The Real Cost of Caring Week In Week Out


The Real Cost of Caring

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Good morning Mr Williams are you ready to get up?

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It's something many of us at some stage in our lives may need.

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You just don't know how you're going to face life,

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I've travelled the length and breadth of Wales to find out

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what impact soaring social care costs are having.

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At the moment there are 17 clients on our waiting list.

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I have sleepless nights, because I worry.

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Tonight, we film with those at the heart of delivering the service.

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You've got to rush in and out with them.

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We find out the challenges they face.

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We're having great difficultly due to the lack of staff in the area.

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We have to stop this crisis in social care and we have to make

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these professional carers feel valued

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We uncover a recruitment problem across the sector.

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And we speak to those affected by it.

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I don't care if an alien comes down from Mars.

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If they can do the flippin' job I ll give it to them.

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And as the population gets older and demand increases,

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we ask how will we look after some of the most vulnerable

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I struggle to find a word that's one higher than crisis,

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I think in a sense we're probably at the point of near failure.

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The start of a new day on the Lleyn Peninsula in North Wales.

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It's eight o'clock and Amanda is beginning her day's work

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Amanda's been a carer for three years helping the elderly

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and vulnerable live independent lives at home.

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There are 20,000 care workers like Amanda across Wales.

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Today, she's with former teacher William Williams,

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It's just nice to know can go out and help other people and that

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they're safe and at home in their own house and don't

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have to go into care or anything like that.

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The girls, I have to admit, are terrific.

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They're caring, they're understanding

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Like many carers up and down the country,

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She's paid just over the national living wage,

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at ?7.55-an-hour but she's on a zero hours contract, which means

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the hours she works are not guaranteed.

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I did look into buying a house about four years ago,

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but because I didn't have a contract they wouldn't allow me to buy

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You see your friends out every weekend, going for supper.

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Try and be a little earlier than this morning.

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You could work from 7.30am straight through to 10pm.

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But I could see up to about ten, 11 people a day.

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It's really a hard days' work really.

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Amanda works for a family-run care company near Bangor in Gwynedd.

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"Hello. Cymorth Llaw."

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I'm just concerned about her safety and welfare, really.

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Menna is one of the managers at the company, and has

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The change in that time, the sense of recruiting.

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For the past two years recruiting has been

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There are good carers out there who provide amazing care

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for people and people thank us with cards that we get.

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Menna's one of 200 staff employed by Cymorth Llaw, providing care

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It was founded 17 years ago by Janice and her husband Ken.

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We like what we do, Janice and I, my wife and I, and it gives us great

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pleasure when we see people who get better and don't need us anymore.

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But they are concerned about the future.

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There will be difficult decisions to be made.

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We've made difficult decisions in the past.

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We have to stop this crisis in social care and we have to make

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these professional carers feel valued, not only valued

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members of society but also the remuneration that they deserve.

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Teresa, have you got blank rotas I can have please.

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Menna's trying to juggle the staff rota.

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She's also trying to find room for new clients but she's

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Due to staffing availability and the hours of care

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that they require we physically cannot fit them in on the carers'

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And that's part of the job I do not like to do.

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I have sleepless nights because I worry about not being able

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In Swansea, one care provider found it increasingly difficult

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These were the offices of Crossroads, a well-established

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charity employing 50 staff and providing care to hundreds

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Lynn Watts was a trustee of the charity.

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So what challenges did the charity find itself facing?

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The pressure that we were getting financially to keep up our standards

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of training, our standard of care and giving decent conditions

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of employment to our workers you know we weren't able to provide

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that service under the amount of money that we were getting in.

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Crossroads was forced to close last September.

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I was extremely angry and frustrated but I was also very concerned

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about what this means within the domiciliary care sector.

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I felt we gave a very good service and...

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You know, it's hard to see that matched

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Professor John Williams is an expert in care for the elderly and he fears

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that the current model, which relies heavily

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on private companies, is no longer fit for purpose.

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Is social care something we can buy and sell in a market economy

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We've had 25 years of the, of the market economy and, erm,

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I think everybody recognises the word often used

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I struggle to find a word that's one higher than crisis,

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I think in a sense we're probably at the point of near

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At the offices of Cymorth Llaw, the clock's ticking.

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Is there a possibility that you could help us out this

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A member of staff is sick and there's no-one to visit

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We've been trying to cover this shift since Monday morning and we re

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having great difficultly due to lack of staff in the area.

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Could you please get back to me once you've had this message.

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Time's running out to fill the shift, but after some frantic

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phone calls a potential crisis is averted.

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It's important that we do provide that professional care for them

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Home care companies say one of the biggest problems they face

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When they've obtained such qualifications they can quite easily

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walk into the local hospital as health care assistants.

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That leaves us short in the community.

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And the pay and conditions working for the health board are far,

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Carers at the company, where there are about 30 staff

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vacancies, aren't just leaving to work in hospitals.

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We know the local supermarkets are paying considerably more

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in wages than what we can pay and of course when you work

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in a supermarket you're not putting 50, or 100 miles,

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a week on your car travelling from village to village to see clients.

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You just go to the one venue do your shift and go home.

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Single mum Kirstie Jones worked as a carer for five years

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Sometimes we were the only people they saw in the day to talk to.

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It was hard work but it was fulfilling.

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There were times when I just thought, you know, do

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Then days when it was rewarding with the clients.

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After gaining qualifications while working as a home carer,

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together with that experience, she was able to get a job

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as a health care assistant at her local hospital.

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I made the decision for the sake of family as well as the pay

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Travelling to one place, do my shift, come home.

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Don't get me wrong, I do miss the clients but definitely

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For carers still in the job, like Anne-Marie, they continue

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to do their best despite the challenges they face.

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It's eight o'clock starting and got four calls this morning.

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But after three visits in Gwynedd Anne-Marie

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is already behind schedule and calls the office.

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Can you give my 10am client a ring and let them know I'm

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You got to do the personal care, got to do breakfast,

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prepare lunch and sometimes just need to talk to you,

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five minutes of your time, and you've got to rush,

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Like her colleagues, Anne-Marie is on a zero hours' contract.

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The company has seen its profits fall over the last few years.

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What they do make, they plough back into the family business but it's

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We pay as much as we possibly can and we've always paid

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above what was the national minimum wage and the national living wage

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They get a mileage allowance, they get paid travelling time

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As a company we are legally obliged to pay you know 1% pension,

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13.8% National Insurance and of course training

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and all the other things that go to employing a person.

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There might be people who are watching this

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programme who will say, "Well, you re the boss,

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"why don t you take less of a cut and pay them some more?"

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There are school teachers that earn more than me.

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The amount paid to companies is set by local councils,

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The average paid by local authorities in Wales to companies

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is, according to the body which represents them,

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But many companies, like Cymorth Llaw, say this is not

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always enough particularly when working in more rural areas.

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There, they argue, their costs are greater.

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They have longer distances to travel between clients,

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And it costs more to pay carers for their fuel and travelling time.

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As well as Gwynedd and Anglesey councils, Cymorth Llaw used

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to provide care to Conwy until they decided they had

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no choice but to hand back the contract.

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We didn't think we could provide that service. We were reluctant to

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leave but we had to. It was as simple as that. We are a business. I

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have a bank manager to keep happy as well. We have to make some sort of a

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profit at the end of the year. No business does well running at a

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loss. Conwy council says it is committed to supporting vulnerable

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people in communities despite facing financial challenges. It isn't just

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here in Conwy where contracts have been returned by care providers. We

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asked all 22 local authorities in Wales if they had had contracts

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handed back and 13 of them told that they have.

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The organisation representing care companies, which provide 30 million

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hours of home care across Wales each year, is concerned about what

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businesses are telling them. What we here in Wales is a real sense of

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desperation from some providers, really trying to work out how they

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can remain in business, on the sorts of rates they are being paid by

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local councils. I think in some parts of Wales, particularly rural

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areas, we may see care providers handing back work, or going out of

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business even more quickly than the rest of the country. That is

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something I think the Welsh government needs to take seriously.

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The proportion of council saying they have had contracts handed back

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in Wales is 59%, higher than the UK average of 48%. The Welsh government

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says it has invested in the sector, to raise the terms and conditions of

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workers. It has also provided extra money for councils, to meet the

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increase in the national living wage in April. Local authorities admit

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they face huge challenges, they are struggling to pay care companies

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more. As it stands, unless more money comes in the system, we have a

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real problem. Maybe the fact of how much money we paid people who work

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in the social care sector in the UK. Members are my family work in the

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social care sector. In one sense it is shameful how low of the people

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who provide some of society's most valuable functions are paid, but we

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have to sort this. And it is thought the girls, ready for the day. Rosy

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faces the same recruitment problems as care companies. She already

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employs Matt Taylor three days a week as her personal assistant, that

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she is struggling to recruit someone to help for the other four at her

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Cardiff home. I pay higher than the national living wage, and the terms

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and conditions are good. Difficult to fathom out why. This is my job

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application form. Obviously, must be reliable, trustworthy and honest.

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Must be punctual. Must be discreet. Stains in the bathroom! Seems to be

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a total cultural shift in the mindset. People have said you can

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earn more stacking shelves in the shop. Yes, but you cannot have a

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good conversation with a tin of beans. It is great fun, it is Allah.

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Not a job where you have two get drought to work, you know it is the

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same every day, because it is not. You never really know, apart from

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the routine of getting Rosie up, to the breakfast table. After that

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anything could happen. We just have a laugh.

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Getting the blue and green background. Then over painting it.

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Splashing snow on it. Getting the flicking machine in again. I need

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personal care, because I'm an independent person, the physical

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reasons, there are an awful lot of things I cannot do. Requiring people

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to assist me doing those things. Someone might look at me, thinking

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God bless, you are totally helpless. Which I'm not. I do require other

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people for assistance. I would say to anybody out there looking for a

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worthwhile job, whatever age you are, I don't care if an alien comes

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down from Mars, if they can do a good job, I would give it to them.

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Rosie has been trying to recruit an additional care worker since last

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October. Despite some promising applicants, she's still looking. In

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Wales, from 2020, care workers will have to be registered. The Welsh

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government says it will improve the recruitment of carers, giving career

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progression and greater kudos for the job.

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She has just got off the phone to Gwynedd Council, the social services

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team responsible for getting care for new clients. It is client at

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home. There is another one, still in hospital, awaiting discharge. I

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requested an updated list of clients, waiting to come out of

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hospital, or at home already had needed care. I have given them the

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availability of the hours we can give them. Unfortunately we cannot

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offer them the times that they request, there is no capacity. At

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that time slot. For any more clients. She recognises one of the

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patients. The same person also on the waiting list last week. What has

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happened to that person? Where is the? Still in hospital. Backlight

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will remain in hospital until suit -- until suitable time becomes

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available. Bed blocking. We cannot do that one there. One of the

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company bosses, Ian, checks with her if they have space for any new

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clients. Hard to fit them in. It is frustrating for us. We are trying

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our best to alleviate the situation the best we can. We realise the

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managers themselves are under a lot of pressure. And so are the care

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staff. Trying to come to some sort of happy medium. With all the women

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the world, we want to have every person can. Councils and health

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boards across Wales are trying to tackle the problem of people waiting

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for care. Either in hospital or at home. In Port Talbot, they have set

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up a dedicated team. Shall we start from the top? The rapid response

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team is meeting to discuss the day's work. Each client has a number.

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Number seven. How is she doing now? The team was set up by the local

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council, to help keep people at risk of the committed to hospital in

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their Ron Holmes. Also to help people out of hospital more quickly.

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To prevent bed blocking. 29. This is a lady, bless her, I could not taken

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last week, we had quite a few on. She was crying, so thrilled. Over

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the weekend, a lot of changes. A few people we know have got better,

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coming off our books. I was able to speak to the hospital this morning,

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saying I could not taken last week, I could today. Meeting over. The

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team are rough to deliver domiciliary care to people in the

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area, including Lady 29. The council works closely with the

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local health board here. Hello, surely. Come to see how you are

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getting on. Christine is part of the health board's very able man team,

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providing medical assistance to get people out of hospital more quickly.

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She is checking on Shirley, who was in hospital after breaking her arm

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in a fall. This is where it all happened. Everything went flying, I

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lost my balance. Went backwards, against the fridge freezer. That

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cost me weeks and weeks, of being out of action. 90-year-old Shirley

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was in hospital for three weeks. Once she was passed fit to go home,

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the team stepped in to help her, including occupational therapist,

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Christine. You were quite down, your mood was low? Yes, I have never been

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that bad over everything. A combination of things. With pressure

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to free up the beds, they got there out of hospital as quickly as

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possible, despite surely having some misgivings about going home. You

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just don't know how you will face life. How you are going to manage.

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You don't know how much helps you are going to get. I was getting

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terrible pain, up to my elbow. Christine and the team ensured that

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surely was able to live at home. Helping her with everyday tasks. Our

:23:34.:23:38.

priority is supporting patients coming out of hospital. Don't want

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to keep somebody hospital, when they don't need to be. Once somebody has

:23:47.:23:49.

the right support, they can function OK. The pressure to find different

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ways of working is borne out in a number of stark figures. The

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majority of people needing care at home of the elderly, and by the year

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2035, the number of people aged over 85 is forecast to rise by over 113%

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in Wales. That will present local councils with a massive funding

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problem. We are currently spending ?1.3 billion on social care in

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Wales. In the next 10-15 years that will double to ?2.6 billion. Where

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will that money come from? Westminster at some point will have

:24:30.:24:33.

to sit down and work out how we are going to pay for this service.

:24:34.:24:37.

Probably general taxation, probably a new national and

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-- National Insurance scheme, funded a different way. There is no letup

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in the pressure. We have taken seven new clients on this week. Trying to

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release people at a hospital is my main priority. Staff provide

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increasingly complex care to clients. These carers work long

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hours. They work sociable hours. They go out in all weather, snow and

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hurricanes, they are out there. How are you viewed at the moment by

:25:22.:25:25.

society and the public? I don't think ahead is a recognised

:25:26.:25:29.

profession. They think somebody has to do it. Yes, somebody has to do

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it, that carer has the right to be respected. Just like any other job.

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Company boss, Ken, shares her frustrations. Saying something needs

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to be done. I don't think that the people that make these decisions

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actually realise what goes on in the community. For instance, has the

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minister ever been out on a wet and windy night in the middle of

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Anglesey? Nine o'clock, knocking on somebody's door to put them to bed?

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I don't think so. Would the minister responsible for social care in Wales

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take Ken up on his invitation? I will happily take him up on that

:26:20.:26:23.

particular offer. To set his mind at rest, I spend a lot of time doing

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visits is right across the country, people receiving care, and the

:26:29.:26:32.

people giving care. Part of the work I do week in, week out. The

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government in England has promised two billion pounds in extra money

:26:37.:26:40.

for social care in the next three years. Wales will receive ?200

:26:41.:26:45.

million as a result. The government has not said how the money will be

:26:46.:26:53.

spent. That will be for finance ministers and colleagues right

:26:54.:26:56.

across coming to the site. Is social care going to get more money? I

:26:57.:27:00.

cannot tell you that today, they'll be discussions going right across

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government, to decide how to use the funding which is coming to the

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government. Even if the ?200 million of extra money in Wales is all spent

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on social care, many argue it is simply not enough. What we are short

:27:16.:27:21.

of his ideas. What we tend to get our bits sticking plaster, to keep

:27:22.:27:28.

the show on the road. It does not address the fundamental problems,

:27:29.:27:34.

the structural problems that social care, domiciliary care are facing.

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Nearly the end of the working day for Amanda. She's back at Willie

:27:42.:27:49.

Williams' house to get ready for bed. How are you? Still here. Her

:27:50.:27:57.

day began at eight o'clock this morning, over 12 hours ago. Despite

:27:58.:28:02.

all the pressures, she has no plans to leave. I would not be tempted.

:28:03.:28:11.

Even though you get more, and you get a contract. I don't think I

:28:12.:28:16.

would be sitting behind a till serving people. I like my job. Nice

:28:17.:28:22.

to see different people, as well. No they are safe in their own homes,

:28:23.:28:26.

you are giving them the care they need. Really nice. I feel good about

:28:27.:28:32.

myself when I've given them that care, as well. Knowing I have done

:28:33.:28:36.

everything right. They are tucked up in bed, the door is locked. There we

:28:37.:28:40.

go, until the next morning. MasterChef is back, to find the

:28:41.:29:02.

country's best home chef. The MasterChef kitchen is alive once

:29:03.:29:07.

more. Come on, let's go!

:29:08.:29:12.

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