Promises given over Fife's home care service

That was the promise from Michael Kellet, director of Fife’s health and social care partnership in the wake of a deluge of complaints from clients of the home care system and carers themselves.

And he says that more staff, increased communication between staff and users of the service and more time to bed in the existing changes before moving forward will help improve the situation.

He spoke directly to the Press after a fortnight of negative headlines as people – service users and staff – spoke out about the problems they have endured since the home care changes were opened out.

Mr Kellet said: “We take very seriously the complaints and issues that have been raised in the newspaper.

“These complaints are regrettable and I am personally sorry for the fact that we have let our service users and their families down and all of us in the partnership are determined to do better and make sure that we can resolve these problems.”

Over the past two weeks the Press has highlighted some of the complaints received about the new home care service, including a lady left sitting on a commode for almost two hours and a man who refused to have a proper shower for over two weeks because he did not have his regular carer.

At the end of last week Councillor David Ross, leader of Fife Council, set up an emergency meeting to tackle growing concerns.

This resulted in more staff being taken on and the roll out of the new Total Mobile electronic system for home carers being halted to allow the bedding in of that already introduced and for lessons to be learned.

Acknowledging that the service had fallen short, Mr Kellet urged anyone experiencing any problems to come to them directly as quickly as possible to speak to someone.

He explained that the new Total Mobile had been introduced in Cardenden and the Templehall area of Kirkcaldy between April and June this year when it had gone “pretty well and without any significant issues.”

However it was when it was rolled out to Kirkcaldy and Leven in September that problems started to arise.

“On the basis of that we have paused any further roll-out to learn the lessons from what has happened here – we think that’s really important,” he said.

“We are looking individually at each of the cases which have been highlighted and have been in dialogue with the service users and their families to say sorry and to check that we are improving things for them.”

Mr Kellet explained that the main aim of Total Mobile was to ensure that the partnership was getting the best from the “precious resource” of the home care staff and their time.

“Money was not the main aim here,” he said, although there would be cost savings in the long run.

He said Total Mobile was being used successfully in other parts of Scotland and the partnership believes it can be used successfully in Fife.

“It worked well before, but we do need to learn lessons,” he said, one of those being the need for more staff.

A recruitment drive to bring in 100 more staff has already achieved 62 being put in place, with another 25 expected in the near future and the rest “as soon as possible.”

“I am not predicting that will be the panacea, but it will help us to meet our obligation to our customers.

He admitted that there was a shortage of staff, but said he did not believe that had been the particular cause of the problems.

“Total Mobile has generated some of these problems but getting more staff will help us to provide a better service.”

The service sees the home carers appointments sent to their mobile phone, with the times and clients arranged to fit the most efficient geographical areas.

However Mr Kellet said that the intention was still to provide a “person centred service.”

“Where at all possible – although it won’t be possible all the time – we try to provide continuity of care so both the staff and person receiving the care can build up a relationship.

“However we have to take into account holidays, sickness absence and staff training, so a person is not guaranteed to see the same carer all the time. In a number of cases this has been what has happened and it is nothing to do with Total Mobile.

“We do our utmost to respect our client’s personal dignity, but we can’t always meet that need. It is about getting the balance right and we do realise that someone seeing ten different carers in ten days is not doing that and that is one of the things we are looking at.

“We are trying to deliver personal care, respecting a person’s dignity while also ensuring that, given our limited resources, we are providing the most efficient service we can, and that is not easy when, to date, you have delivered 190,000 scheduled visits in the Kirkcaldy and Levenmouth area.”

Staff absence levels have been highlighted as one of the problems – and Mr Kellet said he acknowledged that it was a time of change for home carers.

Two carers also contacted the Press to express their concerns about the new system, saying they were unable to deliver the best care to their clients.

“We understand that changes can be stressful and we want to support our staff so they can better support the clients,” said the director.

“ Absence levels are monitored on a regular basis and we want to support them to be at their work. There have been increases in absence levels but we are actively managing these.

“Where it is necessary to support our service users we will use agency staff, but clearly that is not our first choice as it would mean a break in continuity of care and cost us money.

“There’s an increasing demand on the service. We have an increasing elderly population which means demand for the services are going up and theres an obligation on us to ensure that our resources are deployed as efficiently as possible.

“That’s where the impetus for the change of system came from.

“We are trying to ensure that it is patient need which drives the system and not the system driving patient need, so if someone needs support then they will get it as much as we are able to provide it.”