Even with the best homecare service and the best intentions in the world, sometimes things just don’t go as we expect. In this post we’ll be talking about the kinds of things that can go wrong, how to address them, and where to go for further help.
If you ever have serious concerns about your or anyone else’s safety or wellbeing you should contact your local authority safeguarding team or even contact the police if you need to. You can ask someone else to do this on your behalf. This can include an advocate.
In the early days of the service, if it has been arranged at short notice, you may find you are visited at variable times or by different staff as the co-ordinator works out your best regular service. This situation shouldn’t last more then a few days and although not ideal, does also give you a chance too to see what’s best for you. For instance, I have often had people decide they would rather have their call somewhat earlier or later than thought so that they could be visited by a particular member of staff who was already committed elsewhere at the original planned time.
Of course a good agency won’t leave you hanging and should let you know who to expect and when.
It may also take your care workers a few visits to get the feel of things, but they should all know what they are doing and be capable of doing the tasks described in your care and support plan, even if you do have to talk them through things a bit for the first few visits. The agency would not have taken on your service in the first place if they didn’t think they could meet your needs and preferences. If it seems like they can’t, and your service was commissioned by the local authority or someone else speak to them about this. If you arranged it yourself, speak to your contact at the service in the first instance. You can ask a friend or family member to speak to the service on your behalf.
Care workers running late
Domiciliary care rostering can be an absolute nightmare at the best of times and of something happens at the very last minute, such as staff sickness or having to isolate, then this can throw the best laid plans into chaos. However, it should only be in the most extreme of circumstances that the service fails to communicate what is happening to people who are not going to receive their visit at the time they expect or from the staff they expect.
Necessity does mean that your call times may vary by a few minutes plus or minus each day, but you should know when to expect your staff and who is coming. The service should also have given you a number to ring, even out of hours, so you can contact them to enquire if it seems like your carer is running late. What constitutes a reasonable amount of time to wait before you call depends on your circumstances. If your care workers are usually bang on time because your medicine is time critical, then obviously you should be ringing the office quite quickly – on the other hand, if you’re just waiting for someone to come and do the dusting, and you know your care worker is travelling by bus, you’ll probably want to give them a wee bit longer.
If your visits are more than occasionally erratic, you should follow the service’s complaints procedure or speak to whoever arranged your care.
Not getting on with your care worker
As in any real life situation, sometimes people just don’t get on, and usually this is fine – we just avoid that person! But when someone you don’t like is coming to your house and is expected to attend to your personal care, this is a much more tricky situation. Of course there may be initial, minor misunderstandings as you get used to having a stranger coming into your house, and they get used to visiting you, but if you feel uncomfortable or unsafe then you need to communicate that to your named contact at the service or whoever arranged your care for you as soon as possible.
It can feel uncomfortable expressing to a service that you don’t wish to be visited in future by a particular staff member. But the service should take your concerns seriously and confidentially. They need to know, especially if it relates to their care skills, that you aren’t happy. But even if it’s just a personality clash, you can request a change of care workers. “We just don’t get on, and I’d like a new care worker as soon as it can be arranged” is a perfectly reasonable request to make and is often a relief all round!
Your care worker seems to be genuinely incompetent
It may occasionally happen that you’re attended by a member of staff who strikes you as lacking the skills for the job. If you’re sure they have been told what needs to be done but they aren’t doing it, then you should speak to your contact at the agency or whoever arranged your care.
You might worry about getting someone into trouble – but if they aren’t doing their job properly, then people are being put at risk. By speaking up you help other clients who may be unable to speak up.
If you think the problems are caused by the service, for instance, if you think your staff member has been poorly trained, and you’re concerned about talking to them, you can always contact your local authority or the Care Quality Commission directly, without first speaking to the service. Information on contacting the local authority should be in your service user guide.
When raising a concern or complaint doesn’t work
If you have complained to the service and it has had no effect on the issue, or you are otherwise unsatisfied, then you have some options. If it’s a larger company, you may be able to escalate your complaint further internally, to a service manager or quality lead of some sort. You should have details of the complaints procedure in your service user guide. This should also contain instructions on how to raise a complaint externally, giving the contact details of the team at the local authority who deal with complaints and concerns about services. If not, just check your local council’s website or give their main contact number a call and ask them to connect you with the right team.
The next step, if you’re still not satisfied, is to contact the Local Authority and Social Care Ombudsman. They deal with specific complaints and have the legal powers to investigate your complaint in depth and instruct the service or local authority to take action.
You should also contact the Care Quality Commission with your concerns about the service, but they don’t investigate specific complaints in the way the ombudsman does. However, they use the information they receive about services to decide if any regulatory action, such as inspection, needs to be taken.
If you can, keep evidence of the concerns you are raising. Take notes if you are worried about forgetting details. Raise your concerns as soon as is practicable. A good agency will welcome your feedback, be it positive or negative, and will have robust procedures in place for dealing with concerns and complaints.
If your concerns are minor, and they deal with them immediately, there may not be a written outcome by default but you can ask for one. Formal complaints should always be followed up in writing – the agency should write to you and let you know what is happening and the timescales they are happening in. Many complaints can be dealt with quickly, but with serious matters you may find the service says they will take 28 days or even longer, up to 12 weeks, if the matter is complex. Where there are safeguarding concerns, the local authority will take the lead and they will advise you of what will happen.