No food, water or medication: The grim reality of home 'care' for the elderly exposed in an undercover probe

By ARIFA Faroog
BBC reporter Arifa Farooq went undercover as a carer for the 2009 Panorama expose Britain’s Homecare Scandal. Here she relives her experience and lays bare the horrifying truth about the industry.
The shambles of home care for the elderly was revealed to me in an appalling incident when I was sent to care for a terminally ill man who was doubly incontinent and in great pain.
The only way he could be moved was with a hoist, but I had received little training in the use of such equipment — indeed my only instruction in caring at all had been a few days of seminars and DVDs.
I was completely out of my depth as I looked at the poor man, surrounded by machinery and tubes. He really needed proper medical attention, not an inexperienced carer like me.
I tried to treat him in the most dignified manner I could, but it was so difficult that I had to keep ringing the company office, asking for more support. Yet all my calls kept going through to an answering machine. It is an episode that haunts me to this day.
This incident happened while I was working undercover as a carer, doing an investigation into inadequate home care for BBC’s Panorama. The reality is that thousands of carers have no more experience or support than I did — and their elderly charges are equally neglected.

This disgrace was exposed this week by a new report from the Equality and Human Rights Commission, which revealed how many elderly people are let down by the home care system run by local authorities — their visits curtailed, meals not provided and washing inadequate.
According to the Commission, standards are so appalling in some cases that basic human rights have been breached. The report found that some older people have been left in their beds for 17 hours at a time or have been undressed in their rooms in full view of their neighbours.

Others have been abandoned in soiled bed sheets and clothes, or told to choose between being fed or washed.
The Commission’s study mirrors my own experience working as a domiciliary carer for several months, providing support to a number of elderly clients around Scotland.
As a Muslim, I come from a culture in which the elderly are revered, and young people are taught to show them the deepest respect. But what I found during this undercover experience was shocking.
There was a constant state of pressure and crisis, so that the clients were not given the time they either need or have paid for.
While most patients have their care financed by the local authority — who outsource the work to private companies — some clients pay for private care.
During the making of the programme the level to which cost-cutting is the priority for local councils was painfully clear. An online auction decided South Lanarkshire council’s new care provider.

One of Scotland’s largest care providers, Domiciliary Care, won the auction — which saw bidders bidding down, not up. It agreed to provide care for just £9.95 an hour.
The company I worked for was the fourth largest in Scotland, yet there was always a sense of being short-staffed, of being rushed off your feet, of always desperately trying to cram in all our tasks, of not being aware of the real needs of our clients.
It was clear to me that the quality of care is massively compromised by the determination of commercial firms to make as much money as possible out of looking after the elderly.
Care is dominated by profit-making companies, with independent providers now controlling 70 per cent of the market. The sector is said to be worth at least £1.5 billion and is growing all the time, due to the ageing British population.

But the ever-more-lucrative nature of the market does not mean that the elderly are receiving a better deal. Far from it.
I should stress that all the carers I worked with were devoted to their jobs. They all wanted to do the best they could.
But, just as the Commission reported, they were up against a cash-orientated, corner-cutting system that meant that they could not do their work properly.

Many of our clients were bed-bound and needed intensive support, from the cleaning of their beds and changing their sheets, to feeding them and getting them dressed. To give a client a proper bath, for instance, could easily take half an hour, yet sometimes we had to be in and out of the home in five minutes, rushing off to the next client. The schedule was ridiculous, compounded by the lack of time allowed by the company for travelling.
Nor was the logistic support adequate. For a start, we were given little training. Before I began my job, I received a few days instruction, which was hardly sufficient for the complexity of my clients’ needs. Then I was thrown in at the deep end, expected to cope with extremely vulnerable, sometimes very ill people. 
There were other problems which made the system all the worse. One was the huge turnover in staff, which meant that the clients would be facing a bewildering array of new faces every week, hardly a way of establishing confidence.

And thanks to the chaotic rota system, these different carers would often know nothing about the needs of specific clients. We sometimes got into the ridiculous position of having to ask people what they required, which was hopeless if they were suffering from dementia.
This kind of difficulty should have been overcome by the official rule that every client was meant to have an individual care plan, setting out in detail all their needs.

But these were often inadequate or even missing from the home of the client, which meant that we were operating in the dark. The casualness about the plans was indicative of the mess the system was in.
I remember seeing a pile of them lying on the back seat of a manager’s car — despite the fact they were meant to be highly important and confidential.
But that was hardly unique. A fellow Panorama reporter, Hayley Cutts, also went undercover and her experience was as bad as mine. Again, she was pushed into a front-line job after just four days of training and, like me, she found that the amount of time set aside for visits was inadequate.
One of the firms Hayley worked for was Care UK, which had 15,000 clients and 48 contracts around the country when the programme was made. 
A graphic symbol of the appalling care provided by this firm was the case of Janet Finn, an 89-year-old woman from Hertfordshire who suffered from dementia and double incontinence, meaning that she required three home care visits a day, each lasting for at least half an hour.

Yet one day in June 2008, her visits were skipped entirely. For 24 hours she had no food, no water, no medication and was left sitting in her own faeces and urine. She was found by her son in this terrible state of neglect. 
Partly as a result of the outrage over this case, Hertfordshire got rid of Care UK, though the firm still operates elsewhere. And the abuses continue.
In a civilised society, the impulse of compassion should be the driving force behind the care of the elderly. Those who have given so much to our society deserve to be treated with respect and dignity in their final years when they are at their most vulnerable.
Yet the recent scandals over abuses in residential homes, the maltreatment of older patients in NHS wards and now the home care revelations show that this is clearly not what is happening.
It is one of the tragic paradoxes of our society that our civic institutions and judicial system continually trumpet their commitment to human rights.
Indeed, the human rights agenda has become one of the central themes of modern civic life. Yet, when it comes to the rights of the elderly, they seem to have been forgotten.