The great Brexit calamity blows everything else away. Nothing gets done and serious crises are left mouldering by this absentee government. At least Brexit warfare distracts from the dilapidations of never-ending austerity. Top of the heap of festering neglect is social care, disappearing for escalating numbers of old people as stricken councils cut back, care homes close, and over 1.4 million are left home alone with little or no help.
A heavy blow fell on care workers last Friday. The court of appeal overturned a previous ruling on the pay of care staff at night, at a stroke cutting their meagre pay by £30 a night. Those who sleep in for night shifts will no longer be regarded as working, no longer entitled to the £7.83 an hour minimum wage. This extraordinarily unjust ruling suggests judges have no idea of life in a care home, looking after people with dementia and severe mental disabilities. They should spend a night sleeping in on duty, to see if it feels like “work”
Yesterday I talked to Adam as he was about to start a care home shift at 3pm. It was not due to end until 5pm today. Caring for people with severe mental impairments, he works until 10pm and then “sleeps” in the home until 7am, when his next shift starts. Those he cares for don’t sleep much. “They can be up all night, talking, shouting, slamming doors, going to the toilet on the floor,” he says. On his baby monitor, he listens for people getting up or making loud noises and one woman who laughs all night, setting monitors beeping. “The man I look after mostly often comes and knocks on my door. I struggle to sleep much.” The original judgment, doubling his per-night earnings to £60, “made all the difference” to someone who was on £15,000 a year. Adam was also expecting £6,000 in back pay. But on Friday that too was withdrawn.
Most people would regard having to sleep in your place of work – let alone in a care home with heavy responsibilities, ever watchful and being woken constantly – as part of a paid job. Mothers working sleeping-in shifts often have to find babysitters for their own children, or carers for their own elderly relatives. But the judges think sleeping in is not really work: they characterised it as “available for work”, not “actually working”. Well, let the judges try it.
Adam works in a Mencap home, the charity that fought the case against the edict that care homes should pay the minimum wage for every hour during the night. The government was reluctantly obeying tribunal judgments won by Unison that said sleeping in was “work”; care homes were also ordered to pay their staff six years’ back pay. That came as a financial shock to charities and private care homes, landing them with a thumping great £400m bill. Many were already barely solvent. Some councils pay as little as £2.24 an hour per state-financed resident, barely enough to warehouse people, let alone care for them well. No wonder almost a thousand care homes have closed in the past decade.
Last year the Care Quality Commission gave a third of care homes an “inadequate” or “requires improvement” rating. Staff turnover is almost 50% a year, with EU personnel getting harder to recruit. Adam says he could find better paid work, but stays because he is fond of those he has cared for over five years: “They have become like family to me.” I have spoken to other care workers whose kindness is exploited by a system that pays them so little.
Although Unison fights on with an appeal to the supreme court, it recognises that the likes of Mencap are not to blame. Dave Prentis, Unison’s general secretary, says: “This judgment is a mistake, but let’s be clear where the fault lies.” It “must be laid at the government’s door” for underfunding social care.
A green paper on social care due in the “summer of 2017” was kicked to the “end of 2017”, then “before summer recess 2018” – and now it’s “autumn 2018”. But a new health and social care secretary will be starting all over again on this political conundrum. A King’s Fund and Health Foundation report points to 12 green or white social care papers since 1998 – all ignored, despite the urgent needs of a rapidly growing number of over-80s. Care has deteriorated so far that it would take another £15bn a year over the next decade just to restore it to 2010 quality (which was never that great).
After the Tory manifesto fiasco last year when its social care funding plan – dubbed the “dementia tax” – became electoral novichok, it is vanishingly improbable that this beleaguered government will ever do what should be done: ask older people to tap into their untaxed property bonanza to pay for care. The pollsters Ipsos Mori find that to be the least favoured option: most people want a tax-funded scheme, free for all – like the NHS. But that risks shifting the cost of wealthier elderly people on to the shoulders of a less well-off younger generation. Lord Darzi’s report for the Institute for Public Policy Research suggests that 1% on national insurance and means-testing perks such as winter fuel payments could fix it. In last year’s budget the chancellor, Philip Hammond, said “for the avoidance of doubt” options for social care “do not include and never have included a death tax”. That severely limits any socially just long-term solution.
Meanwhile, under this government in paralysis, NHS beds stay blocked for lack of care homes; many elderly people are neglected; and underpaid, undervalued staff are yet again made to pay the price. A government grinding public spending to its lowest proportion of GDP since the war causes public squalor, and exploitation of low-paid care workers.