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BBC Interview

Health Professionals Homecare at the BBC

Two years after our Registered Manager Michele Jogee participated in a BBC5Live broadcast regarding The National Institute for Health and Care Excellence’s (NICE) recommendations for 15-minute minimum home care visits Michele considers the subsequent impact on both clients and carers…

“At the time I took part in the radio discussion about NICE’s recommended visit durations, I was wholly against the 15-minute minimum time allocation. My opinion has not changed. Home care visits can be extremely unpredictable because people being cared for at home generally have fluctuating needs and vulnerabilities, sometimes on an hourly basis. Those needs may be emotional as well as medical and having their needs consigned to 15-minutes, even if that is daily, is just unacceptable. Equally, I noted that many health-related disadvantages could result in increased costs for the National Health Service.

From time to time, we recruit and train to our standards former local authority carers and feedback they have given regarding their transition from public to private care at home sector is revealing. Typically, according to collective feedback, a public sector home carer in London would be expected to make visits lasting a minimum of 15 minutes, after having to travel considerable distances to get to clients. So, whilst they valued their profession as a home carer, they found the visit timing restrictions very distressing, and demoralising for them and their clients. It was just all too rushed and felt uncomfortable.

At Health Professionals, we of course offer a private rather than social care at home service, so are not constrained by having to comply with 15-30 minute home care visits. Many of our care at home clients engage two carers for 24-hour care, each on 12-hour shifts. We are established, and offer our carers regular, relevant and certified training so they are always confident and capable.

On that basis, even for daily care at home involving, for example, medication administration, personal care, companionship and light household duties, it is unlikely that any of our carers would stay with a client for less than a few hours. This is rewarding and beneficial for both clients and carers: the client receives the very best levels of care and companionship, and the carer is rewarded not just financially, but vocationally, as they feel fulfilled in the high quality levels of care that they deliver.

As a home care agency, we strive to ensure that once a carer is successfully assigned to a client that they remain in the life of their client for the duration of the care, so that a trusted and familiar relationship is built with the clients and their families. A familiar face and continuity of care is especially vital for our home care clients who suffer from dementia-related conditions because despite short-term memory loss, for example, they can still detect, and become disorientated by change.

Another difference with our private care at home service, compared with a social home care package, is the fact that, as Registered Manager, I make frequent visits to clients’ homes to assess whether or not their needs have changed since initial engagement. This ensures that all aspects of their care plans are being fulfilled according to how their needs fluctuate throughout the plan’s duration.

Finally, to sum up, two years after NICE issued its care visit duration recommendations, many carers and their clients are dissatisfied by having limitations put on the care given and received. In my opinion it is a two-way dis-service… I am just thankful that some of the home carers, who want to put their hearts and souls into their vocation of caring for people in their own homes, are able to do so by working for Health Professionals. Public purse costs are always a consideration, but what price can be put on caring for vulnerable people who deserve to stay in their own homes and maintain a semblance of quality of life for as long as possible?”

Read the full transcript here


Presenter: Health and care watchdog NICE has issued guidance to councils and firms setting out for the first time national standards for care in England, they say elderly or disabled people should generally get at least 30 minute visits from their professional care worker, it follows reports of carers making visits of 15 minutes and less. We're going to be talking about this until seven o clock tonight. If you receive care or a relative of yours gets care or if you're a carer yourself, get in touch and let us know your story 85058 bbc5live both good and bad. We can hear from a carer now, Michele Jogee is the head of homecare at health professionals a private home nursing company based in London.

Presenter: Hello Michele.

Michele: Hello how are you.

Presenter: Yes Michele there are two million people receiving care in the UK and of course many families helping out as well but what about those that aren't involved think they know what's involved in care, just explain put some context in this for us what does a homecare worker do.

Michele: Okay so a homecare worker is there to enable a vulnerable person to be able to stay living in their own home, in the comfort of their own home with the practical care that they require being brought home to them, so it prevents institutionalisation if you like.

Presenter: Yes now is thirty minutes the bear minimum because we have had people text into this program tonight saying that… Clair from Wilmslow for example my mother only wanted someone to make supper and make a cup of tea, 15 minutes was perfect and another texter said well if you're just giving medicine, 15 minutes is sufficient.

Michele: It may well be but the thing is that you can never tell what you're going to meet when you arrive at the home of that elderly vulnerable person it might be that maybe that on their care plan they only require to have medication administered which may take 15 minutes, that happens however you may arrive and discover that the elderly person is unwell, they've had a situation of being incontinent or they haven't had anything to eat or they're just lonely and they haven't seen anybody that day and they want to have a chat.

Presenter: Yes so I'm just looking at this thirty minute window that’s being placed on this, in an ideal world I guess if you knew your patient you could possibly plan for 15 minutes but it might have to extend you might have to be flexible depending on their condition. Is what you're saying.

Michele: Absolutely, completely; you cannot predict what you will meet when you arrive when you arrive at the client’s home.

Presenter: And what about this issue as well that nice have touched on that carers shouldn’t be changed to frequently that they a patient should know their carer well if possible.

Michele: Completely it's all about continuity of care as we get older change becomes more and more difficult and just the fact that the elderly person feels they need to explain all over again to a new face how they like to have things done. Even though handovers take place and you know, new carers may go along and shadow before they actually work a shift but somehow they feel comfortable with the person they've got you know that’s their carer that comes to visit them every day or twice a week or whatever.

Presenter: Yes, even again that thirty minute window even if people can comply with that we have had other texts saying that they have had a carer who simply sat for ten minutes and filled out forms between and didn’t engage with the patient.

Michele: Well this is the difficulty because you know it's not an automatous role but it's not monitored on the spot the degree of monitoring I hope in terms of supervisory visits etcetera but you know you these are the things you need to make sure when you uh recruit care workers that they're equipped with all the necessary training and that they actually want to do the job, it’s a difficult job. And you have to want to be a carer.

Presenter: Yes I mentioned two million people before but one and a half million people rely on family and friends but there are five hundred thousand receiving homecare seventy percent of those get contributions from councils, this could be quite an expense for local councils if these visits are extended because you know extrapolated people aren't going to making enough visits in a day they are going to have workers that are going to have to work harder.

Michele: Absolutely, and then it's difficult for the workers to because they're having to go from home to home it has to be worthwhile for the worker in order to get the commitment for the worker you’ve mentioned about them sitting filling out forms which suggests to me they're not really enjoying their job their hearts not in it so as much as it's a going to be a cost in terms of paying the worker but also equipping the worker with the necessary training so that they do a good job.

Presenter: And just generally Michele what about the mind-set of care workers because you'd imagine it’s a vocational job really you know how do people, I wonder how people pick themselves out for the job because you don’t quite know what to expect and some of the jobs you would be expected to do aren't those that everyone would want to do on a daily basis.

Michele: Well its interesting because I don’t necessary recruit people just because they're from a nursing background because I've had a lot of excellent carers over the course of time who perhaps had an experience nursing an elderly relative and discovered that actually they found it very rewarding they really felt that they made a difference to that relatives life and they actually want to continue on and make that a job. So I've had other care workers that have done totally unrelated things and have discovered that they have transferable skills that they can bring into a caring role and make a very good job of it.

Presenter: Yes. And just finally for now Michele there will be people listening to this who will discuss the cost of such an enterprise certainly extended visits from 15 minutes to thirty.

Michele: Yes

Presenter: How much can be achieved with an extra 15 minutes will it make a noticeable difference to someone that is alone perhaps all day just for another 15 minutes.

Michele: Well just another 15 minutes for someone that’s alone all day I mean you said it there really it’s the company you know we have proven that solitary eating with old people leads to a physical decline in their health that has a further impact on the NHS so you know that company is having someone to talk to it definitely increases longevity when older people can have company even having a care worker that has time to actually just sit with them whilst they have their sandwich and have a cup of tea with them that is a very valuable job and contribution they have made to their life, the elderly person.

Presenter: Yes Michele thankyou stay with us if you're involved in social care get in touch and tell us your thoughts.

Other Topic -

Presenter: Michele I don’t know if you were agreeing with something Scott was saying there during that interview. I'll just remind people this is Michele Jogee head of home care at health professionals. This is the issue isn't it about a carer can you teach that compassion that’s required as part of the job.

Michele: I mean training definitely helps, never undermine training in fact recently all of our carers have now been trained and completed their certificate which is something that from next year will be obligatory for all carers to complete and obviously the training is very useful but yes they definitely have to come into it with that compassion and willingness to care, to want to help and make a difference to people's lives.