A great deal of news coverage has recently been devoted to evidence which suggests that home-care is increasingly been commissioned by local councils in slots of 15 minutes and that very often these 15 minutes slots become even shorter because care workers are not paid for the time it takes to travel from one ‘job’ to another.
I helped establish the Inquiry into home care carried out by the Equality and Human Rights Commission, which identified this issue as a structural risk to human rights. The inquiry found evidence of support with tasks involving intimate personal care such as washing and dressing, or on which physiological well-being depended such as eating, drinking or taking medication being crammed into these short visits in a manner which placed older people’s human rights to dignity and autonomy at risk.
It does not follow however that short visits are always de facto a bad thing and it struck me as odd that Leonard Cheshire launched a campaign specifically against them rather than for a guarantee that local councils would place respect for human rights are the heart of their commissioning policy and practices. A half hour visit could of course be insufficient for some people with complex requirements. The issue is whether sufficient time is given to perform the tasks effectively and respectfully.
Furthermore, coverage of the story in the media drew attention to the fact that many older people receiving care at home looked forward above all else to the social contact that such visits brought – that very often this was what they valued most – and that such short visits deprived them of this contact.
Notwithstanding the fact that people may quite understandably wish to form a trusting relationship with people coming into their home to perform such tasks, or that we might hope that such services are not rendered simply transactional in character, we really cannot lay fault for the isolation and loneliness of disabled and older people at the door of 15 minute care visits.
Such is the false illusion created by the word ‘care’ that society is led to believe (or allows itself to believe) it can sub-contract the very essence of being human – being in the world – to be ‘delivered’ by professionals (frequently underpaid and overstretched professionals at that). This is patently a nonsense. The services which fall under the heading ‘care’ should be delivered in a ‘caring’ way. But they are largely functional and practical in character and provide no substitute for friendship, company, stimulation, intimacy, warmth and fun.
If we really care, the business of fostering genuine social inclusion – and not just the States role but all of our responsibilities to make this happen – needs to be in the spotlight.
We might start by considering whether the word ‘care’ itself has long since had its 15 minutes of fame.