Employing someone to work in your home is a big decision to make. In this post I provide a few tips and suggestions based on my own experience of employing carers for James.
When James was very young it became apparent that his level of need was going to mean we needed some additional support at home. He was very tiny, severe reflux meant he was in and out of hospital and failing to thrive. He was constantly sick and could only take a few ounces of feed every hour or two, day and night. Even when he had nasal tubes for us to supplement his feed he struggled. Just keeping on top of his feeding alone was exhausting without the many other complications. Darryl was working full time and after my maternity leave I had returned to work part time. Between us we’d do shifts at night, but between feeding and cleaning up when James was sick we would often both go to work on very little sleep only to come home and start over again.
Ask For Help
Initially, our health visitor was able to get us some support from the paediatric community nursing team. Some time before James’ first birthday they began to come to us two nights a week at 10pm and leave at 7am. This was a waking night shift. That continued for a few years but, as things became increasingly difficult, we were given the funds to find agency help for some additional nights. If my memory serves me correctly James was around 7 years old by then.
I had no previous knowledge at all about care agencies and what I found was that their services largely seemed to be aimed at the elderly, dementia patients or people recuperating after illness or surgery. I was then told about a relatively new company who specialised in caring for children with disabilities. The manager came out to meet me and so began our long working relationship which lasted until covid hit in March 2020 and we stopped all outside staff coming into our home. Little did we know then that James was going to move into his own flat in April 2021 and we would never be having agency staff in again.
Continuity Was Important
Unfortunately, my experience is that a considerable amount of agency staff are looking for short term employment. They often work for an agency alongside studying. This can mean that, due to other commitments, they may be very restricted as to when they are available to work as they are working around college/university timetables. We had many staff who once they had completed their studies then moved on to find full time jobs. This constant turnover of staff is not great at all. As James has complex needs it was essential that we had the same regular staff. He couldn’t have someone he didn’t know fill in if his staff weren’t available. He was asleep in bed when they arrived at 10pm and it would be totally unacceptable for him to wake to someone he had never met before, plus his routines and care plans were very comprehensive so it was important that staff were familiar with this.
Initially when introducing a new care worker to us the agency asked if they could come and meet us during the day, but this was not appropriate due to the complexity of James night time routine. Reluctantly the agency agreed to paying new staff to come in with a regular carer who knew James well and to do a whole night shadow shift and meet him properly when he woke in the morning.
Amongst our care staff we had many who were young mums. They seemed to feel that this was a way they could work alongside bringing up their own children and I’m sure that often works successfully. But we had numerous issues with this. We’d get let down because either their partners didn’t get home in time to care for their own children or their own childcare let them down. They weren’t always disciplined about making sure they had enough sleep to do a waking night shift. This was a particular issue during the school holidays or if their children were home sick. We had times when I would find staff asleep on shift when they were meant to be watching James. My youngest son, Harry, would often alert me to this as he would hear them snoring when he got up to the bathroom. I’d go in and find them asleep and send them home whatever the time was and I’d never have them back again. Once they had broken my trust I couldn’t knowingly go to bed leaving James in their care again. We had some staff who would regularly call in sick when their own children were on school holidays, and one who would commit to working but would then ring in sick every bank holiday. It got that we knew it would happen and would wait for the phone call.
Good Staff Were Hard To Come By
We did, of course, have some lovely, reliable staff. These were often more mature and for them it was their job rather than a stop gap. I was always keen to hang on to them but the agency seemed to struggle to retain good staff and it was often the case that we lost them as they were placed where it was felt there was a greater need. There was a lot of that went on. I’d get a call to say our carer was off sick, next time they were in I’d ask if they were better and find they weren’t off sick at all but had been placed elsewhere. Communication from the agency office staff was poor and I often caught them out for blatant lying. Unfortunately I had many run-ins with them, many meetings trying to rectify the ongoing issues we had. For a while I even moved to another agency but found that it was no better. Sadly, it seemed to be how agencies ran.
Because staff were cancelled so regularly there were times that management would send in staff to cover a shift who were unwell and in no fit state to be working with a vulnerable young person. I’d let them in and quickly realise they didn’t appear well, or on occasion the staff told me themselves they had told the manager they felt sick but they’d been told to come in and let me make that decision to send them home. I sent staff home many times and the agency tried to charge me for the night. They’d argue that they provided me with staff and it was my choice to send them away. I never paid for those nights. It got so ridiculous in the end the agency would send me my monthly invoice and I’d query something and they’d say pay what you think you owe so I did!
Unreliable!
There were times I’d get so frustrated by the poor service we were getting that I wondered if it was worth having them in at all. We’d get let down so often and for various reasons I always appeared to be complaining to them. The intrusion into our home and our privacy was a lot to deal with too, and Harry found this hard as well, but the reality was that without those nights where we could get some sleep we wouldn’t be able to manage.
Over the years I think we experienced every possible excuse or scenario there could possibly be in terms of working with agency support but there’s one story I must tell you, if for no other reason than it was totally unbelievable. We’d had a young carer coming to us for some time. She was a nice girl, seemed to work ok and get on with James. One morning when my husband, Darryl, had come downstairs he noticed that the clothes airer I’d left stood in front of our conservatory door into the garden was moved. He asked me if I’d moved it, I knew I hadn’t. What became apparent was that in the middle of the night the carer had come downstairs, she had gone into a cupboard and found the key to our kitchen door leading into the conservatory, she also found the key for the door to the garden, had moved the airer and gone into the garden for a smoke. She didn’t hide her tracks very well because she left ash and the cigarette butt in the garden, but when she came back in she locked both doors and replaced the keys but had failed to put the clothes airer back. She had left a vulnerable young person who was connected up to a feeding pump and could’ve had a seizure at any time to go outside and have a smoke. Needless to say she did not come back into my house!!
Things To Consider
I’m sure many of you will have had your own experiences with agency staff both good and bad. I really hope you have had more positive experiences than me. I have put together some tips and things to consider if you are looking to employ agency workers in your home.
🤔 If you decide you need the support of an outside agency do some research. Ask around, recommendations are always good. Check that any agencies you decide to contact are CQC registered. The Care Quality Commission evaluate and review all agencies with regard to leadership, health care, safety, effectiveness, caring and responsiveness. You will find the CQC rating of registered agencies on the agency’s own website and also on the CQC official website. The CQC carry out yearly inspections but if an agency is under performing it may be more frequent.
🤔 Think about exactly what care it is you require in order that you can ask for an estimate of costings. Look at the agencies website to see if they offer the support you require, some agencies specialise in specific types of care. If you are not funding this yourself you will need to discuss this with your Social Worker or care manager if you have one, or contact your local Social Services department. You may need to undergo an assessment so that funding can be arranged. You may wish to ask how the agencies handle payments e.g. are you invoiced directly and therefore responsible for paying them. Bear in mind too that the agency may charge more at weekends and Bank Holidays.
🤔 When you first meet with the agency ask about personalised care plans. Do you and the agency discuss and write this together? Be as specific as you can about your requirements to avoid any confusion down the line. Do they review the care plan, how often, what if the care plan is not meeting your needs?
🤔 Ask how the agency recruit their carers, what references, criminal background checks etc they carry out. What qualifications do they have?
🤔 How does the agency match care workers to clients? Will you always have the same care worker – continuity may or may not be important to you. What happens if your care worker is off sick or on holiday? What training do they have – they may need to use specific pieces of equipment, carry out specified procedures in relation to your child’s care. Do they have experience in your child’s condition?
🤔 What records of visits will be kept and do you have access to them?
🤔 Can you have a trial period and then review what is/isn’t working for you? Can you ask to have different staff if you feel you and your child’s carer are not compatible?
These really are just a few ideas for you to think about. There are many more questions you may wish to ask. Employing someone to work in your home is a big decision to make. As we found it can be really intrusive so it’s important to have carers you feel comfortable with and trust, particularly if you are going out and leaving the carer alone with your child in your home, or going to bed as we did. You can find a lot more information about employing care agency staff online.
