Is it ‘far right’ to expect decent standards of care?

 

There have recently (August 2024) been protests and indeed violent disturbances apparently because of issues involving migrants. I’m not going to delve into the issues that the mainstream media, and politicians, have been discussing; Viv and I have personal, recent, experience of the effectiveness of overseas recruits working in close contact with the public in England.  

I have revised this post in case anything I had initially written could possibly have been misunderstood. That I should feel it necessary to do this at 3.30 on a Saturday morning is a sad reflection on modern society. 

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For years we’ve heard of a ‘social care crisis’: there aren’t enough care workers to fulfil demand; hospitals won’t discharge patients unless care is arranged for them, and the health and care aspect of the welfare state is gradually grinding to a halt. Viv and I have been ‘service users’ (that’s what they call beneficiaries of social care) on and off for the last seven years, all related to Viv’s medical conditions. We had carers helping us for a year or so in 2017/18 and were, generally, very happy with what they did for us; recently we engaged a different care agency with the objective of giving Viv more interaction with people other than me, and freeing me up so I could go out and do things on my own while a competent carer was around Viv to help her with anything she needed. However, we recently decided to let this carer go; the reason we gave the agency was that the DWP had stopped Viv’s PIP (which was true), but in fact we could just about have afforded to keep her on - perhaps with reduced hours - but she did not provide good value for money. 

Our experiences of the changes in the quality of service delivered by care agencies over recent years are probably far from unique. Politicians make much of ‘social care’ and what they’d like to do about it, but they are too distant from the problem. Indeed, few people in work of any sort, let alone a role of power or influence, really know what it is like to deal with the sector, which is blamed for seemingly never ending increases in council tax charges, and used as an excuse for significant failings in other parts of the public sector - health and local government being two - because they don't have day to day contact with a carer, they are too remote from the problem. Viv's and my experience is that standards have fallen significantly; and, as to why we think this, you’ll need to read on.

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Back in 2017, the carers we had working for us were mostly highly motivated - they would arrive, ask us how we were, and get on with things right away. They did not need us to tell them what to do. They were experienced, they had been given appropriate training. They could communicate with us well - we could understand them, and they clearly understood us. They did not require managing or directing. With one or two exceptions, they did their job very well. And they cost £18 per hour.

In 2024 all that has changed. We all know the background: the care sector had been struggling with recruitment for years, but the way the staff were treated during Covid was disgraceful. 100,000 went to work in other sectors rather than being given a ‘safe and effective’ vaccine that was later shown to sometimes cause brain injury, heart issues or immune system problems. The governing elite’s response to the resulting shortage of carers has been to look to immigration to fill the gap, and recruits from many countries have indeed been encouraged to travel here to work as carers. Our experience of this ‘elite’ solution to our recent care needs has been very much less than satisfactory, to say the least. 

The carer we had assigned to us this year had come from overseas recently, and, I'm afraid, needed a lot of encouragement to do just about anything. Her normal routine would be to arrive while we were still having breakfast, then plonk herself down on the sofa and look at her phone for twenty minutes while we finished eating. She did not initiate anything - we had to ask her to do even mundane things; she would do cleaning, but only on one of the two days a week she came to us, and then she would do what she considered to be required: she never dusted, or hoovered under the cushions on the sofa, and was most put out when Viv asked her to do the windowsill and shelves in our ensuite. She would help Viv with some exercises, but only ones she understood: the idea of specific exercises for rehab seemed to be beyond her comprehension. She didn’t appear to have been given much training in what it means to be a carer: she seemed unaware that we were paying for her time, seemed to have no idea of what it means to provide a service to a customer, and clearly felt under no pressure to be busy for the whole four or six hour period that she was here each week. (It was four hours on Wednesdays, and six on Fridays).  Whenever she had finished her immediate task she would return to the sofa and pick up her phone until we asked her to do something else; there was no apparent sign of her having any pride whatsoever in what she did.  

Out of those ten hours, she was probably busy for no more than five each week.

A couple of times Viv asked her to go to the shops with her, and was amazed that she had little understanding of many of the products on sale, asking Viv about them as the two of them walked by the shelves. On the way home once she asked what the metal grid on the road by the kerb was; Viv had to try to explain the basics of drainage systems to her. They clearly didn’t have drains where she came from - which may not appear important until you realise that a carer has to be able to take action if something happens, and if Viv had caught her ankle in a drain on the way back from the shops, not knowing what it was could have made getting help more difficult. 

Viv had to ask our carer to get her a drink when she was thirsty - and Viv is not very forward in such things. Often it fell to me to prompt Viv and then arrange the drink, and it always fell to me to arrange Viv’s lunch. Our carer didn’t seem to realise that the old, and vulnerable, need to be offered food in the middle of the day, let alone given encouragement to eat it. Twice I was out until the early afternoon and left Viv with the carer; Viv went without lunch both days. That’s right, a ‘carer’ let a ‘service user’ go without a meal. Something was definitely amiss with her training.

Our carer was reluctant to get involved with Viv’s medication; that I understood and agreed to, but I had never intended it to include eye drops. Viv needs drops in her eyes when they get dry, but either Viv had to do it herself (which she always struggles to do) or I had to do it. What on earth were we paying the agency for?

Her caring skills also came into question when we noticed how she would sometimes watch Viv going up our stairs; she would watch from the bottom while Viv made her way up. That left her in a great place to watch Viv fall, if that was going to happen. She should have been right behind Viv, to prevent her falling if she did slip, and I did demonstrate that to her on at least one occasion.

Our carer did do our ironing, that is, until we did some ourselves and found a significant amount of melted nylon on the base plate of the iron - and realised that a couple of items of our clothing were nowhere to be found. It would seem that she had not fully understood the ironing instructions on garments and had set the iron too hot for something. She never said anything about it, if she had admitted to a problem we wouldn’t have minded, and surely her training should have made her aware of the need to be open and honest about problems.

Communication with our carer was a huge problem. She spoke very softly; not good when both Viv and I have hearing issues - I have visible hearing aids, and Viv’s total deafness in one ear were clearly mentioned to the manager when Viv was assessed. Again, our carer should have been prepared for this in her training. She also had a very pronounced accent, and English wasn't her first language. On many occasions neither Viv nor I could understand what she was saying, and I wasn’t entirely sure that she understood what I was saying either. A carer who cannot communicate with their ‘service user’ is a liability; I felt reluctant to leave Viv on her own with her for long, which rather negated one of the main reasons for us having a carer in the first place.

For much of the time we had the carer this year, Viv and I found ourselves having to plan Viv’s day to fit in with the carer: what could we ask her to do, what was.within her capabilities, what did we need to do to prepare. That’s not what we had been looking for or were prepared to do. Most weeks we struggled to find things to use our carer's time, and she did not volunteer any ideas; she preferred sitting on the sofa staring at her phone to engaging with and helping the person she was being paid to look after. Some rest time was expected, but not excluding any attempt at conversation with Viv. In all, we felt as if we had to put ourselves out to accommodate her; and, of course, we were paying for her time. Not a token amount either, a full £28 per hour. I understand that the carer was getting at least half of that, plus travel expenses. Was she worth £28 per hour to us? No, we decided, and that’s why we dispensed with her services.

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Our story is no doubt being played out thousands of times over up and down the country. The shortage of carers, and high minimum wage levels, have driven up the cost of care; the use of poorly-skilled recruits to meet the demand is drastically reducing the quality of service delivered. Viv and I are lucky: we do not actually need a carer on a daily basis, only for respite. Anyone who has the misfortune to have been assessed by social services as requiring regular care support will not be so lucky, and may find themselves having to put up with expensive, rubbish service, and seeing their savings depleted at an alarming rate as a result. And of course, in other cases the cost is not borne privately but by council tax payers - yes, that’s why your council tax bill goes up every year!

It's not just social care that’s affected. We’ve all, I think, experienced dealing with someone in the NHS who doesn’t understand us when we speak, or we don’t understand them, and we are left wondering whether they actually understand what their colleagues are telling them about a patient’s needs. The elite fail to understand how technical teams work, and the importance of effective communication. A migrant, unfamiliar with England, the English, our rules and customs, and unable to properly speak or follow spoken English is not up to delivering the service that we need from them.  They should be trained and brought up to standard before they are required to take on the responsibility of looking after a vulnerable person; unfortunately, our politicians, eager for quick fixes, don’t see that.

Moreover, the problem isn’t one of racism, fascism, or discrimination: it’s a fundamental failure on the part of the politicians to understand how people of different backgrounds can work together properly, how they integrate to form a successful team. And integration of an individual within a team is not the responsibility of the individual: it is the responsibility of the organiser, the manager, the commissioning organisation; the care agency, in our case, maybe the NHS for those recruited to work in hospitals; ultimately, from a national perspective, the government.

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What can be done about it? Singing ‘we want our country back’, as protesters do, articulates the problem well, but it's too late. The globalism-obsessed elite have messed things up, and, in a state of total denial, are proceeding to make matters worse by calling anyone critical of UK immigration policy ‘far right’, and worse. 

Three things could be done immediately. Firstly, there should be an implementation of compulsory English language tests, encompassing verbal comprehension, spoken and written language for all new recruits working in public service (private or state sector), including health and social care, and these tests should be considered essential for all recruits from non-anglophone countries (possibly, to avoid doubt, for anyone not having a UK GCSE English pass - in my working life I had problems with one team member whose poor understanding of spoken UK English meant he could not follow what was said in meetings). Secondly, there should be a requirement for all licensed care agencies and NHS Trusts to ensure their new recruits are trained in all relevant matters, including language skills, before unleashing them on ‘service users’, so that the users receive a decent level of service: in our case, for instance, there were many things we couldn’t trust our carer to do, even (as mentioned) use our iron. Someone being charged out at £28 per hour shouldn’t need to be managed, directed or trained by those paying the bill for their services. Thirdly, the Care Quality Commission - recently described as ‘not fit for purpose’ -  and commissioning organisations (like local authorities) need to drive up the standards of care being delivered to ensure they provide value for money to the paying customer and taxpayer alike. 

It is noticeable that migrants in previous generations were proud to learn about England, and learn the language, before they came or when they first got here, even to the extent of anglicising their names. I once worked with John, who came her from Austria before the war. In the eighties I went out with a gorgeous girl by the name of Christina Biscopou; to all and sundry though she was plain Christine Bishop, and from her speech you would never have guessed her Greek ancestry. Why aren't modern day migrants following such examples, why aren’t the authorities encouraging it: would it be considered racist? 

Maybe I’m expecting too much. Maybe it is too much to expect decent care for £28 an hour in a supposedly civilised country, especially with the level of competence shown by our leaders.