paperwork and attending meetings

Which can be important work in itself but this reality completely put me off the idea of qualifying as a nurse, a long time ago. (I’m not a big fan of western medicine and the very dodgy pharmaceutical industry anyway – but that’s another story!) From a 2013 Royal College of Nursing study:- “More than three quarters of nurses said the time spent completing paperwork prevented them from attending to patients.” Financially of course, qualified nurses get a relatively good deal compared to carers, starting at over £20,000 in the NHS. But it might be wise to remember who is often doing most of the hard physical and emotional work – and who is often being diabolically paid for it and sometimes being taken advantage of by their employers. Finally, a carer has recently taken a company to court for failure to pay the minimum wage.

Over the last few years, at last, there has rightly been plenty of mainstream media coverage about the problems with abuse and poor standards of care. More relatives are complaining to the Care Quality Commission. But beyond the moral outrage, isn’t it time we all started digging a bit deeper into some of the causes of these problems – the cultural attitudes and political decisions behind them – and did something about it? Why, for example, aren’t the still increasing numbers of foreign care assistants required to take a basic English test? Filipinos and Polish workers in particular can be more committed and better at the job but I have lost count of the number of times I’ve heard “It’s so nice to have a conversation with someone who speaks proper English”, from a resident or patient.

Be it in home care, nursing homes or hospitals, many of the (mainly female) staff are exhausted, demoralized and broke. Profits are still being made by many private companies who often pay their staff less than can be earned in supermarkets or factories. The situation is not anything like as extreme in many other countries and the whole culture needs to change here.

Carers, our parents, and our grandparents deserve better.

BUPA care homes – big profits, bad pay

BUPA Dean Wood, near Brighton. Lovely £7 million building, shame about the pay for carers and nurses.

“This home is open to all”, says the message outside Dean Wood nursing home, a BUPA home just outside Brighton. At around £1000 per week, I think that really should be “all – who have quite a lot of money”, shouldn’t it?

Over the last two years, as an agency healthcare assistant (many people think that agency workers are often part of the problem of poor care but I do my best), I’ve worked at several BUPA care homes on a semi-regular basis in Sussex. All things considered, I thought the actual standard of care was pretty good in all of them. Would I be happy for a relative of mine to be in one of them – perhaps the ultimate test of what one really feels about a care home – yes, having seen a lot worse over the years, I probably would. But BUPA is a big organization with around 290 care homes, so it’s no surprise that not everyone has had the same experience or thinks the same, as this thread on Mumsnet shows. A quick browse of the thread shows many common general care home complaints from both employees and family members with relatives in BUPA homes.

The last I heard, regular BUPA carers in Sussex homes were on £6.57 per hour, which I was told at one home is less than the kitchen staff are paid. Qualified nurses are also paid poorly, below average. Not content with this though, the management had put “motivational” messages up on the walls of the staff room to remind everyone of a few things. I may not have the exact wording right but I remember posters along the lines of “BUPA is generating millions of pounds worth of business around the world” next to “BUPA staff are happy in their jobs”. Getting a bit 1984 or Brave New World with that last one aren’t they!? Not only is this massive multimillion international company only paying healthcare assistants close to the minimum wage, during staff tea breaks BUPA is reminding all the badly paid carers and nurses of the massive profits the company makes – talk about “rubbing your face in it”!

Not surprisingly, staff morale tends to be low in BUPA homes (as with quite a few nursing homes of course) and many carers – including very good ones – leave after a few months.

Why are care workers on the minimum wage?

Wayne Rooney, £1,785 per hour

With the announcement last week that Manchester United striker Wayne Rooney is about to earn £300,000 per week – that’s £1,785 per hour – my mind turned yet again to the low pay of care workers in the UK. Most of the ones I work with earn the minimum wage of £6.31 per hour or slightly more.

Professional footballer = £1,785 per hour.

Care worker = £6.31 per hour.

Am I missing something or is this complete, total and utter madness? Would care workers be so badly paid if most of them were men? Who cares for the carers, where is the public outrage? What kind of society are we living in that apparently accepts this situation?

I have worked with more than one Healthcare Assistant who has loved the job but has had to move on because of the bad pay – in one case to go and earn more on the checkouts in Tesco. By contrast, a small percentage of places pay their staff around £8 or more, as do care agencies who provide temporary staff such as myself. £8 per hour is closer to the so-called “living wage”, a strange concept, the obvious implication being that those on the lower “minimum wage” are not actually living! As you would expect, the staff are usually happier and far more settled when paid more, and the residents/patients receive a better standard of care.

Care worker, £6.31 per hour

Care work is considered unskilled, the implication being that anyone could do it. Is this actually the case? In my experience, work in nursing homes, NHS hospitals and the community can be physically, mentally, emotionally and spiritually demanding in the extreme. There is often poo, vomit and blood to wipe up. At the risk of stating the obvious, sick and dying grandmothers and grandfathers are not always easy people. Almost superhuman patience is sometimes required.

The chances are that, one day, you will be one of the vulnerable and elderly being cared for by exhausted and underpaid carers.

I have heard that the situation is nothing like as bad in Scandinavia and many other countries. No remotely civilized and decent society would quietly allow such a situation to continue. Gavin Kelly, (chief executive of Resolution Foundation, an independent thinktank aiming to improve living standards for low to middle income families in the United Kingdom) has drawn attention to the fact that, due to not being paid for the time spent travelling between home visits, many carers are being paid even less than the minimum wage.

Professional footballer = £1,785 per hour.

Care worker = £6.31 per hour.

15 years of agency care and support work

My main income since the late nineties has involved just about every form (apart from more specialized and highly qualified roles) of care, nursing and support work that there is. It has been, and continues to be, an “interesting” journey, to put it mildly.

Like many people in care and nursing, I began with home care. For a couple of years I had three regular characters who I would cook and shop for, and in the case of the blind young man, occasionally take him down to the local pub. The retired chef from Bangladesh was always keen to tell me about his experiences with prostitutes. The self-styled “bastard in a wheelchair” of my own age was another great character, but I wasn’t surprised to hear that he later drank himself to death. From there I gradually moved into nursing homes and geriatric wards at a local hospital. Commonly known as “the poo wards”, they were wisely shut down some years later.

Modelling an NHS incontinence pad, around 2003

Having already had experience of helping the mentally ill with both my mother’s and a friend’s troubles, next came extensive experience at two NHS psychiatric hospitals for a few years. Ah, the joy of death threats from psychotic schizophrenics. Round about the same time, I also started work at an excellent NHS neuro-rehab unit, some of my most enjoyable and genuinely rewarding experiences – partly because a lot of the patients would actually get better. They would come in with a stroke, or in a coma from a failed suicide attempt, or a brain haemorrage brought on by an extreme lifestyle, or a recurrence of multiple sclerosis symptoms. Even though I was still working for an agency, I felt very much part of the team. One actually made a difference in helping many people recover, even if only partly. Good times.

For several years I considered qualifying as either a general or psychiatric nurse. For a number of reasons I decided against it. As an unqualified “healthcare assistant” or “nursing auxiliary,” one is hands-on caring for people, not endlessly filling in paperwork and dispensing products from the pharmaceutical industry.

Other work involved experience of autism and challenging behaviour, general wards in several hospitals, also children’s homes. Round about 2007, I gradually moved into supported housing and working at homeless hostels run by the local council. Most residents at these places had a mix of mental health and drug and alcohol (“substance misuse” as they like to call it) problems. As nice as some of them were, dealing with heroin addicts on a regular basis will quickly wipe out any of the more romantic notions that anyone might have had about helping the homeless!

Following big management problems with my last agency (the local branch closed down), over the last year I have re-established myself through two different agencies – in care homes, some different NHS psychiatric units, hospitals and a few other places such as a home for the blind. It’s okay, mostly I do actually feel I’m making a difference. I wish it paid a bit more, and of course it can be physically and mentally exhausting at times. At least as an agency worker I get a bit more than many regular carers – many are on £6.50 or less an hour. Something not quite right there?

My mother’s mental illness

Just recently I have been thinking more than usual about my mother, and the impact she has had on my life. Rumour has it she gave birth to me, that was quite a big impact for a start wasn’t it?! Her initial diagnosis of “paranoid schizophrenia” (there is plenty of debate as to how helpful or accurate these kind of labels actually are…) was in 1969 or so and although she has had quite long periods of mental stability since, she never really recovered.

Roughly ten years ago I made the decision to completely cut her out of my life. As an only child who had done my best, I had simply had enough – there were times when she was pulling me under too. As difficult as it might be for the majority of people to understand, it was one of the best decisions I have ever made. Those who have had to deal first-hand with the reality of extreme mental illness (e.g. attacking my Dad with a knife in front of me, wandering the streets half-naked in the middle of the night, religious fanaticism, stays in psychiatric hospitals etc.) will get where I’m coming from. She has been in a care home these last few years and I heard recently that she has now begun to develop dementia. I politely declined the request to take on the Power of Attorney, I have no interest in being sucked back into her bonkers world. God bless her, if that doesn’t sound too patronizing. I love her of course.

Kind of ironically, dealing with my Mum turned out to be ideal training for all the psychiatric support work I’ve done. Also, looking at her astrological birth chart for the first time (it explained so much) was the beginning of my serious interest in astrology. My mother was a successful classical violinist, so I guess I can thank her for some of my music too.

In terms of compassion and support from society, mental health is not as sexy as cancer, famine relief, or the cat’s home. Many of the mentally ill are on benefits, it looks likely that many will be amongst the first to suffer as a result of the UK government cutbacks. There are organizations such as MIND and the under-funded NHS doing great work, but as a whole, I don’t think society cares much about people with mental health problems. This seems a bit odd as it indirectly or directly touches so many of us, even Stacey and her mother in Eastenders… ahem.

Thoughts on death

A dear friend of mine has very recently passed away at the age of 65 after a long battle with cancer. Today I heard that Rick Wright, the Pink Floyd keyboard player, has also just died of cancer. Both of these people made many positive contributions to the lives of others, one can’t help feeling they moved on a little prematurely.

Working in nursing and care work for over ten years, death and dying has never been far away and I’ve been the first person to find a recently deceased individual on several occasions. If they are lucky, they go peacefully in bed. On one occasion I found a man sat upright in a chair in a dignified fashion, having announced just a few hours earlier that he’d “had enough of this”. On another occasion I discovered one elderly lady in a not so dignified situation – on the toilet. Dealing with these situations is not always easy.

A few months ago I helped a Filipino nurse wash and generally clear up the body of a lady who had just passed away on a general ward in a Sussex hospital. She died with her loving family (well they seemed to be, you never know, funny things families…) all around her, a pretty good way to go I think. I had never met the nurse before, and we found ourselves immediately discussing the most profound questions about life and what exactly makes us human. Although I have a long-standing passionate interest in all things “spiritual”, my experience of these situations has not made me any clearer as to whether I believe there is some form of life after death, or whether death is a full stop, so to speak. The person’s life energy has obviously gone somewhere in some form, but this energy might just dissipate back into the general energy of the universe? Or there might be a soul that travels on, as many accounts of near-death experiences suggest. I have no idea whatsoever!

What I do know is that we don’t seem to be very good at dealing with death and dying in our culture. Odd really, when it’s one of the few certainties of life, perhaps the only certainty of life. Many years ago, a chapter in an Aldous Huxley novel (I think it was called “Island”) made a big impression on me. In it, schoolchildren were taken to visit the dying, including members of their own family, as part of their general education. Death was completely accepted and embraced as part of the human experience. Love and peace to all who have passed away, especially my friend Jayne.

A night shift

As there have been a few problems with new staff getting me work at my nursing agency, I took a night shift at Southlands Hospital for the first time in ages on Tuesday night. As night shifts go, it was quite busy, but quite enjoyable. I was on an orthopaedic ward, the patients are only there for a few days while they have their hip/shoulder replacements (or whatever) and then they go home as soon as possible. Compared to some places I work they mostly need a lot of monitoring, particularly after their operations. This involves hourly taking of blood pressures and temperatures which can get a bit tedious after a while, although the patients don’t seem to complain.

It can be a slightly creepy experience wandering around a large hospital in the early hours of the morning. At least I remembered to bring some half-decent food with me this time, it keeps you feeling half-human when you haven’t had any sleep. A couple of new admissions knocked on the door at 7.00 a.m. which kept us busy at the end of the shift. But just as we thought everything was done and the two staff nurses had started to handover to the morning day staff, we discovered a woman sitting in a mixture of her own faeces and fluid leaking from a wound. Clearing that lot up woke me up!

The main problem for me with night shifts is how they muck up your sleep patterns, unless you are doing them regularly. Otherwise I would probably do more as they pay better and are usually quite relaxed compared to day shifts.

One or two album reviews have surfaced on the net this week, and there’s been some very nice feedback indeed from several people who’ve bought a copy. That really does make it all worthwhile.