Support at home report

Healthwatch North East Lincolnshire undertook research on needs of support at home services.  They used surveys, focus groups, and interviews to speak to 404 people.

Those that receive Support at Home and informal carers struggle to communicate with Care Agencies and often feel that nothing changes when they have identified issues. They feel that if a carer is late or does not turn up, they have to ring the Care Agency and try and sort out the issue, then ring Adult Social Care (ASC) to complain, then try and sort cover for other care, especially if they are not local.  Some informal carers are still not aware of the services that are on offer within the wider community, from VCSE organisations, more communications of what services are on offer needs to be planned throughout the year so informal carers are aware.  

Being able to communicate with the users of support at home services is important to informal carers. Those that have a diagnosis of dementia or Alzheimer's have differing communication needs and carers need to be up to speed on which communication needs they have.

Those that receive a support at home package and their informal carers are aware that they cannot have the same carers all of the time but would like a regular team that they have built a relationship with. The reason for wanting consistent staff varies from they would know exactly who is coming into their home to carers knowing how to communicate with them. Informal carers would then also not have to repeat themselves.

The training of staff has been raised by all the groups spoken to. The co-production group would like a consistent programme of training in place, so the informal carers know that carers are all trained to the same standard. Those receiving services would also to be assured that carers have the correct training to be able to deal with their individual needs. There needs to be an identified set of standards and a list of essential training that needs to be carried out.

Those receiving support at home and their informal carers understand that an exact time for a call cannot be given, however a time slot could be. Sometimes a morning call takes part very close to lunchtime calls, some respondents said they miss breakfast or lunch as meals can be very close together. Evening calls can vary dramatically. Those that receive support at home services have said that they can vary from 6pm to 11.45pm. This variation over a six hour period is not what people want as some said they just sit there waiting. Those receiving support at home explained that this needs organising better as if the carers are assisting you to go to bed 6pm is too early and 11.45pm is too late. They understand it may not always be able to carry this out on a personal preference but time slots would be a good idea.

For those receiving a care at home package and for informal carers they feel that care plans are not being used to their full potential. They feel that they are either not read or not adhered to. Informal carers explained that carers often do not have the time to read them in full or read them at all. They are sometimes also not completed properly and that notes are not left as a way of communicating between the carer and the informal carer. Informal carers feel that care plans could be summarised better for carers who are not familiar with those receiving support at home. Informal carers explained that this information needs to be easy to read for care recipients who have communication difficulties or memory issues cannot explain everything to the carers directly.

A care agency that does not turn up impacts on both the informal carer and those receiving support at home services. Informal carers feel that if the care agency doesn’t turn up then it is them that have to phone and get extra support and chase everyone up. Informal carers asked if there was an early warning system in place if support at home fails? As care agencies just assume that the informal carer will fill the gap. Informal carers feel they have to cancel appointments, social activities, shopping and visits to friends because the care agencies are unreliable.

Technology was suggested as solution to ensure informal carers are kept up to date. Informal carers said that a care agency had this facility, but it wasn’t used effectively. Care plans could also be accessible for all those that needed to see it and it would be up to date and a working document. informal carers could also raise issues through the app and see if care was provided and what time medications were given. Some however were reticent about the idea of technology as they felt it might be complicated, they wouldn’t know how to use it or care agencies just wouldn’t bother keeping it up to date.