Lack of domiciliary care staff a challenge for the Trust

Staff absence, turnover and an inability to replace staff are the main challenges facing the Trust when it comes to domiciliary care.

Thursday, 18th November 2021, 3:02 pm
Dr. Bob Brown

The inability to put care packages in place to enable some patients return home or to a care facility continues to heap pressure on the health service.

Members of Derry and Strabane’s Health and Community Committee expressed their deep concerns at the ongoing situation as they received a presentation from Dr Bob Brown and Teresa Molloy from the Western Health and Social Care Trust.

Dr Brown told Members: “We are doing best of all Trusts with regards to people who have a gap in their care and are unable to get out of hospital because of unavailability of a carer.

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“We have 141 clients who are delayed or don't have their full package of care. The highest number in the region is 424.

“Our 141 amounts to 1200 hours, the total of missed hours in the region in recents days was 15,000.”

Sinn Féin Councillor Michaela Boyle spoke of the need for the Department of Health ‘to bring forward its plan to reform social care'.

“They particularly need to build a social care workforce immediately, including plans for a living wage for staff,” she said. “The lack of available carers is another example of the lack of workforce planning that has been felt across all of the social care sectors.”

Agreeing, Dr Brown said: “I do support your points about a longer term plan. The Minister has supported the putting into place of a social care work forum and indeed there is a review of adult social care as part of that work. It just needs to happen at pace.”

SDLP Councillor Martin Reilly talked about the stress families were being put under when they couldn’t get their loved ones home from hospital.

He added: “I have seen and heard stories of people who are in hospital and are unable to get home again and the stress that puts the family under because they are worried about the fact that when a person is in hospital for longer they are more at risk and more susceptible to developing other core mobilities, suffering falls and accidents that may not happen when they are at home.

“How are the Trust planning on getting people home as soon as they are ready to be discharged?"

Dr Brown responded: “The Board and Department has submitted plans for additional capacity in the community and in our case that would include using some of our Trust residential beds for people who are delayed and waiting for a care package as an interim step down.

“Also, the purchasing of additional care home capacity to facilitate discharges of general or dementia nursing into the community.

“The challenge for these care home providers is workforce availability and they are, of course, very concerned about Covid risks coming through into their areas as well. However, there is work underway to try and put in additional community capacity this winter.”

People Before Profit Councillor Maeve O’Neill spoke of the ‘poor terms and conditions’ that domiciliary staff working for private providers have.

She said: “We have domiciliary workers under the Trust who get expenses for mileage and who have sick pay, whereas the private providers do not have the same protections and rates of pay for staff and the journey from patient to patient’s house isn’t even covered in their wage.

“Are we looking at increasing the number of domiciliary workers the Trust employs to fill those gaps or are the solutions to give more money to private providers?”

Dr Brown, the Trust’s Executive Director of Nursing explained that ‘contractually we have no intention at this stage to go beyond the current set up as such.”

Councillor O’Neill’s party colleague Shaun Harkin added: “The problem is the Executive has created a context with privatisation, with outsourcing, with deregulation of this sector, that is actually now hurting people dependent on care and putting tremendous pressures on our health service and people are walking away with big money. They are making huge profits out of this while workers in this sector suffer.

“I think the solution is to bring domiciliary care into public control, back into the health service and then we can increase wages and bring them back into a living wage where we can then improve terms and conditions for workers otherwise there isn’t going to be a solution.”

UUP Alderman Darren Guy agreed saying: “This isn't just a new problem, it's got to a stage where people are seeing their care cut in half. This has been coming down the tracks. The pay is awful and there's just not enough people doing it and it's the cut that has been handed down over the years to the Trusts.”

Sinn Féin Councillor Patricia Logue said she ‘shared the concerns’ around domiciliary care adding: “It is nothing new, but I don’t believe giving the workers the extra £2 is going to be a long term fix but I do think something needs to be done to resolve this situation.”