Agency and hospital appointment

Share information, support and advice on all aspects of caring.
I asked our current live-in carer to accompany Mum and I to her outpatient appointments at various hospitals. Mum travels by ambulance and is wheeled into her appointments on a stretcher (she has advanced Parkinson's Disease and other problems). I asked the carer to accompany us in case Mum needs a pad change etc. I can't manage this on my own. She seemed happy to do this and has been with us twice so far.

Then earlier tonight she said she didn't see why we needed her to accompany us, as the hospital is full of nurses who will change Mum's pad etc (she has an orthopaedic appointment on Thursday, which is really important, as she has a fully torn tendon, which has been causing unbearable, uncontrolled pain for a long time now). How caring of her! As I've said before, the title 'carer' is a joke with a lot of paid care workers. We've only had one who I believe really cared about Mum.

I told her the nurses in the hospital will refuse to do Mum's personal care. It's not what they are there for. I don't know that for sure but from past experience of accompanying Mum to outpatient appointments, I think it is highly unlikely. I asked her what if Mum gets diarrhoea while we are there. She replied that if she didn't have it beforehand...? It can come on any time fgs, as with a lot of her problems!

Do any of you have personal experience of this? Do you think the nurses would help if needed? I know I could phone and ask but again, from past experience, I don't think I will get a reliable answer.

Apparently, the agency's care co-ordinator and the manager (a former nurse) both said to the live-in carer that the nurses at the hospital would do a pad change etc but I think they're living in 'cloud cuckoo land'!

We are at our wits end with the live-in carers and the agency (some of you may remember my last post about this). Mum has CHC funding. What would happen if we went private for a short while, until they could sort out swapping agencies? Would we lose the funding do you think? I don't think they will refuse swapping, as I've complained to them about the agency before but I feel like getting up later and pulling the plug on this agency right now. We can't live with the unsuitable carers they are sending us anymore. I want to get rid now.
Hiya,
Do you have direct payments? If you do then you can change the Care Company whenever you like. If not then maybe this will have some info to help
http://www.personalhealthbudgets.englan ... h_2014.pdf

First of all get your LA list from their website of approved care Companies, and check them out with CQC. Start calling around and try to find a company you think will actually be good for you and Mum. Interview them. Ask for a Care Plan and check it out to see that it covers all your daily requirements and possible extra requirements. I suspect that your current care plan does not cover accompanying to hospital so the Care Worker feels safe in raising objections.
In the meantime, are you sure getting rid of this care company before you have another in place will be more help than hindrance? You may not find one who could immediately step in.
Good luck
Elaine
Hi Blue Mermaid,

I very much doubt there would be sufficient staff to help change your Mum's pad at an outpatient orthopaedic appointment. I have regular ortho appointments myself and the nurse's role is to chaperone patients when they see the consultant. I wouldn't take it as gospel that the care worker has really asked her manager. The live in care worker is paid to support your mum, I don't see how it is up to her to pick which parts of your mum's care she does/doesn't do!

When you find a new agency, I would draw up the care tasks you need help with beforehand, so that it is all agreed in advance.

Melly1
If mum is funded by CHC, then tell their manager what is going on, and get them to sort it out. After all, it is part of the NHS. If the CHC manager isn't doing her job, then complain. You have more than enough of your plate without having to battle with the agency on your own. What is the job description of the live in carer? I would have thought that being with the caree was part of it - after all, she will still expect to be paid, so she should expect to be working!!!
Thanks very much guys for all your support and good advice.

We don't have a personal health budget. I did ask the CHC a few months back about that (when I complained about the agency). They told me how to apply for one but I didn't take it any further at the time.

I had a long talk (a few actually) with the live-in carer and things have improved. She said that it wasn't that she didn't care, regarding the hospital appointment. From what she said, I think she felt like a bit of a spare part at the last 2 appointments. I assured her that both Mum and I felt supported with her there and she made a valuable contribution during both consultations with the doctors. She's agreed to accompany us to future appointments (I also told her I phoned the hospital to enquire whether a nurse would change Mum's pad if needed and as I suspected, they wouldn't have time to do so. Thank you for sharing your experience as well Melly1).

I discussed other issues with the carer as well and again, things have started to improve on those fronts.

We were supposed to have a meeting with the manager today and just like all of you have suggested, we were going to talk to her about what the carers duties are supposed to be and get them put into the care plan. The current care plan is very basic and hasn't been updated. We didn't even have a copy until 3 months after the care package started and that was only because I kept complaining about it!

I had to cancel the meeting, as Mum woke up very confused and upset, so it wouldn't have been appropriate. The manager is going to try again on Monday.

There have been major developments regarding the agency. I had a phone call from the Safeguarding Unit. They had been informed about the live-in carer who stole from us. They are having a meeting next week with the CQC, the CHC, the police and possibly the manager of the agency (that's not decided yet), to see if the agency were at fault in any way and to discuss Mum's safety.

They asked me if I'd seen the CQC report and I told them I'd only seen the old one, as the new one wasn't online yet. They told me the new assessment had been completed and it was now online. They warned me how bad it was.

I was shocked when I read it. I don't know why after our experience with them. They are now under "special measures". From what I've read, I can't understand why they are not being closed down immediately.

There is no way we can stay with them now. Anyone reading that report would be crazy to do so.

Mum wants to try and keep our current live-in. She doesn't want to have to get used to yet another new one (she's the 8th live-in we've had since August). So, I'm going to phone the agency I spoke to locally, to see if they will interview her (she is willing to swap agencies). They don't have the capacity at the moment to help us but we are at the top of their waiting list and they are currently recruiting new carers. They train all new carers to a very high standard, so she would learn a thing or two I am sure!

I told the woman from the Safeguarding Unit about the new agency and she said she could tell the CHC we want to stay with the old agency until the new one has capacity (so we can keep the current live-in). I don't know if the CHC would agree to commission the new agency (of course, we would have control if we applied and managed to get a Personal Health Budget).

The other problem is the new agency is very small, so it could be a long time before they have the capacity to fulfil Mum's needs. Even if they did decide to employ our current live-in, they'd still need to be able to provide temporary replacements for her time off/holidays.

I will have to look into other agencies but it's finding the energy when I'm already exhausted. My fear is we'll soon be with another one the CHC has chosen and we could go from the frying pan into the fire!

Why does everything have to be so difficult and worrying?

Thanks again guys.
Gosh BlueMermaid.

....can't think of anything else to say ...

Melly1
Hi Bluemermaid,
If the agency is in that much trouble I wonder whether they might close down and re-invent themselves under another name? I've known that happen and carers being withdrawn with very short, or no notice. It's a pain to understand the rules and regs but IF you (and Mum) are happy with the current carer, I wonder if there's an argument for employing her directly? OR if she suddenly finds herself out of a job, if the agency closes suddenly, would she consider becoming self employed for a period of time? Perhaps your new agency would be able to field someone to cover holidays and time off? If your current live in is employed by your new agency, there's no guarantee that they will then provide her to cover your Mum's care. She might get a job and they could still say they can't fulfil your needs.
I found small agencies, like our current one, a mixed blessing. The care they provide is very good indeed, but with a limited number of staff there is always the worry that with one carer on holiday, two unexpectedly sick and another's car breaks down, that they suddenly are struggling to cover the calls.
Personally I would find the direct employment a nightmare. You probably wouldn't want to take on that with all you have got to cope with. If you did consider those options, google 'employed or self employed' and look at the .gov site.
Elaine
Our new care agency were happy to poach one of our regular carers from our former agency (later closed down) - I think partly because they were expanding in the area.