Can you give advice on home care agencies/carers please?

[Skylark2024]

I am the Registered Manager for a new home care company, due to be launching next month. We want to strive to be the best we possibly can, for both our clients and our carers.

Have you had any experiences with home care agencies where they went above and beyond?

Any tips or ideas on what you would really like to see carers doing more/less of?

I am looking for the views of 'experts by experience' - people who have received home care themselves, or who have a friend or family member who they support who has had carers coming in.

Any experiences, opinion, views, thoughts and ideas much appreciated!

 

[TamsinT]

This member has been given permission to post.

 

[Jessbow]

Continuity for the client where you can
A carer that knows the patient and where things are , goes a long way!

 

[canary]

We have a very good agency for OH who come in get him washed, shaved, epimax on skin, catheter care and dressed. I gather that the carers are arranged into "cells" with about half a dozen covering clients in a similar location. This means that OH gets about 3 or 4 regular carers, but when someone is off sick, or on holiday there isnt someone totally new picking up the threads. Obviously we do get new people as there is natural turnover and sometimes (like now) half the staff are off sick and its just a question of trying to fill all the slots!

We have had over and above care. The latest was before Christmas when my washing machine suddenly packed up and I was trying to get the engineer in to fix it. At the same time, I had trouble with my car, so couldnt take dirty washing to the laundrette, so I was keeping my fingers crossed that things could get fixed quickly. Unfortunately, before anything could, OH had a major catheter malfunction where the night bag came adrift and in the morning all the bedding was soaked. The kylie sheet and mattress and duvet protectors saved the mattress and duvet, but everything else was soaked. Normally Id just whip it all off the bed and shove it in the washing machine, but couldnt. The carer found me in tears. Having got OH sorted and sat downstair with a cup of coffee she stripped the bed and asked for a couple of bin liners, then (unasked) she put all the siled bedding in the bags, took it home, washed it all in her own washing machine, and then, also in her own time, brought it back that afternoon. I was overwhelmed with gratitude, but she just apologised that she couldnt dry it too

The worst thing about the agency is lack of communication over rota changes. I appreciate that sometimes the rota will change after I have been emailed a copy and the carers are good at texting me if they are going to e late, but no-one tells me when there is a rota change and Ive been caught out a couple of times.

 

[Chizz]

Wow @canary that was an amazing act of kindness by your carer! I would not expect that.

We also have a rota of a few carers, but I'm never told by the care co. managers when the rota changes of if carers are away for illness or holidays. I would be nice to be told.

The main "good practice" item in my book is the carers being caring and nice to my OH which involves speaking gently to her to say what they are about to do, as they're doing it, and when they've done it. Even after all these years, my OH still dislikes being rolled from side to side when the carers need to wash and change her, and kind gentle speaking eases and soothes the anxiety my OH has, as she can't remember from one visit to the next what is coming.

I hope that may assist.

 

[canary]

Wow @canary that was an amazing act of kindness by your carer! I would not expect that.

No, I hadnt expected it either. I was stunned that she would do that. And she wouldnt accept anything, not even to cover her costs

 

[Skylark2024]

Thank you everyone, this is all really useful! It seems that continuity of care and communication, particularly around rota changes, are two of the main areas to focus on and that we should take opportunities to help out in additional ways when we can - they will be remembered and appreciated.

Are there any other thoughts? What about having IDs/uniforms, the on call service, having new carers shadow more experienced carers? Office staff? Carers needing to log in and out? What have the best carers done to be thought of as the best?

 

[Grannie G]

When I was considering agency care I wanted the management to understand my husband before I left him with one of their carers.

The manager of the company I contacted spent two hours with me on a home visit discussing my husband’s personality and needs.

She agreed to our discussion taking place in our kitchen while my husband ignored us both and sat in the living room. If he had known we were discussing his care he would have walked out of the house in a strop. He thought the visitor was there to help me.

At the end of the discussion the manager asked to be introduced to my husband. He was in full hostess mode and if I hadn’t discussed his challenging behaviour in such detail the manager would have had no idea.

This groundwork ensured an excellent relationship between myself, the care company and eventually the carers.

The first carer who came became the regular carer and my husband loved her company. I can’t pay a higher compliment than that


Edit

Uniforms are important. My husband thought his carers were nurses

 

[Dirge]

I would add clear and concise record keeping to the list, very useful for family and changes of carer to have access to all the details rather than brief notes.

 

[canary]

What about having IDs/uniforms, the on call service, having new carers shadow more experienced carers? Office staff? Carers needing to log in and out? What have the best carers done to be thought of as the best?

They all wear uniform and have ID. The male carers wear grey, though, and the cell leaders wear a darker uniform. I think OH responds better to people in uniform as they are more of an authority figure!

OH does not mind having new carers shadowing the more experienced ones. I was asked whether this would be a problem right at the start and I said no. It would be best to get permission, I would think.

The office staff are friendly and I never feel a nuisance if I have to contact them

Carers logging in and out is quite a big problem. Not for me, but for the carers. They used to log in and out using a QR code, but now they all have to use an app on their phones to log in, write their reports and then log out while they are on my property. Unfortunately, I live in a village where there is very poor mobile coverage and they have all commented about problems with getting a signal

The best carers are the ones who chat to OH (hes very deaf so you have to use a whiteboard, which makes everything harder) and are willing to take their time if hes wobbly, or a bit confused.

 

[Skylark2024]

Thank you, everyone! So I have added clear and concise recordkeeping to the list, patience, willingness to chat and taking the time to get to know the person's history, background, needs, symptoms, typical behaviour, strengths, etc, before beginning to support them.

What about words and phrases - has anyone used a word or phrase which you found offensive?
Has anyone asked unprofessional or intrusive questions?
Have you found any culture or language differences which have impacted on the quality of care provided?
Have you overcome any challenges with a staff member and if so, how did this happen?
What do you wish agencies had more/less of?
If you could change one thing about the agency, what would it be?

 

[Veritas]

I'm based in London, which in general means greater challenges around staff turnover and continuity of care. The agency I use responded to my initial enquiry with great kindness and sympathy, which was much needed and appreciated as our lives had become quite difficult, and I was feeling the strain more than I knew. The care co-ordinator who visited us to assess my husband's needs had listened to what I'd said to her beforehand and wasn't fooled by him going into host mode.

The companion carer who has been coming for a few hours a week since has been excellent - a very good match for my husband's needs, and she has got the measure of him very well.

My worry is how much of the (quite significant) hourly fee actually ends up with the carer. I hope it is at least London Living Wage though I rather doubt it. This would be the one thing I would change - I appreciate that a profit has to be made, but once we are in to regular bookings with the same carers the overheads should be much lower, and leave room to pay carers better.

On the uniform question - it doesn't seem to bother my husband, although if they go out together for a walk her wearing uniform doesn't feel hugely discreet!

 

[nitram]

Not what you asked for just grist for the mill.

CQC finds common issues undermining majority of good home care - Care Quality Commission

The findings of a report into home care launched today, Wednesday 13 February, by the Care Quality Commission, show that people want to be listened to, respected and able to exercise choice. The report entitled, ‘Not just a number’, will be launched at a Parliamentary breakfast hosted by Rosie...

www.cqc.org.uk

Home Care Guideline: Key recommendations for providers

www.nice.org.uk

 

[nitram]

You might be interested in

home care software - Google Search

Much easier to initially set up than convert manual system

 

[Banjomansmate]

The Banjoman ended up with three different care firms. The first two were usually pretty good as far as I am aware but times of visits were sometimes a bit haphazard. Equally I appreciate that could be because an earlier client had a problem and the carer stayed to sort it out. Both of these firms were usually very helpful in accommodating changing visit times to fit around hospital appointments in particular.
The third, smaller company, were excellent timekeepers but refused point blank to alter their visiting times even when I explained that he had an early 9.00.a.m. hospital appointment and needed breakfast and getting washed and dressed in time to get him ready for the hospital transport service. According to them I should’ve got the hospital appointment changed to a more suitable time! I was not amused!

 

[Knitandpurl]

Fortunately we at the moment do not need outside but care, but I would just add to Canary’s comment re carers logging in and out via mobile app. We are in Lincolnshire , here mobile coverage is also poor, this would be a big problem in our village as well.

 

[Chizz]

Yes our carers where a uniform top in dark red with the company name on it, plus an id badge.
Yes they keep a log, but they sometimes exaggerate the time spent on the call, probably to cover their travel times ( but I keep my own log of times). I also keep a log of my OH bowel movements, in case there is a problem.
Yes the carers phone if they're going to be more than 10 or 15 mins late - eg, when they are bus and/or train strikes etc.
The company send round a person of manager level to discuss how they're getting on, whether the carers are carrying out what they should in the way they should, requesting feed back and complaints, whether we want any changes, etc. They do this every 3 months.

 

[Agzy]

As one who will be seeking care help pretty soon this thread has unwittingly been fascinating and very helpful, thank you all.

 

[LJJ]

My best offering is that my mum’s carer was the same lady, 4 visits a day 7 days a week. She got quite grumpy and I’m not surprised as this was a challenge but she picked up more clients on a weekend over and above her other 3 clients she had during the week. Please don’t let your workers demand more than humanly possible because they take it out on the client. Subtle at first but a mix of people would have given mum a break from the grumps. Silent treatment, use of phones while managing the care. All things that can make your VIP feel less important. It would make your life easy to give shifts to someone who says they don’t want time off. I hope that is helpful feedback.

 

[I thank you for the years]

I have had experience of two different care companies; both of which have been positive.

As I don’t live with my PWD, having access to the electronic case notes of my PWD has been very helpful.

The two companies had different systems. The one called openPASS is excellent. Not only does it contain electronic case notes of visits and the rota for the current week, it also contains the care plan for the client and a checklist of the routine tasks that need completing for the client.