Britain's Home-Care Crisis Panorama

Tonight, home-care companies in crisis because they can't

recruit enough staff.

I have sleepless nights because I worry.

We are physically not being able to fit them

in on the carers rotas.

Good morning.

We meet hard-pressed carers on zero-hours contracts.

It is hard.

Because I didn't have a contract, they wouldn't

allow me to buy a house, or anything like that.

We discover nearly 100 councils have had home-care contracts

handed back to them.

That was a terrible thing to do, both for service

users and for care staff.

Frankly, what choice did we have?

The nationwide shortage of carers means people are stuck in hospital,

blocking precious beds.

It won't be long now, so I am doing everything to get you home.

The Government's just promised more money for social care,

but is it too little, too late?

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

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

The Llyn peninsula in north Wales.

It's eight o'clock in the morning, and home-carer Amanda

is beginning her working day.

Her first call is in Pwllheli.

Good morning!

Have you got your bleeper on?

My bleeper, why?

What bleeping time do you call this?

Amanda's one of the UK's 800,000 home-care

workers, helping the elderly and disabled live

independent lives at home.

Today, she's with former teacher William Williams,

who has multiple sclerosis.

It's just nice knowing that I could go out there

and help other people and make sure that they're safe

in their own home, and that they can actually stay home, and live

at home in their own house, and don't have to go into care

or anything like that.

I'm 72, remember.

I haven't got much time left!

We have!

Many years to go again!

The girls, I have to admit, are terrific.

Absolutely terrific.

They're caring, they're understanding

and they're full of fun.

Like many carers, Amanda struggles to make ends meet.

She's paid ?7.55 an hour, just above the national living wage,

but she's on a zero hours contract, which means the hours

she works are not guaranteed.

I did look into buying a house four years ago,

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

a house, or anything like that.

It's hard, it is hard.

You see your friends out every weekend, going

for supper with each other.

It's just like "No, I can't come."

Try and be a little earlier than this morning, will you?

I'll be sat in the car, waiting!

Ta-ra, Will!

It's really a hard day's work really.

With working out in the community.

You could work from 7.30am straight through to 10pm but you do get

breaks in that time.

But I could see up to about 10, 11 people a day.

Amanda is one of 200 staff at a family-run care company

near Bangor in Gwynedd.

Hello.

Cymorth Llaw.

Cymorth llaw, which means Helping Hand,

is paid by local councils to provide home care.

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

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

worked here for 14 years.

The change in that time, the sense of recruiting ?

for the last two years recruitment has been phenomenally

hard out there.

Have you got blank rotas I can have, please?

Menna's trying to juggle the staff rota.

There are gaps that need covering.

She's also trying to find carers for new clients.

Due to staffing availability, and the hours of care

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

rotas, unfortunately.

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

And how does it make you feel in those situations?

I have sleepless nights because I worry.

Across the water in Liverpool, and the pressures are the same.

A shortage of care workers means it's difficult

to get people who've been in hospital back home.

This way?

Yes.

Bad leg up?

Yes.

Bad leg up.

86-year-old Anastasia O'Leary was transferred to the Granby

Rehabilitation Unit from the city's Royal Liverpool University

Hospital last November.

I was very sorry to hear about your fall,

and you were on the floor for five days?

Five days I was on the floor, love, for five days, and it was a really

dark night.

All me nose was bleeding and me mouth was bleeding.

I had terrible scars on me hands trying

to grab hold of the cabinet to get

meself up off the floor, but I couldn't.

I just had to lie there ? I was only banging on the walls for five days

but nobody heard me, but, on the fifth day,

somebody must have just heard me, and the next thing I knew the fire

brigade had to smash all me door down and get me out.

I was in a pretty bad way, wasn't I, love?

You was, and look at you now.

I was, love, in a bad way.

Anastasia's been well enough to go home since January.

She'll need four visits a day from carers.

But finding that care package is proving difficult.

There's currently about five people.

Anastasia is one, that are still with us now.

They've been here more than the 28 days,

is on average the amount of time people spend with us.

Some patients have been with us 12 and 14 weeks because all the therapy

is complete but unfortunately there's no care package available

at the end of it.

Back at the home-care company in North Wales,

there's a crisis looming.

Is there a possibility please that you could help us out

this evening at all?

You can't?

Right.

OK.

Thank you.

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

an elderly client this evening.

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

having great difficulty due to lack of staff in area.

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

Time's running out to fill the shift

but, after some frantic phone calls, they eventually find a member

of staff to step in.

We are caring for people's lives here.

It's not just...

you know, anybody.

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

out in the community.

Home-care companies across the UK say one of the biggest

problems they face is recruiting and keeping carers.

Staff at Cymordd Llaw are receiving training.

The company says it's an important area to invest in,

but sometimes that can back-fire.

When they've attained such qualifications,

they can quite easily walk into the local hospital

as health care assistants.

Yes, they are staying in care and, yes, they are doing a valuable

job in the local hospitals but, of course, that leaves us

short in the community.

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

far better than what we can offer.

Carers at the company ? where there are around

30 staff vacancies - aren't just leaving

to work in hospitals.

We know the local supermarkets are paying considerably more

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

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

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

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

Single mum Kirstie Jones worked as a carer for five years

in the Prestatyn area of North Wales.

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

You do become close to them ? I don't think you're

human if you don't.

It was hard work, but it was fulfilling.

After gaining qualifications while working as a home carer,

she got a job as a healthcare assistant at her local hospital.

The pay was better, the hours were better.

No wear and tear on my car.

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

but I definitely don't miss the hours.

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

to do their best despite the many demands they face.

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

After three visits in Gwynedd, Anne-Marie

is already behind schedule and calls the office.

Hi, Teresa.

It's Anne-Marie.

All right?

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

for about 20 minutes?

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

prepare lunch, sometimes just need to talk to you ? five

minutes of your time ? but you've got to rush,

in and out, in and out with them.

So you feel a bit rude.

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

Have you seen this, Ken?

The company's been in business since 2000 but it's

seen its profits fall over the last few years.

What they do make, they plough back into the family business but say

it's still not enough to increase wages.

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

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

They get a mileage allowance, they get paid travelling time

between their clients.

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

13.8% National Insurance and of course training

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

It doesn't leave a great deal.

The company used to provide care for three

councils in North Wales.

But last year it stopped working with one ? Conwy ? which initially

paid ?14.20 an hour for care.

They then offered to raise that to ?15.00 but the company decided

that still wasn't enough, so they handed back the contract.

We didn't think we could provide this level of service for that

amount of money that Conwy were offreing.

We were very reluctant to leave, but we had to leave.

It was as simple as that.

Conwy Council says it's committed to supporting vulnerable

people in communities, despite facing financial challenges.

Conwy's not alone.

Our research reveals that, across the UK,

almost 100 councils have had home-care contracts

handed back to them.

?12.60 in the North East, ?12.95 in the North West.

These are the average figures some councils pay companies per hour

to provide home-care, according to the

industry's trade body.

It says many companies are really struggling.

We have some really desperate providers, who really do not know

whether they're going to be able to continue in business, um,

beyond the next year.

That means they're really having to make some hard,

commercial decisions, whether they might need to cease

trading or indeed just hand back work to local councils.

Home-care company Mears is the second

biggest in the industry.

It used to have a contract with Liverpool City Council but

handed it back last July, saying the ?13.10 an hour paid

simply wasn't enough to cover their costs.

That was a terrible thing to do both for service

users and for care staff.

We absolutely did not take that lightly but frankly

what choice did we have?

Mears says it needed at least ?15 an hour to provide

the care expected of them, and like home-care companies

across the UK, claims its costs are often greater than the amount

councils are prepared to pay.

We just cannot do the two most basic things

that you need to do in homecare ? one, pay staff the absolute

minimum of living wage and, two, be able to recruit people,

enough people to deliver the service that Liverpool Council

actually expected from us.

Mears has also handed back contracts to two

other English councils, with more in the pipeline.

Over the last seven years, Liverpool City Council's budget

has been cut by ?330 million.

Now it has to find a further ?90 million over

the next three years.

Samih Kalekache is the outgoing director of adult social services.

When Mears pulled out of the city, other providers managed to pick up

the work but the pressure remains.

It is concerning when the care provider is saying, "We can't

maintain this level of care."

Absolutely we could see that, and that's why ourselves,

and all the directors nationally, are looking to address it.

But, frankly, how could you address it when there are no resources

coming from elsewhere?

Most home care across the UK is provided by the private sector.

Panorama has commissioned analysis of the financial state

of Britain's 2,500 home-care companies.

The research suggests that more than one in four of them

are at risk of insolvency.

The analysis also reveals growing numbers of home-care companies

simply shutting up shop and walking away ? 69

in the last three months alone.

We've had 25 years of the market economy

and I think everybody recognises the word often used

is, 'we're in crisis'.

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

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

failure in the market.

Oh, hi.

It's Jo from Care Brokerage here.

I was just wondering if you could let me know if you've

got any capacity today, and if so in which postcode areas?

If you could have a little look at it for me?

Like many councils, Liverpool has a busy team constantly

searching for carers.

Nothing at all?

All right then.

Thank you.

Bye.

They're trying to find care packages for people at home and those

in hospital waiting to leave.

We're really desperate to get him out of hospital.

But it's not easy.

It's the staffing isn't it, basically.

There's quick turnaround with that job, I think people do it and then

they leave and then they're stuck.

Yeah, like yesterday where a care provider had

picked up a hospital case.

It all been agreed.

The gentleman was discharged from hospital at 9.30am yesterday,

and then care provider got in touch called at 11am to say due to two

staff resigning night before, they weren't able

to provide the care.

So it's a bit of a crisis situation.

This gentleman was now at home.

Family were there for now, weren't they?

Yeah.

They were going to try and organise a home visit.

We've got a provisional offer from one provider,

who's going to get back to us later today.

So, fingers crossed.

That provisional offer fell through.

It took another two days to find a company able to take the case on.

If they've got capacity, then obviously they want the work.

There's too many people need care and not enough carers.

It's the same picture in North Wales.

Lovely, ta-ra, ta-ra, ta-ra.

Menna's just got off the phone to Gwynedd Council.

Its Social Services team is trying to find care packages for people

waiting to leave hospital.

There's a client at home here, waiting for care.

There's another one still in hospital, waiting discharge.

I requested an updated list of clients that are waiting to come

out of hospital or are at home already that need care.

I've given them availability of the hours that we can give them.

Unfortunately, we cannot offer them the times that they request,

as there's just no capacity at that time slot for any more clients.

Menna recognises one of the patients, the same person

was also on the waiting list for care last week.

So what's happened to that person now, where is he or she?

Still in hospital.

That client will remain in hospital until a suitable

time comes available.

Bed-blocking.

Bed-blocking.

There are more than 6,500 people across Britain stuck

in an acute hospital bed, despite being well enough to leave.

In England, a third of these are waiting for a home care package.

Hello.

I'm back again.

82-year-old Shirley Haughie has dementia.

Her daughter Yvonne has come to visit.

You don't think so?

That's OK then, isn't it?

Shirley was taken to Liverpool's Royal University

hospital suffering from dehydration in early January, then transferred

here to Broadgreen Hospital shortly afterwards.

I am doing everything to get you home.

She doesn't know where she is.

It's a strange place.

The confusion is just devastating.

It's hard to sleep when you're in hospital, isn't it.

Yeah, yeah.

Yvonne's getting her mum's house ready for her return.

Shirley's been well enough to leave hospital for nearly nine weeks.

But difficulties finding her a care package are delaying the process.

Hi, it's Yvonne here.

You rang me earlier about the care package we're hoping to get

in place for my mum.

She's medically fit to come home and they want her to go home.

She has been assessed by a social worker.

Everything has been approved, the care she needs,

what she requires.

That's all been approved.

Direct payments have been approved, now it's basically finding somebody

who can provide that care, which is not as easy as it sounds.

We're finding it really, really hard.

You know, you think there's loads out there.

It should be dead easy, but it isn't.

It won't be long now.

Yeah.

OK?

Pressure on council's social services departments across the UK

is growing each year, as life expectancy increases.

There are more than five million people over the age

of 75 at the moment.

There'll be two million more in ten years' time.

The Granby Rehabilitation Centre in Liverpool is run

by the City Council, to relieve pressure on the area's

larger acute hospitals, but it too is full.

We've had four referrals this morning

There's only two beds.

We're still under tremendous pressure to get as many patients

home as possible from the patients at the Royal across to ourselves

and get them reassessed.

I think this week, the bed crisis, A was just chock-a-block.

For Liverpool's director of adult social services,

it's a familiar story.

Chris, what's the status today?

Today we've got 28 people in Aintree hospital,

who are awaiting care packages or placements in care homes,

or short-term care.

We've got 45 people in the Royal hospital.

Most of it is because there's quite lot of people waiting for care

packages and beds in intermediate care or care homes.

It's just a matter of trying to source those packages.

Is there a crisis in the homecare services?

I'd say yes, there is.

And it's not just money.

It's the sheer volume of demographics.

We've got an ageing population, which we welcome, but we don't have

enough people coming into the industry.

It's estimated we'll need at least two million more

carers in England alone, in both domiciliary care

and care homes, to cope with the growing demand by 2025.

Last October, the regulator in England, the Care Quality

Commission, warned the home care sector was at a tipping point.

Six months on, it says nothing has changed.

The homecare sector continues to be a fragile sector.

It continues to need to have a long-term,

sustainable solution to the problems that it's got.

We've carried out our own research that shows that

one in four companies are at risk of insolvency.

In some parts of England, it's as high as one in three.

Does that surprise you?

I'm afraid it does not surprise me that there are a number

of services that are at risk.

And we need those services to survive.

We need those services to continue to provide good care.

It is a real worry that the smaller services that are focusing

on providing high quality person-centred care

are finding it difficult.

As pressure builds on the hospitals in Liverpool, carers employed

by a council initiative called Homefirst are working flat

out to free up beds, but even this service

is under strain.

Hiya, you alright?

Yes.

Homefirst carer Gail Bainbridge is helping 79-year-old

Violet Hill, who's back home after a stay in hospital.

Is it cold out?

Yes, it's going cold now.

Hospitals can discharge patients like Violet,

if they know a Homefirst carer is free to help them

regain their independence at home.

What do you fancy for tea tonight?

Chicken casserole.

You go and do it then!

Come on.

Shall we go now then?

Yes.

No peace for the wicked, you know.

Homefirst gives the council a breathing space to find

a private care package.

Ad the more independent Violet is, the less help she'll need.

Sometimes I'm already dressed, sometimes they give me

a hand at getting dressed or having a shower.

I've gotta be have someone in the shower room with me,

because I'm terrified in case I slip.

Can't grumble with them at all.

They're lovely girls, honestly.

We have a laugh, yes.

I wish they could stay longer.

Hello Homefirst team, can I help you?

Demand from the local hospitals is overwhelming.

Right, we'll be able to take it, but wouldn't be able

to start till Monday.

We haven't got that in that area, I'm afraid, Jen, no.

But Liverpool's latest effort to free up hospital beds is again

hindered by the shortage of home care workers in the private sector.

No capacity, sorry.

The longer it takes to find private home care for people like Violet,

the less space Homefirst has to take on someone new.

Violet has been with us since October, and she is

on our list of long-term people, you know.

She requires a long-term package of care, and it can't be sourced.

So we keep them.

Of course, that blocks us then, because we can't

take anybody else on.

No, I didn't like that at all, Gail.

Do you want anything else instead?

No, not at the moment, might have something later on.

Have a bit of toast later on, yeah?

Yeah, bit of cake or something!

Hello, Cymorth Llaw.

Back in North Wales, and with the demands

on her carers increasing, Menna feels they're not

always valued by society.

These carers work long hours, unsociable hours.

They go out in all weathers, weather it's snow, hurricane wind.

They're out in it.

How are you, Maggie?

I don't think care is a recognised profession.

I think ? oh, somebody's got to do it.

That career has got the right to be respected.

Just like any other job out there.

We need to make sure that we are valuing and recognising

that these are difficult jobs, but they are incredibly rewarding

and fulfilling jobs as well.

But we can't just rely on people's commitment and dedication.

We have to make sure that we're supporting them properly and we're

rewarding them appropriately.

The UK Government has announced ?2 billion extra for social care

for English councils over the next three years.

Scotland, Northern Ireland and Wales will decide themselves how

they spend their extra funding.

But the industry says that with an increasingly ageing

population, it's just not enough to keep pace with demand.

I don't think that the people who make these decisions

actually realise what goes on in the community.

For instance, has the Minister of Health ever been out on a wet,

windy night in the middle of Anglesey with a home career

at 9pm knocking on somebody's door to go in to put them to bed?

I don't think so.

The UK Government declined an interview, but in a statement,

said it has given English councils a total of ?9.25 billion

to fund social care.

It says it will be bringing forward proposals later this year to ensure

a more financially sustainable social care system.

Liverpool City council will receive an extra ?27 million,

following this month's Budget announcement, but like many

struggling councils, they say it's too little, too late.

I've been given a sticking plaster, after two to three years,

if the system doesn't change, I don't think we'll

be able to maintain the services the way they are.

It makes me feel very angry, that we cannot provide the care

which should be available.

Instead, wer'e having to prioritise.

Is that a service which I want?

Definitely not.

But what else can I do?

For Anastasia in Liverpool, the waiting is at an end.

# We'll meet again some sunny day #.

After being here since November, carers have finally been found

to help her at home.

For Shirley, until a care package can be put in place,

the wait goes on in hospital.

And in North Wales, it's the end of the working day for Amanda.

And she's back at William Williams' house to get him ready for bed.

Hello.

How are we?

Still here.

Still here, well that's a good.

Her day began at 8am, over 12 hours ago.

I like my job and I feel good about myself, when I've given

them that care as well.

I know I've done everything right and that they're tucked up in bed

and the doors locked.

And there we go until the next morning.

With more of us living longer and a growing

shortage of care-workers, is time running out

to find a solution to Britain's home-care crisis?