0:00:05 > 0:00:08Tonight, home-care companies in crisis because they can't
0:00:08 > 0:00:11recruit enough staff.
0:00:11 > 0:00:13I have sleepless nights because I worry.
0:00:13 > 0:00:16We are physically not being able to fit them
0:00:16 > 0:00:17in on the carers rotas.
0:00:17 > 0:00:20Good morning.
0:00:20 > 0:00:23We meet hard-pressed carers on zero-hours contracts.
0:00:23 > 0:00:25It is hard.
0:00:25 > 0:00:27Because I didn't have a contract, they wouldn't
0:00:27 > 0:00:30allow me to buy a house, or anything like that.
0:00:30 > 0:00:33We discover nearly 100 councils have had home-care contracts
0:00:33 > 0:00:37handed back to them.
0:00:37 > 0:00:39That was a terrible thing to do, both for service
0:00:39 > 0:00:41users and for care staff.
0:00:41 > 0:00:43Frankly, what choice did we have?
0:00:43 > 0:00:46The nationwide shortage of carers means people are stuck in hospital,
0:00:46 > 0:00:47blocking precious beds.
0:00:47 > 0:00:54It won't be long now, so I am doing everything to get you home.
0:00:54 > 0:00:57The Government's just promised more money for social care,
0:00:57 > 0:01:00but is it too little, too late?
0:01:00 > 0:01:03I struggle to find a word that's one higher than crisis ? I think
0:01:03 > 0:01:10in a sense we're probably at the point of near failure.
0:01:17 > 0:01:21The Llyn peninsula in north Wales.
0:01:21 > 0:01:23It's eight o'clock in the morning, and home-carer Amanda
0:01:23 > 0:01:24is beginning her working day.
0:01:24 > 0:01:28Her first call is in Pwllheli.
0:01:28 > 0:01:29Good morning!
0:01:29 > 0:01:31Have you got your bleeper on?
0:01:31 > 0:01:32My bleeper, why?
0:01:32 > 0:01:38What bleeping time do you call this?
0:01:38 > 0:01:40Amanda's one of the UK's 800,000 home-care
0:01:40 > 0:01:42workers, helping the elderly and disabled live
0:01:42 > 0:01:46independent lives at home.
0:01:46 > 0:01:48Today, she's with former teacher William Williams,
0:01:48 > 0:01:52who has multiple sclerosis.
0:01:52 > 0:01:55It's just nice knowing that I could go out there
0:01:55 > 0:01:57and help other people and make sure that they're safe
0:01:57 > 0:02:00in their own home, and that they can actually stay home, and live
0:02:00 > 0:02:04at home in their own house, and don't have to go into care
0:02:04 > 0:02:07or anything like that.
0:02:07 > 0:02:08I'm 72, remember.
0:02:08 > 0:02:10I haven't got much time left!
0:02:10 > 0:02:11We have!
0:02:11 > 0:02:14Many years to go again!
0:02:14 > 0:02:16The girls, I have to admit, are terrific.
0:02:16 > 0:02:19Absolutely terrific.
0:02:19 > 0:02:20They're caring, they're understanding
0:02:20 > 0:02:25and they're full of fun.
0:02:25 > 0:02:29Like many carers, Amanda struggles to make ends meet.
0:02:29 > 0:02:34She's paid ?7.55 an hour, just above the national living wage,
0:02:34 > 0:02:37but she's on a zero hours contract, which means the hours
0:02:37 > 0:02:41she works are not guaranteed.
0:02:41 > 0:02:43I did look into buying a house four years ago,
0:02:43 > 0:02:46but because I didn't have a contract they wouldn't allow me to buy
0:02:46 > 0:02:49a house, or anything like that.
0:02:49 > 0:02:53It's hard, it is hard.
0:02:53 > 0:02:56You see your friends out every weekend, going
0:02:56 > 0:02:58for supper with each other.
0:02:58 > 0:03:01It's just like "No, I can't come."
0:03:01 > 0:03:04Try and be a little earlier than this morning, will you?
0:03:04 > 0:03:06I'll be sat in the car, waiting!
0:03:06 > 0:03:10Ta-ra, Will!
0:03:10 > 0:03:12It's really a hard day's work really.
0:03:12 > 0:03:16With working out in the community.
0:03:16 > 0:03:19You could work from 7.30am straight through to 10pm but you do get
0:03:19 > 0:03:23breaks in that time.
0:03:23 > 0:03:29But I could see up to about 10, 11 people a day.
0:03:29 > 0:03:32Amanda is one of 200 staff at a family-run care company
0:03:32 > 0:03:36near Bangor in Gwynedd.
0:03:36 > 0:03:37Hello.
0:03:37 > 0:03:39Cymorth Llaw.
0:03:39 > 0:03:43Cymorth llaw, which means Helping Hand,
0:03:43 > 0:03:46is paid by local councils to provide home care.
0:03:46 > 0:03:50I'm just concerned about her safety and welfare, really.
0:03:50 > 0:03:53Menna is one of the managers at the company, and has
0:03:53 > 0:03:56worked here for 14 years.
0:03:56 > 0:03:58The change in that time, the sense of recruiting ?
0:03:58 > 0:04:01for the last two years recruitment has been phenomenally
0:04:01 > 0:04:04hard out there.
0:04:04 > 0:04:06Have you got blank rotas I can have, please?
0:04:06 > 0:04:09Menna's trying to juggle the staff rota.
0:04:09 > 0:04:10There are gaps that need covering.
0:04:10 > 0:04:14She's also trying to find carers for new clients.
0:04:14 > 0:04:17Due to staffing availability, and the hours of care
0:04:17 > 0:04:20that they require, we physically cannot fit them in on the carers'
0:04:20 > 0:04:23rotas, unfortunately.
0:04:23 > 0:04:27And that's part of the job I do not like to do,
0:04:27 > 0:04:30And how does it make you feel in those situations?
0:04:30 > 0:04:34I have sleepless nights because I worry.
0:04:34 > 0:04:38Across the water in Liverpool, and the pressures are the same.
0:04:38 > 0:04:40A shortage of care workers means it's difficult
0:04:40 > 0:04:44to get people who've been in hospital back home.
0:04:44 > 0:04:45This way?
0:04:45 > 0:04:47Yes.
0:04:47 > 0:04:48Bad leg up?
0:04:48 > 0:04:49Yes.
0:04:49 > 0:04:51Bad leg up.
0:04:51 > 0:04:5486-year-old Anastasia O'Leary was transferred to the Granby
0:04:54 > 0:04:57Rehabilitation Unit from the city's Royal Liverpool University
0:04:57 > 0:05:02Hospital last November.
0:05:02 > 0:05:04I was very sorry to hear about your fall,
0:05:04 > 0:05:08and you were on the floor for five days?
0:05:08 > 0:05:12Five days I was on the floor, love, for five days, and it was a really
0:05:12 > 0:05:13dark night.
0:05:13 > 0:05:15All me nose was bleeding and me mouth was bleeding.
0:05:15 > 0:05:17I had terrible scars on me hands trying
0:05:17 > 0:05:19to grab hold of the cabinet to get
0:05:19 > 0:05:21meself up off the floor, but I couldn't.
0:05:21 > 0:05:25I just had to lie there ? I was only banging on the walls for five days
0:05:25 > 0:05:34but nobody heard me, but, on the fifth day,
0:05:34 > 0:05:37somebody must have just heard me, and the next thing I knew the fire
0:05:37 > 0:05:40brigade had to smash all me door down and get me out.
0:05:40 > 0:05:44I was in a pretty bad way, wasn't I, love?
0:05:44 > 0:05:46You was, and look at you now.
0:05:46 > 0:05:48I was, love, in a bad way.
0:05:48 > 0:05:51Anastasia's been well enough to go home since January.
0:05:51 > 0:05:53She'll need four visits a day from carers.
0:05:53 > 0:05:59But finding that care package is proving difficult.
0:05:59 > 0:06:00There's currently about five people.
0:06:00 > 0:06:02Anastasia is one, that are still with us now.
0:06:02 > 0:06:04They've been here more than the 28 days,
0:06:04 > 0:06:07is on average the amount of time people spend with us.
0:06:07 > 0:06:10Some patients have been with us 12 and 14 weeks because all the therapy
0:06:10 > 0:06:12is complete but unfortunately there's no care package available
0:06:12 > 0:06:16at the end of it.
0:06:16 > 0:06:18Back at the home-care company in North Wales,
0:06:18 > 0:06:25there's a crisis looming.
0:06:25 > 0:06:27Is there a possibility please that you could help us out
0:06:27 > 0:06:28this evening at all?
0:06:28 > 0:06:30You can't?
0:06:30 > 0:06:30Right.
0:06:30 > 0:06:31OK.
0:06:31 > 0:06:35Thank you.
0:06:35 > 0:06:37A member of staff is sick and there's no-one to visit
0:06:37 > 0:06:42an elderly client this evening.
0:06:42 > 0:06:45We've been trying to cover this shift since Monday morning and we're
0:06:45 > 0:06:47having great difficulty due to lack of staff in area.
0:06:47 > 0:06:53Could you please get back to me once you've had this message?
0:06:53 > 0:06:55Time's running out to fill the shift
0:06:55 > 0:06:57but, after some frantic phone calls, they eventually find a member
0:06:57 > 0:07:03of staff to step in.
0:07:03 > 0:07:04We are caring for people's lives here.
0:07:04 > 0:07:05It's not just...
0:07:05 > 0:07:06you know, anybody.
0:07:06 > 0:07:09It's important that we do provide that professional care for them
0:07:09 > 0:07:19out in the community.
0:07:19 > 0:07:22Home-care companies across the UK say one of the biggest
0:07:22 > 0:07:28problems they face is recruiting and keeping carers.
0:07:28 > 0:07:31Staff at Cymordd Llaw are receiving training.
0:07:31 > 0:07:34The company says it's an important area to invest in,
0:07:34 > 0:07:37but sometimes that can back-fire.
0:07:37 > 0:07:39When they've attained such qualifications,
0:07:39 > 0:07:42they can quite easily walk into the local hospital
0:07:42 > 0:07:43as health care assistants.
0:07:43 > 0:07:46Yes, they are staying in care and, yes, they are doing a valuable
0:07:46 > 0:07:49job in the local hospitals but, of course, that leaves us
0:07:49 > 0:07:55short in the community.
0:07:55 > 0:07:57And the pay and conditions working for the health board are far,
0:07:57 > 0:08:00far better than what we can offer.
0:08:00 > 0:08:02Carers at the company ? where there are around
0:08:02 > 0:08:0430 staff vacancies - aren't just leaving
0:08:04 > 0:08:07to work in hospitals.
0:08:07 > 0:08:09We know the local supermarkets are paying considerably more
0:08:09 > 0:08:12in wages than what we can pay and of course when you work
0:08:12 > 0:08:15in a supermarket you're not putting 50, or 100 miles
0:08:15 > 0:08:19a week on your car travelling from village to village to see clients.
0:08:19 > 0:08:27You just go to the one venue, do your shift, and go home.
0:08:27 > 0:08:30Single mum Kirstie Jones worked as a carer for five years
0:08:30 > 0:08:36in the Prestatyn area of North Wales.
0:08:36 > 0:08:41Sometimes we were the only people they actually saw in day to talk to.
0:08:41 > 0:08:44You do become close to them ? I don't think you're
0:08:44 > 0:08:47human if you don't.
0:08:47 > 0:08:51It was hard work, but it was fulfilling.
0:08:51 > 0:08:53After gaining qualifications while working as a home carer,
0:08:53 > 0:09:02she got a job as a healthcare assistant at her local hospital.
0:09:02 > 0:09:04The pay was better, the hours were better.
0:09:04 > 0:09:05No wear and tear on my car.
0:09:05 > 0:09:07Don't get me wrong, I do miss the clients,
0:09:07 > 0:09:14but I definitely don't miss the hours.
0:09:14 > 0:09:16For carers still in the job, like Anne-Marie, they continue
0:09:16 > 0:09:23to do their best despite the many demands they face.
0:09:23 > 0:09:26It's eight o'clock starting and got four calls this morning.
0:09:26 > 0:09:27After three visits in Gwynedd, Anne-Marie
0:09:27 > 0:09:32is already behind schedule and calls the office.
0:09:32 > 0:09:33Hi, Teresa.
0:09:33 > 0:09:34It's Anne-Marie.
0:09:34 > 0:09:35All right?
0:09:35 > 0:09:39Can you give my 10am client a ring and let them know I'm running late
0:09:39 > 0:09:41for about 20 minutes?
0:09:41 > 0:09:44You got to do the personal care, got to do the breakfast,
0:09:44 > 0:09:47prepare lunch, sometimes just need to talk to you ? five
0:09:47 > 0:09:49minutes of your time ? but you've got to rush,
0:09:49 > 0:09:51in and out, in and out with them.
0:09:51 > 0:09:53So you feel a bit rude.
0:09:53 > 0:09:59Like her colleagues, Anne-Marie is on a zero hours' contract.
0:09:59 > 0:10:01Have you seen this, Ken?
0:10:01 > 0:10:05The company's been in business since 2000 but it's
0:10:05 > 0:10:08seen its profits fall over the last few years.
0:10:08 > 0:10:11What they do make, they plough back into the family business but say
0:10:11 > 0:10:19it's still not enough to increase wages.
0:10:19 > 0:10:21We pay as much as we possibly can and we've always paid
0:10:21 > 0:10:24above what was the national minimum wage and the national living wage.
0:10:24 > 0:10:27They get a mileage allowance, they get paid travelling time
0:10:27 > 0:10:32between their clients.
0:10:32 > 0:10:35As a company we are legally obliged to pay, you know, 1% pension,
0:10:35 > 0:10:3613.8% National Insurance and of course training
0:10:36 > 0:10:39and all the other things that go to employing a person.
0:10:39 > 0:10:44It doesn't leave a great deal.
0:10:44 > 0:10:46The company used to provide care for three
0:10:46 > 0:10:47councils in North Wales.
0:10:47 > 0:10:50But last year it stopped working with one ? Conwy ? which initially
0:10:50 > 0:10:58paid ?14.20 an hour for care.
0:10:58 > 0:11:01They then offered to raise that to ?15.00 but the company decided
0:11:01 > 0:11:06that still wasn't enough, so they handed back the contract.
0:11:06 > 0:11:09We didn't think we could provide this level of service for that
0:11:09 > 0:11:11amount of money that Conwy were offreing.
0:11:11 > 0:11:14We were very reluctant to leave, but we had to leave.
0:11:14 > 0:11:17It was as simple as that.
0:11:17 > 0:11:19Conwy Council says it's committed to supporting vulnerable
0:11:19 > 0:11:27people in communities, despite facing financial challenges.
0:11:27 > 0:11:29Conwy's not alone.
0:11:29 > 0:11:31Our research reveals that, across the UK,
0:11:31 > 0:11:33almost 100 councils have had home-care contracts
0:11:33 > 0:11:40handed back to them.
0:11:40 > 0:11:43?12.60 in the North East, ?12.95 in the North West.
0:11:43 > 0:11:45These are the average figures some councils pay companies per hour
0:11:45 > 0:11:47to provide home-care, according to the
0:11:47 > 0:11:51industry's trade body.
0:11:51 > 0:11:53It says many companies are really struggling.
0:11:53 > 0:11:56We have some really desperate providers, who really do not know
0:11:56 > 0:11:59whether they're going to be able to continue in business, um,
0:11:59 > 0:12:03beyond the next year.
0:12:03 > 0:12:05That means they're really having to make some hard,
0:12:05 > 0:12:07commercial decisions, whether they might need to cease
0:12:07 > 0:12:16trading or indeed just hand back work to local councils.
0:12:16 > 0:12:17Home-care company Mears is the second
0:12:17 > 0:12:20biggest in the industry.
0:12:20 > 0:12:23It used to have a contract with Liverpool City Council but
0:12:23 > 0:12:28handed it back last July, saying the ?13.10 an hour paid
0:12:28 > 0:12:34simply wasn't enough to cover their costs.
0:12:34 > 0:12:36That was a terrible thing to do both for service
0:12:36 > 0:12:37users and for care staff.
0:12:37 > 0:12:39We absolutely did not take that lightly but frankly
0:12:39 > 0:12:42what choice did we have?
0:12:42 > 0:12:45Mears says it needed at least ?15 an hour to provide
0:12:45 > 0:12:48the care expected of them, and like home-care companies
0:12:48 > 0:12:52across the UK, claims its costs are often greater than the amount
0:12:52 > 0:12:58councils are prepared to pay.
0:12:58 > 0:13:00We just cannot do the two most basic things
0:13:00 > 0:13:07that you need to do in homecare ? one, pay staff the absolute
0:13:07 > 0:13:10minimum of living wage and, two, be able to recruit people,
0:13:10 > 0:13:12enough people to deliver the service that Liverpool Council
0:13:12 > 0:13:22actually expected from us.
0:13:23 > 0:13:25Mears has also handed back contracts to two
0:13:25 > 0:13:28other English councils, with more in the pipeline.
0:13:28 > 0:13:30Over the last seven years, Liverpool City Council's budget
0:13:30 > 0:13:36has been cut by ?330 million.
0:13:36 > 0:13:39Now it has to find a further ?90 million over
0:13:39 > 0:13:43the next three years.
0:13:43 > 0:13:46Samih Kalekache is the outgoing director of adult social services.
0:13:46 > 0:13:50When Mears pulled out of the city, other providers managed to pick up
0:13:50 > 0:13:57the work but the pressure remains.
0:13:57 > 0:13:59It is concerning when the care provider is saying, "We can't
0:13:59 > 0:14:02maintain this level of care."
0:14:02 > 0:14:04Absolutely we could see that, and that's why ourselves,
0:14:04 > 0:14:07and all the directors nationally, are looking to address it.
0:14:07 > 0:14:10But, frankly, how could you address it when there are no resources
0:14:10 > 0:14:13coming from elsewhere?
0:14:13 > 0:14:18Most home care across the UK is provided by the private sector.
0:14:18 > 0:14:20Panorama has commissioned analysis of the financial state
0:14:20 > 0:14:26of Britain's 2,500 home-care companies.
0:14:26 > 0:14:28The research suggests that more than one in four of them
0:14:28 > 0:14:32are at risk of insolvency.
0:14:32 > 0:14:35The analysis also reveals growing numbers of home-care companies
0:14:35 > 0:14:39simply shutting up shop and walking away ? 69
0:14:39 > 0:14:44in the last three months alone.
0:14:44 > 0:14:46We've had 25 years of the market economy
0:14:46 > 0:14:50and I think everybody recognises the word often used
0:14:50 > 0:14:53is, 'we're in crisis'.
0:14:53 > 0:14:56I struggle to find a word that's one higher than crisis,
0:14:56 > 0:14:59I think, in a sense, we're probably at the point of near
0:14:59 > 0:15:05failure in the market.
0:15:05 > 0:15:06Oh, hi.
0:15:06 > 0:15:09It's Jo from Care Brokerage here.
0:15:09 > 0:15:12I was just wondering if you could let me know if you've
0:15:12 > 0:15:14got any capacity today, and if so in which postcode areas?
0:15:14 > 0:15:17If you could have a little look at it for me?
0:15:17 > 0:15:19Like many councils, Liverpool has a busy team constantly
0:15:19 > 0:15:22searching for carers.
0:15:22 > 0:15:22Nothing at all?
0:15:22 > 0:15:24All right then.
0:15:24 > 0:15:25Thank you.
0:15:25 > 0:15:27Bye.
0:15:27 > 0:15:30They're trying to find care packages for people at home and those
0:15:30 > 0:15:32in hospital waiting to leave.
0:15:32 > 0:15:36We're really desperate to get him out of hospital.
0:15:36 > 0:15:38But it's not easy.
0:15:38 > 0:15:40It's the staffing isn't it, basically.
0:15:40 > 0:15:43There's quick turnaround with that job, I think people do it and then
0:15:43 > 0:15:45they leave and then they're stuck.
0:15:45 > 0:15:49Yeah, like yesterday where a care provider had
0:15:49 > 0:15:52picked up a hospital case.
0:15:52 > 0:15:54It all been agreed.
0:15:54 > 0:15:58The gentleman was discharged from hospital at 9.30am yesterday,
0:15:58 > 0:16:02and then care provider got in touch called at 11am to say due to two
0:16:02 > 0:16:07staff resigning night before, they weren't able
0:16:07 > 0:16:09to provide the care.
0:16:09 > 0:16:16So it's a bit of a crisis situation.
0:16:16 > 0:16:18This gentleman was now at home.
0:16:18 > 0:16:20Family were there for now, weren't they?
0:16:20 > 0:16:21Yeah.
0:16:21 > 0:16:24They were going to try and organise a home visit.
0:16:24 > 0:16:26We've got a provisional offer from one provider,
0:16:26 > 0:16:28who's going to get back to us later today.
0:16:28 > 0:16:29So, fingers crossed.
0:16:29 > 0:16:31That provisional offer fell through.
0:16:31 > 0:16:34It took another two days to find a company able to take the case on.
0:16:34 > 0:16:37If they've got capacity, then obviously they want the work.
0:16:37 > 0:16:44There's too many people need care and not enough carers.
0:16:44 > 0:16:47It's the same picture in North Wales.
0:16:47 > 0:16:51Lovely, ta-ra, ta-ra, ta-ra.
0:16:51 > 0:16:55Menna's just got off the phone to Gwynedd Council.
0:16:55 > 0:16:58Its Social Services team is trying to find care packages for people
0:16:58 > 0:17:00waiting to leave hospital.
0:17:00 > 0:17:03There's a client at home here, waiting for care.
0:17:03 > 0:17:06There's another one still in hospital, waiting discharge.
0:17:06 > 0:17:09I requested an updated list of clients that are waiting to come
0:17:09 > 0:17:13out of hospital or are at home already that need care.
0:17:13 > 0:17:17I've given them availability of the hours that we can give them.
0:17:17 > 0:17:22Unfortunately, we cannot offer them the times that they request,
0:17:22 > 0:17:29as there's just no capacity at that time slot for any more clients.
0:17:29 > 0:17:32Menna recognises one of the patients, the same person
0:17:32 > 0:17:36was also on the waiting list for care last week.
0:17:36 > 0:17:39So what's happened to that person now, where is he or she?
0:17:39 > 0:17:40Still in hospital.
0:17:40 > 0:17:43That client will remain in hospital until a suitable
0:17:43 > 0:17:45time comes available.
0:17:45 > 0:17:47Bed-blocking.
0:17:47 > 0:17:50Bed-blocking.
0:17:50 > 0:17:53There are more than 6,500 people across Britain stuck
0:17:53 > 0:17:58in an acute hospital bed, despite being well enough to leave.
0:17:58 > 0:18:04In England, a third of these are waiting for a home care package.
0:18:04 > 0:18:05Hello.
0:18:05 > 0:18:07I'm back again.
0:18:07 > 0:18:1082-year-old Shirley Haughie has dementia.
0:18:10 > 0:18:13Her daughter Yvonne has come to visit.
0:18:13 > 0:18:15You don't think so?
0:18:15 > 0:18:17That's OK then, isn't it?
0:18:17 > 0:18:20Shirley was taken to Liverpool's Royal University
0:18:20 > 0:18:24hospital suffering from dehydration in early January, then transferred
0:18:24 > 0:18:27here to Broadgreen Hospital shortly afterwards.
0:18:27 > 0:18:30I am doing everything to get you home.
0:18:30 > 0:18:31She doesn't know where she is.
0:18:31 > 0:18:33It's a strange place.
0:18:33 > 0:18:37The confusion is just devastating.
0:18:37 > 0:18:39It's hard to sleep when you're in hospital, isn't it.
0:18:39 > 0:18:45Yeah, yeah.
0:18:47 > 0:18:51Yvonne's getting her mum's house ready for her return.
0:18:51 > 0:18:54Shirley's been well enough to leave hospital for nearly nine weeks.
0:18:54 > 0:19:00But difficulties finding her a care package are delaying the process.
0:19:00 > 0:19:01Hi, it's Yvonne here.
0:19:01 > 0:19:04You rang me earlier about the care package we're hoping to get
0:19:04 > 0:19:08in place for my mum.
0:19:08 > 0:19:11She's medically fit to come home and they want her to go home.
0:19:11 > 0:19:13She has been assessed by a social worker.
0:19:13 > 0:19:17Everything has been approved, the care she needs,
0:19:17 > 0:19:19what she requires.
0:19:19 > 0:19:21That's all been approved.
0:19:21 > 0:19:25Direct payments have been approved, now it's basically finding somebody
0:19:25 > 0:19:31who can provide that care, which is not as easy as it sounds.
0:19:31 > 0:19:33We're finding it really, really hard.
0:19:33 > 0:19:35You know, you think there's loads out there.
0:19:35 > 0:19:38It should be dead easy, but it isn't.
0:19:38 > 0:19:40It won't be long now.
0:19:40 > 0:19:42Yeah.
0:19:42 > 0:19:46OK?
0:19:46 > 0:19:50Pressure on council's social services departments across the UK
0:19:50 > 0:19:54is growing each year, as life expectancy increases.
0:19:54 > 0:19:57There are more than five million people over the age
0:19:57 > 0:19:59of 75 at the moment.
0:19:59 > 0:20:03There'll be two million more in ten years' time.
0:20:03 > 0:20:05The Granby Rehabilitation Centre in Liverpool is run
0:20:05 > 0:20:09by the City Council, to relieve pressure on the area's
0:20:09 > 0:20:19larger acute hospitals, but it too is full.
0:20:20 > 0:20:28We've had four referrals this morning
0:20:28 > 0:20:30There's only two beds.
0:20:30 > 0:20:32We're still under tremendous pressure to get as many patients
0:20:32 > 0:20:35home as possible from the patients at the Royal across to ourselves
0:20:35 > 0:20:36and get them reassessed.
0:20:36 > 0:20:38I think this week, the bed crisis, A was just chock-a-block.
0:20:38 > 0:20:40For Liverpool's director of adult social services,
0:20:40 > 0:20:41it's a familiar story.
0:20:41 > 0:20:42Chris, what's the status today?
0:20:42 > 0:20:44Today we've got 28 people in Aintree hospital,
0:20:44 > 0:20:47who are awaiting care packages or placements in care homes,
0:20:47 > 0:20:48or short-term care.
0:20:48 > 0:20:50We've got 45 people in the Royal hospital.
0:20:50 > 0:20:53Most of it is because there's quite lot of people waiting for care
0:20:53 > 0:20:55packages and beds in intermediate care or care homes.
0:20:55 > 0:20:59It's just a matter of trying to source those packages.
0:20:59 > 0:21:01Is there a crisis in the homecare services?
0:21:01 > 0:21:04I'd say yes, there is.
0:21:04 > 0:21:06And it's not just money.
0:21:06 > 0:21:10It's the sheer volume of demographics.
0:21:10 > 0:21:13We've got an ageing population, which we welcome, but we don't have
0:21:13 > 0:21:17enough people coming into the industry.
0:21:17 > 0:21:20It's estimated we'll need at least two million more
0:21:20 > 0:21:23carers in England alone, in both domiciliary care
0:21:23 > 0:21:31and care homes, to cope with the growing demand by 2025.
0:21:31 > 0:21:34Last October, the regulator in England, the Care Quality
0:21:34 > 0:21:38Commission, warned the home care sector was at a tipping point.
0:21:38 > 0:21:42Six months on, it says nothing has changed.
0:21:42 > 0:21:45The homecare sector continues to be a fragile sector.
0:21:45 > 0:21:55It continues to need to have a long-term,
0:21:56 > 0:22:02sustainable solution to the problems that it's got.
0:22:02 > 0:22:04We've carried out our own research that shows that
0:22:04 > 0:22:07one in four companies are at risk of insolvency.
0:22:07 > 0:22:09In some parts of England, it's as high as one in three.
0:22:09 > 0:22:10Does that surprise you?
0:22:10 > 0:22:13I'm afraid it does not surprise me that there are a number
0:22:13 > 0:22:15of services that are at risk.
0:22:15 > 0:22:16And we need those services to survive.
0:22:16 > 0:22:19We need those services to continue to provide good care.
0:22:19 > 0:22:22It is a real worry that the smaller services that are focusing
0:22:22 > 0:22:23on providing high quality person-centred care
0:22:23 > 0:22:26are finding it difficult.
0:22:26 > 0:22:29As pressure builds on the hospitals in Liverpool, carers employed
0:22:29 > 0:22:33by a council initiative called Homefirst are working flat
0:22:33 > 0:22:36out to free up beds, but even this service
0:22:36 > 0:22:38is under strain.
0:22:38 > 0:22:40Hiya, you alright?
0:22:40 > 0:22:42Yes.
0:22:42 > 0:22:44Homefirst carer Gail Bainbridge is helping 79-year-old
0:22:44 > 0:22:46Violet Hill, who's back home after a stay in hospital.
0:22:46 > 0:22:49Is it cold out?
0:22:49 > 0:22:51Yes, it's going cold now.
0:22:51 > 0:22:53Hospitals can discharge patients like Violet,
0:22:53 > 0:22:55if they know a Homefirst carer is free to help them
0:22:55 > 0:22:58regain their independence at home.
0:22:58 > 0:22:59What do you fancy for tea tonight?
0:22:59 > 0:23:02Chicken casserole.
0:23:02 > 0:23:04You go and do it then!
0:23:04 > 0:23:05Come on.
0:23:05 > 0:23:07Shall we go now then?
0:23:07 > 0:23:09Yes.
0:23:09 > 0:23:11No peace for the wicked, you know.
0:23:11 > 0:23:13Homefirst gives the council a breathing space to find
0:23:13 > 0:23:15a private care package.
0:23:15 > 0:23:17Ad the more independent Violet is, the less help she'll need.
0:23:17 > 0:23:20Sometimes I'm already dressed, sometimes they give me
0:23:20 > 0:23:22a hand at getting dressed or having a shower.
0:23:22 > 0:23:24I've gotta be have someone in the shower room with me,
0:23:24 > 0:23:28because I'm terrified in case I slip.
0:23:28 > 0:23:30Can't grumble with them at all.
0:23:30 > 0:23:32They're lovely girls, honestly.
0:23:32 > 0:23:34We have a laugh, yes.
0:23:34 > 0:23:38I wish they could stay longer.
0:23:38 > 0:23:41Hello Homefirst team, can I help you?
0:23:41 > 0:23:48Demand from the local hospitals is overwhelming.
0:23:48 > 0:23:51Right, we'll be able to take it, but wouldn't be able
0:23:51 > 0:23:51to start till Monday.
0:23:51 > 0:23:54We haven't got that in that area, I'm afraid, Jen, no.
0:23:54 > 0:23:57But Liverpool's latest effort to free up hospital beds is again
0:23:57 > 0:24:00hindered by the shortage of home care workers in the private sector.
0:24:00 > 0:24:03No capacity, sorry.
0:24:03 > 0:24:09The longer it takes to find private home care for people like Violet,
0:24:09 > 0:24:13the less space Homefirst has to take on someone new.
0:24:13 > 0:24:16Violet has been with us since October, and she is
0:24:16 > 0:24:18on our list of long-term people, you know.
0:24:18 > 0:24:22She requires a long-term package of care, and it can't be sourced.
0:24:22 > 0:24:24So we keep them.
0:24:24 > 0:24:26Of course, that blocks us then, because we can't
0:24:26 > 0:24:28take anybody else on.
0:24:28 > 0:24:30No, I didn't like that at all, Gail.
0:24:30 > 0:24:32Do you want anything else instead?
0:24:32 > 0:24:35No, not at the moment, might have something later on.
0:24:35 > 0:24:37Have a bit of toast later on, yeah?
0:24:37 > 0:24:42Yeah, bit of cake or something!
0:24:42 > 0:24:45Hello, Cymorth Llaw.
0:24:45 > 0:24:47Back in North Wales, and with the demands
0:24:47 > 0:24:49on her carers increasing, Menna feels they're not
0:24:49 > 0:24:53always valued by society.
0:24:53 > 0:24:57These carers work long hours, unsociable hours.
0:24:57 > 0:25:02They go out in all weathers, weather it's snow, hurricane wind.
0:25:02 > 0:25:04They're out in it.
0:25:04 > 0:25:06How are you, Maggie?
0:25:06 > 0:25:08I don't think care is a recognised profession.
0:25:08 > 0:25:10I think ? oh, somebody's got to do it.
0:25:10 > 0:25:17That career has got the right to be respected.
0:25:17 > 0:25:18Just like any other job out there.
0:25:18 > 0:25:21We need to make sure that we are valuing and recognising
0:25:21 > 0:25:23that these are difficult jobs, but they are incredibly rewarding
0:25:23 > 0:25:26and fulfilling jobs as well.
0:25:26 > 0:25:30But we can't just rely on people's commitment and dedication.
0:25:30 > 0:25:33We have to make sure that we're supporting them properly and we're
0:25:33 > 0:25:39rewarding them appropriately.
0:25:39 > 0:25:44The UK Government has announced ?2 billion extra for social care
0:25:44 > 0:25:48for English councils over the next three years.
0:25:48 > 0:25:51Scotland, Northern Ireland and Wales will decide themselves how
0:25:51 > 0:25:55they spend their extra funding.
0:25:55 > 0:25:58But the industry says that with an increasingly ageing
0:25:58 > 0:26:04population, it's just not enough to keep pace with demand.
0:26:04 > 0:26:07I don't think that the people who make these decisions
0:26:07 > 0:26:12actually realise what goes on in the community.
0:26:12 > 0:26:15For instance, has the Minister of Health ever been out on a wet,
0:26:15 > 0:26:18windy night in the middle of Anglesey with a home career
0:26:18 > 0:26:22at 9pm knocking on somebody's door to go in to put them to bed?
0:26:22 > 0:26:25I don't think so.
0:26:25 > 0:26:28The UK Government declined an interview, but in a statement,
0:26:28 > 0:26:33said it has given English councils a total of ?9.25 billion
0:26:33 > 0:26:35to fund social care.
0:26:35 > 0:26:39It says it will be bringing forward proposals later this year to ensure
0:26:39 > 0:26:44a more financially sustainable social care system.
0:26:44 > 0:26:49Liverpool City council will receive an extra ?27 million,
0:26:49 > 0:26:52following this month's Budget announcement, but like many
0:26:52 > 0:26:57struggling councils, they say it's too little, too late.
0:26:57 > 0:27:01I've been given a sticking plaster, after two to three years,
0:27:01 > 0:27:05if the system doesn't change, I don't think we'll
0:27:05 > 0:27:08be able to maintain the services the way they are.
0:27:08 > 0:27:13It makes me feel very angry, that we cannot provide the care
0:27:13 > 0:27:16which should be available.
0:27:16 > 0:27:18Instead, wer'e having to prioritise.
0:27:18 > 0:27:21Is that a service which I want?
0:27:21 > 0:27:22Definitely not.
0:27:22 > 0:27:27But what else can I do?
0:27:27 > 0:27:32For Anastasia in Liverpool, the waiting is at an end.
0:27:32 > 0:27:38# We'll meet again some sunny day #.
0:27:38 > 0:27:42After being here since November, carers have finally been found
0:27:42 > 0:27:45to help her at home.
0:27:45 > 0:27:48For Shirley, until a care package can be put in place,
0:27:48 > 0:27:52the wait goes on in hospital.
0:27:52 > 0:27:57And in North Wales, it's the end of the working day for Amanda.
0:27:57 > 0:28:01And she's back at William Williams' house to get him ready for bed.
0:28:01 > 0:28:02Hello.
0:28:02 > 0:28:03How are we?
0:28:03 > 0:28:05Still here.
0:28:05 > 0:28:07Still here, well that's a good.
0:28:07 > 0:28:13Her day began at 8am, over 12 hours ago.
0:28:13 > 0:28:16I like my job and I feel good about myself, when I've given
0:28:16 > 0:28:18them that care as well.
0:28:18 > 0:28:22I know I've done everything right and that they're tucked up in bed
0:28:22 > 0:28:24and the doors locked.
0:28:24 > 0:28:30And there we go until the next morning.
0:28:30 > 0:28:32With more of us living longer and a growing
0:28:32 > 0:28:35shortage of care-workers, is time running out
0:28:35 > 0:28:42to find a solution to Britain's home-care crisis?