UK dementia care agency’s half-hour home visits ‘lasted as little as three minutes’

Robert Booth Social affairs correspondent
Mon, 30 January 2023 



A dementia home care agency spent as little as three and a half minutes on taxpayer-funded care visits and filed records claiming far more care was given, according to evidence seen by the Guardian.

The hasty care was exposed by Susan Beswick’s family, who called it “totally inadequate”. They say they had been told visits to 78-year-old Beswick, who has Alzheimer’s disease, were supposed to last 30 or 45 minutes.

Across nine visits this month, care workers formally logged close to six hours of care. But security cameras suggest they were in the house for under one hour 20 minutes – less than nine minutes a visit on average.

The case in Hampshire comes amid councils “rationing” care and a nationwide shortage of home care workers with about one in eight positions vacant – higher than at any point since records began in 2012.

On one evening visit, footage showed two carers entering, asking if Beswick had eaten and checking her incontinence pad, before leaving three minutes and 15 seconds later. But they appeared to log on a care tracking app that they had been with her for one hour and 16 minutes.

One lunchtime they stayed for less than six minutes but appeared to record a half-hour visit on the app. The Beswick family provided the Guardian with footage from a hallway camera showing the carers coming and going through the front door and screengrabs from the app showing how long they claimed they were there around the same periods.

Beswick, who for years was a care worker herself, “deserves so much better”, said her daughter-in-law Karen Beswick.

“It’s upsetting us the way mum is being cared for here,” she said. “They come in and check her [incontinence] pad and go. They are supposed to be encouraging her to drink. They don’t really talk to mum a lot. It’s not good at all. I will start crying. We are all trying to get the best for mum.”

Her son, Peter Beswick, said he informed the agency staff he had installed a camera and considered it “disgusting” they claimed they had been there longer than they had.

In the first six months of 2022, 3.3m hours of home care was not delivered to people who needed it in England because of staff shortages, according to the Association of Directors of Adult Social Services.

Many domiciliary care workers are likely to be receiving illegally low pay, with typical wages of £9.20 an hour – below the adult minimum wage – when unpaid travel time between care visits is deducted, according to research by the Resolution Foundation.

The Homecare Association is warning that councils may shorten care visits from the current norm of 30 minutes to 15 minutes, which is “stressful, risks quality, and is less efficient”. Almost half of home care staff work under zero-hours contracts.

Susan Beswick’s homecare provider, Pathways of Hope, was this month labelled “inadequate” by the Care Quality Commission, which concluded “people were not safe and were at risk of avoidable harm”. At the time it was inspected it supported 39 other people and the regulator found staff were spending just eight minutes with another client who was paying for 30 minutes. It has been recruiting staff from overseas but could not show sufficient information to be assured new staff were safe to work in care, CQC said.

Earlier this month the social care ombudsman uncovered similar three-minute visits in Warrington and said short visits were unlikely to meet care needs and were not dignified.

Liz Kendall, the shadow social care minister, said: “The appalling care received by Susan yet again highlights the scale of problems facing social care, with 165,000 vacancies and over half of care workers looking for a job outside of the sector.”

Labour is promising to tackle staff shortages “by delivering the pay, training, terms and conditions that they deserve”.

A spokesperson for the Department of Health and Social Care said it was investing up to £7.5bn over the next two years to support adult social care “to help local authorities address waiting lists, low fee rates, and workforce pressures in the sector”.

It said it was developing a way to assess the performance of local authorities’ delivery of their adult social care duties, through the CQC.

Hampshire county council, which commissioned the care, said it was prioritising an inquiry into the concerns. It said providers were vetted and “failing to subsequently deliver what is required and essential for people’s wellbeing is not acceptable – and action will be taken where we find this is the case”.

The care workers log each visit on an app that allows them to input notes and the length of the visit. There is also a family version of the app that allows loved ones to track visits. Peter Beswick noticed that the times logged did not match what he saw on the hallway camera.

The agency’s director, Hilda Chehore, did not return requests for comment. The council has stopped the agency providing care for Susan Beswick, the family said.

Jane Townson, the director of the Homecare Association, said inadequate council budgets – on average at least 30% below the amount needed to pay care workers fair wage – mean care is being “rationed”.

“State-funded homecare is typically only available for those with highest needs who have absolutely no one else to support them,” she said. “This means a growing number of people are quitting their jobs to take on caring responsibilities, constricting economic growth.”

“We call on the government to invest adequately in homecare to grow the workforce, innovate, improve quality of life, extend healthy life expectancy, take pressure off the NHS, reduce costs, and enable economic recovery,” she said.