:00:07. > :00:10.Good morning Mr Williams are you ready to get up?
:00:11. > :00:17.It's something many of us at some stage in our lives may need.
:00:18. > :00:20.You just don't know how you're going to face life,
:00:21. > :00:24.I've travelled the length and breadth of Wales to find out
:00:25. > :00:29.what impact soaring social care costs are having.
:00:30. > :00:32.At the moment there are 17 clients on our waiting list.
:00:33. > :00:35.I have sleepless nights, because I worry.
:00:36. > :00:41.Tonight, we film with those at the heart of delivering the service.
:00:42. > :00:44.You've got to rush in and out with them.
:00:45. > :00:49.We find out the challenges they face.
:00:50. > :00:53.We're having great difficultly due to the lack of staff in the area.
:00:54. > :00:57.We have to stop this crisis in social care and we have to make
:00:58. > :01:00.these professional carers feel valued
:01:01. > :01:04.We uncover a recruitment problem across the sector.
:01:05. > :01:07.And we speak to those affected by it.
:01:08. > :01:10.I don't care if an alien comes down from Mars.
:01:11. > :01:12.If they can do the flippin' job I ll give it to them.
:01:13. > :01:15.And as the population gets older and demand increases,
:01:16. > :01:19.we ask how will we look after some of the most vulnerable
:01:20. > :01:24.I struggle to find a word that's one higher than crisis,
:01:25. > :01:39.I think in a sense we're probably at the point of near failure.
:01:40. > :01:43.The start of a new day on the Lleyn Peninsula in North Wales.
:01:44. > :01:46.It's eight o'clock and Amanda is beginning her day's work
:01:47. > :02:04.Amanda's been a carer for three years helping the elderly
:02:05. > :02:08.and vulnerable live independent lives at home.
:02:09. > :02:11.There are 20,000 care workers like Amanda across Wales.
:02:12. > :02:14.Today, she's with former teacher William Williams,
:02:15. > :02:22.It's just nice to know can go out and help other people and that
:02:23. > :02:27.they're safe and at home in their own house and don't
:02:28. > :02:32.have to go into care or anything like that.
:02:33. > :02:42.The girls, I have to admit, are terrific.
:02:43. > :02:48.They're caring, they're understanding
:02:49. > :02:53.Like many carers up and down the country,
:02:54. > :03:01.She's paid just over the national living wage,
:03:02. > :03:05.at ?7.55-an-hour but she's on a zero hours contract, which means
:03:06. > :03:10.the hours she works are not guaranteed.
:03:11. > :03:13.I did look into buying a house about four years ago,
:03:14. > :03:22.but because I didn't have a contract they wouldn't allow me to buy
:03:23. > :03:33.You see your friends out every weekend, going for supper.
:03:34. > :03:42.Try and be a little earlier than this morning.
:03:43. > :03:46.You could work from 7.30am straight through to 10pm.
:03:47. > :03:54.But I could see up to about ten, 11 people a day.
:03:55. > :03:57.It's really a hard days' work really.
:03:58. > :04:10.Amanda works for a family-run care company near Bangor in Gwynedd.
:04:11. > :04:13."Hello. Cymorth Llaw."
:04:14. > :04:20.I'm just concerned about her safety and welfare, really.
:04:21. > :04:23.Menna is one of the managers at the company, and has
:04:24. > :04:29.The change in that time, the sense of recruiting.
:04:30. > :04:31.For the past two years recruiting has been
:04:32. > :04:36.There are good carers out there who provide amazing care
:04:37. > :04:45.for people and people thank us with cards that we get.
:04:46. > :04:49.Menna's one of 200 staff employed by Cymorth Llaw, providing care
:04:50. > :05:01.It was founded 17 years ago by Janice and her husband Ken.
:05:02. > :05:05.We like what we do, Janice and I, my wife and I, and it gives us great
:05:06. > :05:09.pleasure when we see people who get better and don't need us anymore.
:05:10. > :05:13.But they are concerned about the future.
:05:14. > :05:15.There will be difficult decisions to be made.
:05:16. > :05:19.We've made difficult decisions in the past.
:05:20. > :05:22.We have to stop this crisis in social care and we have to make
:05:23. > :05:28.these professional carers feel valued, not only valued
:05:29. > :05:36.members of society but also the remuneration that they deserve.
:05:37. > :05:39.Teresa, have you got blank rotas I can have please.
:05:40. > :05:42.Menna's trying to juggle the staff rota.
:05:43. > :05:48.She's also trying to find room for new clients but she's
:05:49. > :05:54.Due to staffing availability and the hours of care
:05:55. > :05:57.that they require we physically cannot fit them in on the carers'
:05:58. > :06:04.And that's part of the job I do not like to do.
:06:05. > :06:09.I have sleepless nights because I worry about not being able
:06:10. > :06:23.In Swansea, one care provider found it increasingly difficult
:06:24. > :06:27.These were the offices of Crossroads, a well-established
:06:28. > :06:30.charity employing 50 staff and providing care to hundreds
:06:31. > :06:36.Lynn Watts was a trustee of the charity.
:06:37. > :06:40.So what challenges did the charity find itself facing?
:06:41. > :06:44.The pressure that we were getting financially to keep up our standards
:06:45. > :06:48.of training, our standard of care and giving decent conditions
:06:49. > :06:52.of employment to our workers you know we weren't able to provide
:06:53. > :06:56.that service under the amount of money that we were getting in.
:06:57. > :06:59.Crossroads was forced to close last September.
:07:00. > :07:08.I was extremely angry and frustrated but I was also very concerned
:07:09. > :07:14.about what this means within the domiciliary care sector.
:07:15. > :07:16.I felt we gave a very good service and...
:07:17. > :07:19.You know, it's hard to see that matched
:07:20. > :07:26.Professor John Williams is an expert in care for the elderly and he fears
:07:27. > :07:28.that the current model, which relies heavily
:07:29. > :07:36.on private companies, is no longer fit for purpose.
:07:37. > :07:40.Is social care something we can buy and sell in a market economy
:07:41. > :07:48.We've had 25 years of the, of the market economy and, erm,
:07:49. > :07:51.I think everybody recognises the word often used
:07:52. > :07:56.I struggle to find a word that's one higher than crisis,
:07:57. > :07:59.I think in a sense we're probably at the point of near
:08:00. > :08:05.At the offices of Cymorth Llaw, the clock's ticking.
:08:06. > :08:11.Is there a possibility that you could help us out this
:08:12. > :08:24.A member of staff is sick and there's no-one to visit
:08:25. > :08:29.We've been trying to cover this shift since Monday morning and we re
:08:30. > :08:36.having great difficultly due to lack of staff in the area.
:08:37. > :08:39.Could you please get back to me once you've had this message.
:08:40. > :08:42.Time's running out to fill the shift, but after some frantic
:08:43. > :08:47.phone calls a potential crisis is averted.
:08:48. > :08:55.It's important that we do provide that professional care for them
:08:56. > :09:02.Home care companies say one of the biggest problems they face
:09:03. > :09:10.When they've obtained such qualifications they can quite easily
:09:11. > :09:13.walk into the local hospital as health care assistants.
:09:14. > :09:16.That leaves us short in the community.
:09:17. > :09:19.And the pay and conditions working for the health board are far,
:09:20. > :09:25.Carers at the company, where there are about 30 staff
:09:26. > :09:29.vacancies, aren't just leaving to work in hospitals.
:09:30. > :09:33.We know the local supermarkets are paying considerably more
:09:34. > :09:37.in wages than what we can pay and of course when you work
:09:38. > :09:40.in a supermarket you're not putting 50, or 100 miles,
:09:41. > :09:44.a week on your car travelling from village to village to see clients.
:09:45. > :09:49.You just go to the one venue do your shift and go home.
:09:50. > :09:52.Single mum Kirstie Jones worked as a carer for five years
:09:53. > :10:03.Sometimes we were the only people they saw in the day to talk to.
:10:04. > :10:07.It was hard work but it was fulfilling.
:10:08. > :10:10.There were times when I just thought, you know, do
:10:11. > :10:20.Then days when it was rewarding with the clients.
:10:21. > :10:24.After gaining qualifications while working as a home carer,
:10:25. > :10:27.together with that experience, she was able to get a job
:10:28. > :10:37.as a health care assistant at her local hospital.
:10:38. > :10:40.I made the decision for the sake of family as well as the pay
:10:41. > :10:47.Travelling to one place, do my shift, come home.
:10:48. > :10:50.Don't get me wrong, I do miss the clients but definitely
:10:51. > :10:58.For carers still in the job, like Anne-Marie, they continue
:10:59. > :11:05.to do their best despite the challenges they face.
:11:06. > :11:08.It's eight o'clock starting and got four calls this morning.
:11:09. > :11:10.But after three visits in Gwynedd Anne-Marie
:11:11. > :11:13.is already behind schedule and calls the office.
:11:14. > :11:19.Can you give my 10am client a ring and let them know I'm
:11:20. > :11:25.You got to do the personal care, got to do breakfast,
:11:26. > :11:29.prepare lunch and sometimes just need to talk to you,
:11:30. > :11:31.five minutes of your time, and you've got to rush,
:11:32. > :11:41.Like her colleagues, Anne-Marie is on a zero hours' contract.
:11:42. > :11:44.The company has seen its profits fall over the last few years.
:11:45. > :11:48.What they do make, they plough back into the family business but it's
:11:49. > :11:56.We pay as much as we possibly can and we've always paid
:11:57. > :12:00.above what was the national minimum wage and the national living wage
:12:01. > :12:03.They get a mileage allowance, they get paid travelling time
:12:04. > :12:10.As a company we are legally obliged to pay you know 1% pension,
:12:11. > :12:14.13.8% National Insurance and of course training
:12:15. > :12:18.and all the other things that go to employing a person.
:12:19. > :12:24.There might be people who are watching this
:12:25. > :12:25.programme who will say, "Well, you re the boss,
:12:26. > :12:29."why don t you take less of a cut and pay them some more?"
:12:30. > :12:31.There are school teachers that earn more than me.
:12:32. > :12:36.The amount paid to companies is set by local councils,
:12:37. > :12:42.The average paid by local authorities in Wales to companies
:12:43. > :12:46.is, according to the body which represents them,
:12:47. > :12:53.But many companies, like Cymorth Llaw, say this is not
:12:54. > :13:01.always enough particularly when working in more rural areas.
:13:02. > :13:03.There, they argue, their costs are greater.
:13:04. > :13:07.They have longer distances to travel between clients,
:13:08. > :13:16.And it costs more to pay carers for their fuel and travelling time.
:13:17. > :13:19.As well as Gwynedd and Anglesey councils, Cymorth Llaw used
:13:20. > :13:24.to provide care to Conwy until they decided they had
:13:25. > :13:36.no choice but to hand back the contract.
:13:37. > :13:43.We didn't think we could provide that service. We were reluctant to
:13:44. > :13:48.leave but we had to. It was as simple as that. We are a business. I
:13:49. > :13:53.have a bank manager to keep happy as well. We have to make some sort of a
:13:54. > :13:58.profit at the end of the year. No business does well running at a
:13:59. > :14:02.loss. Conwy council says it is committed to supporting vulnerable
:14:03. > :14:10.people in communities despite facing financial challenges. It isn't just
:14:11. > :14:15.here in Conwy where contracts have been returned by care providers. We
:14:16. > :14:19.asked all 22 local authorities in Wales if they had had contracts
:14:20. > :14:27.handed back and 13 of them told that they have.
:14:28. > :14:34.The organisation representing care companies, which provide 30 million
:14:35. > :14:38.hours of home care across Wales each year, is concerned about what
:14:39. > :14:43.businesses are telling them. What we here in Wales is a real sense of
:14:44. > :14:47.desperation from some providers, really trying to work out how they
:14:48. > :14:54.can remain in business, on the sorts of rates they are being paid by
:14:55. > :14:59.local councils. I think in some parts of Wales, particularly rural
:15:00. > :15:03.areas, we may see care providers handing back work, or going out of
:15:04. > :15:07.business even more quickly than the rest of the country. That is
:15:08. > :15:11.something I think the Welsh government needs to take seriously.
:15:12. > :15:17.The proportion of council saying they have had contracts handed back
:15:18. > :15:23.in Wales is 59%, higher than the UK average of 48%. The Welsh government
:15:24. > :15:28.says it has invested in the sector, to raise the terms and conditions of
:15:29. > :15:34.workers. It has also provided extra money for councils, to meet the
:15:35. > :15:38.increase in the national living wage in April. Local authorities admit
:15:39. > :15:43.they face huge challenges, they are struggling to pay care companies
:15:44. > :15:47.more. As it stands, unless more money comes in the system, we have a
:15:48. > :15:53.real problem. Maybe the fact of how much money we paid people who work
:15:54. > :15:56.in the social care sector in the UK. Members are my family work in the
:15:57. > :16:02.social care sector. In one sense it is shameful how low of the people
:16:03. > :16:11.who provide some of society's most valuable functions are paid, but we
:16:12. > :16:18.have to sort this. And it is thought the girls, ready for the day. Rosy
:16:19. > :16:24.faces the same recruitment problems as care companies. She already
:16:25. > :16:29.employs Matt Taylor three days a week as her personal assistant, that
:16:30. > :16:33.she is struggling to recruit someone to help for the other four at her
:16:34. > :16:36.Cardiff home. I pay higher than the national living wage, and the terms
:16:37. > :16:46.and conditions are good. Difficult to fathom out why. This is my job
:16:47. > :16:50.application form. Obviously, must be reliable, trustworthy and honest.
:16:51. > :16:56.Must be punctual. Must be discreet. Stains in the bathroom! Seems to be
:16:57. > :17:04.a total cultural shift in the mindset. People have said you can
:17:05. > :17:07.earn more stacking shelves in the shop. Yes, but you cannot have a
:17:08. > :17:16.good conversation with a tin of beans. It is great fun, it is Allah.
:17:17. > :17:21.Not a job where you have two get drought to work, you know it is the
:17:22. > :17:25.same every day, because it is not. You never really know, apart from
:17:26. > :17:28.the routine of getting Rosie up, to the breakfast table. After that
:17:29. > :17:38.anything could happen. We just have a laugh.
:17:39. > :17:46.Getting the blue and green background. Then over painting it.
:17:47. > :17:55.Splashing snow on it. Getting the flicking machine in again. I need
:17:56. > :17:59.personal care, because I'm an independent person, the physical
:18:00. > :18:03.reasons, there are an awful lot of things I cannot do. Requiring people
:18:04. > :18:08.to assist me doing those things. Someone might look at me, thinking
:18:09. > :18:14.God bless, you are totally helpless. Which I'm not. I do require other
:18:15. > :18:18.people for assistance. I would say to anybody out there looking for a
:18:19. > :18:24.worthwhile job, whatever age you are, I don't care if an alien comes
:18:25. > :18:28.down from Mars, if they can do a good job, I would give it to them.
:18:29. > :18:33.Rosie has been trying to recruit an additional care worker since last
:18:34. > :18:41.October. Despite some promising applicants, she's still looking. In
:18:42. > :18:48.Wales, from 2020, care workers will have to be registered. The Welsh
:18:49. > :18:50.government says it will improve the recruitment of carers, giving career
:18:51. > :19:02.progression and greater kudos for the job.
:19:03. > :19:08.She has just got off the phone to Gwynedd Council, the social services
:19:09. > :19:14.team responsible for getting care for new clients. It is client at
:19:15. > :19:18.home. There is another one, still in hospital, awaiting discharge. I
:19:19. > :19:22.requested an updated list of clients, waiting to come out of
:19:23. > :19:26.hospital, or at home already had needed care. I have given them the
:19:27. > :19:31.availability of the hours we can give them. Unfortunately we cannot
:19:32. > :19:35.offer them the times that they request, there is no capacity. At
:19:36. > :19:44.that time slot. For any more clients. She recognises one of the
:19:45. > :19:49.patients. The same person also on the waiting list last week. What has
:19:50. > :19:51.happened to that person? Where is the? Still in hospital. Backlight
:19:52. > :20:00.will remain in hospital until suit -- until suitable time becomes
:20:01. > :20:06.available. Bed blocking. We cannot do that one there. One of the
:20:07. > :20:12.company bosses, Ian, checks with her if they have space for any new
:20:13. > :20:17.clients. Hard to fit them in. It is frustrating for us. We are trying
:20:18. > :20:20.our best to alleviate the situation the best we can. We realise the
:20:21. > :20:25.managers themselves are under a lot of pressure. And so are the care
:20:26. > :20:29.staff. Trying to come to some sort of happy medium. With all the women
:20:30. > :20:35.the world, we want to have every person can. Councils and health
:20:36. > :20:38.boards across Wales are trying to tackle the problem of people waiting
:20:39. > :20:46.for care. Either in hospital or at home. In Port Talbot, they have set
:20:47. > :20:54.up a dedicated team. Shall we start from the top? The rapid response
:20:55. > :21:02.team is meeting to discuss the day's work. Each client has a number.
:21:03. > :21:06.Number seven. How is she doing now? The team was set up by the local
:21:07. > :21:11.council, to help keep people at risk of the committed to hospital in
:21:12. > :21:18.their Ron Holmes. Also to help people out of hospital more quickly.
:21:19. > :21:24.To prevent bed blocking. 29. This is a lady, bless her, I could not taken
:21:25. > :21:31.last week, we had quite a few on. She was crying, so thrilled. Over
:21:32. > :21:36.the weekend, a lot of changes. A few people we know have got better,
:21:37. > :21:40.coming off our books. I was able to speak to the hospital this morning,
:21:41. > :21:45.saying I could not taken last week, I could today. Meeting over. The
:21:46. > :21:47.team are rough to deliver domiciliary care to people in the
:21:48. > :22:03.area, including Lady 29. The council works closely with the
:22:04. > :22:08.local health board here. Hello, surely. Come to see how you are
:22:09. > :22:12.getting on. Christine is part of the health board's very able man team,
:22:13. > :22:18.providing medical assistance to get people out of hospital more quickly.
:22:19. > :22:22.She is checking on Shirley, who was in hospital after breaking her arm
:22:23. > :22:31.in a fall. This is where it all happened. Everything went flying, I
:22:32. > :22:41.lost my balance. Went backwards, against the fridge freezer. That
:22:42. > :22:45.cost me weeks and weeks, of being out of action. 90-year-old Shirley
:22:46. > :22:51.was in hospital for three weeks. Once she was passed fit to go home,
:22:52. > :22:55.the team stepped in to help her, including occupational therapist,
:22:56. > :23:00.Christine. You were quite down, your mood was low? Yes, I have never been
:23:01. > :23:07.that bad over everything. A combination of things. With pressure
:23:08. > :23:11.to free up the beds, they got there out of hospital as quickly as
:23:12. > :23:16.possible, despite surely having some misgivings about going home. You
:23:17. > :23:22.just don't know how you will face life. How you are going to manage.
:23:23. > :23:28.You don't know how much helps you are going to get. I was getting
:23:29. > :23:33.terrible pain, up to my elbow. Christine and the team ensured that
:23:34. > :23:38.surely was able to live at home. Helping her with everyday tasks. Our
:23:39. > :23:46.priority is supporting patients coming out of hospital. Don't want
:23:47. > :23:49.to keep somebody hospital, when they don't need to be. Once somebody has
:23:50. > :23:55.the right support, they can function OK. The pressure to find different
:23:56. > :24:00.ways of working is borne out in a number of stark figures. The
:24:01. > :24:06.majority of people needing care at home of the elderly, and by the year
:24:07. > :24:12.2035, the number of people aged over 85 is forecast to rise by over 113%
:24:13. > :24:20.in Wales. That will present local councils with a massive funding
:24:21. > :24:24.problem. We are currently spending ?1.3 billion on social care in
:24:25. > :24:29.Wales. In the next 10-15 years that will double to ?2.6 billion. Where
:24:30. > :24:33.will that money come from? Westminster at some point will have
:24:34. > :24:37.to sit down and work out how we are going to pay for this service.
:24:38. > :24:43.Probably general taxation, probably a new national and
:24:44. > :24:50.-- National Insurance scheme, funded a different way. There is no letup
:24:51. > :24:54.in the pressure. We have taken seven new clients on this week. Trying to
:24:55. > :24:59.release people at a hospital is my main priority. Staff provide
:25:00. > :25:09.increasingly complex care to clients. These carers work long
:25:10. > :25:21.hours. They work sociable hours. They go out in all weather, snow and
:25:22. > :25:25.hurricanes, they are out there. How are you viewed at the moment by
:25:26. > :25:29.society and the public? I don't think ahead is a recognised
:25:30. > :25:35.profession. They think somebody has to do it. Yes, somebody has to do
:25:36. > :25:45.it, that carer has the right to be respected. Just like any other job.
:25:46. > :25:52.Company boss, Ken, shares her frustrations. Saying something needs
:25:53. > :25:57.to be done. I don't think that the people that make these decisions
:25:58. > :26:04.actually realise what goes on in the community. For instance, has the
:26:05. > :26:08.minister ever been out on a wet and windy night in the middle of
:26:09. > :26:14.Anglesey? Nine o'clock, knocking on somebody's door to put them to bed?
:26:15. > :26:19.I don't think so. Would the minister responsible for social care in Wales
:26:20. > :26:23.take Ken up on his invitation? I will happily take him up on that
:26:24. > :26:28.particular offer. To set his mind at rest, I spend a lot of time doing
:26:29. > :26:32.visits is right across the country, people receiving care, and the
:26:33. > :26:36.people giving care. Part of the work I do week in, week out. The
:26:37. > :26:40.government in England has promised two billion pounds in extra money
:26:41. > :26:45.for social care in the next three years. Wales will receive ?200
:26:46. > :26:53.million as a result. The government has not said how the money will be
:26:54. > :26:56.spent. That will be for finance ministers and colleagues right
:26:57. > :27:00.across coming to the site. Is social care going to get more money? I
:27:01. > :27:04.cannot tell you that today, they'll be discussions going right across
:27:05. > :27:09.government, to decide how to use the funding which is coming to the
:27:10. > :27:15.government. Even if the ?200 million of extra money in Wales is all spent
:27:16. > :27:21.on social care, many argue it is simply not enough. What we are short
:27:22. > :27:28.of his ideas. What we tend to get our bits sticking plaster, to keep
:27:29. > :27:34.the show on the road. It does not address the fundamental problems,
:27:35. > :27:41.the structural problems that social care, domiciliary care are facing.
:27:42. > :27:49.Nearly the end of the working day for Amanda. She's back at Willie
:27:50. > :27:57.Williams' house to get ready for bed. How are you? Still here. Her
:27:58. > :28:02.day began at eight o'clock this morning, over 12 hours ago. Despite
:28:03. > :28:11.all the pressures, she has no plans to leave. I would not be tempted.
:28:12. > :28:16.Even though you get more, and you get a contract. I don't think I
:28:17. > :28:22.would be sitting behind a till serving people. I like my job. Nice
:28:23. > :28:26.to see different people, as well. No they are safe in their own homes,
:28:27. > :28:32.you are giving them the care they need. Really nice. I feel good about
:28:33. > :28:36.myself when I've given them that care, as well. Knowing I have done
:28:37. > :28:40.everything right. They are tucked up in bed, the door is locked. There we
:28:41. > :29:02.go, until the next morning. MasterChef is back, to find the
:29:03. > :29:07.country's best home chef. The MasterChef kitchen is alive once
:29:08. > :29:12.more. Come on, let's go!