Homecare packages - yet another HSE shambles

SAMTALK · 10-01-2023 4:14pm

https://www.boards.ie/discussion/comment/120090328#Comment_120090328

In a way, but it's still a bottomless pit for money, money that could help elsewhere

Mrs OBumble · 10-01-2023 5:01pm

I imagine they have the same labour market issues as everyone else does.

It's not a badly paid job for the qualification and skill levels required. No everyone is on the starting wage rate, either.

But fieldwork can be difficult and unsupported, and it's hard to get enough hours (clients all want to get up, have dinner, go to bed at roughly the same time).

Available staff probably prefer hospital based jobs where they at least have colleagues to hand. I'm not sure there are any easy fixes in the current labour market.

Flinty997 · 10-01-2023 5:59pm

I think it's a very different job to most.

spaceHopper · 11-01-2023 10:46am

My experience of this seems to be the total opposite of everybody else’s. My mum is in East Meath. I got a call one day from a lady working for the HSE my mum has been approved for 1 half hour call a day. What? We never applied, oh the Public health nurse did. Talked to her, “I visited you mother one day, she’s had a fall so felt she needed it.” A year later mum is in hospital for an operation, she chocked on some toast. Parkinson’s is affecting her swallow. She’s sent to rehab under the care of a great Dr, but there is only so much they can do. Eventually Mum want’s to go home, they arranged an enhanced care package that has since been increased. She get 3 calls a say. When she left hospital she asked me to arrange overnight care for a week I convinced her to do for 3 weeks. I made it my business to get on with the agencies and cares. That worked out well the agency wasn’t in position to provide overnight care long term. It’s not part of their core business but they told me where to go to get great care privately. Mums Parkinson’s is getting much worse and she really need the help. So far I’ve filled out no paper work. I’ve had to make lots of call but I always manage to get a visit from the public health nurse, OT. They have no problem approving a sit stand electric chair or bed…

yourdeadwright · 11-01-2023 5:01pm

My mother & father have carers from the HSE & i have to say they are a god send,

The carers themselves are amazing people & do an amazing job on very little pay , Honestly i can't praise them enough

Both parents have dementia to different degrees & can be very hard work & without the carers we would be at a huge lose,

washiskin · 13-01-2023 5:44pm

My Mum ended up in step-down for months after a hospital stay because extra hours took so long to get approved.

The existing service couldn't cover the extra hours and the HSE couldn't find anyone to fill them.

We had all but given up hope when she was diagnosed with cancer and died without ever getting home.

Her existing Home Helps were incredible for the most part, although in fairness to Mam she was a very easy "service user" (a phrase I loathed). It took a long time to get the balance right, but when it did it was a godsend.

The one piece of advice I'd give anyone lucky enough to be approved and have the hours filled is don't accept anyone who lives locally if possible - we had a nightmare with one person.

BrianD3 · 05-02-2023 11:07am

Since my last post I am even more convinced that widespread fraud is happening, facilitated by the useless HSE that pays 150+ million p.a. to homecare agencies. I am having constant problems with agency staff not staying close to the allocated time and rushing the "care". They often stay less than half the time that has been allocated. Then when filling out their logsheets they either "forget" to enter the end time or else falsify it.

I complained - again - to the HSE. First thing I wanted from them was written confirmation of the hours that have been allocated to us under the homecare package. They tell me the hours over the phone and say they'll confirm in writing but then don't. Red flag.

They also tell me to "just get on to the agency" with my complaints which I have done with predictable results.

I am offering on a plate to the HSE objective evidence (incomplete agency records) and my own records that show potential fraud. All I'm getting back from them is avoidance and apathy.

Seems to me that the HSE know full well what is going on but are adopting a see no evil strategy with some token auditing, see below. An Irish solution to an Irish problem?They clearly haven't learned from the scandals of the past.

https://www.irishexaminer.com/news/arid-41049539.html

I have never signed or been asked to sign anything to confirm that a homecare visit has taken place.

https://m.independent.ie/irish-news/health/no-proof-of-visits-in-many-homecare-invoices-38298554.html

Invoices submitted with no proof. HSE logo used by private companies without authorisation. This is the sort of thing I expect from travellers calling to the house offering to do work and presenting a flyer with SEAI, tradesman guild etc. logos on them.

Deeec · 05-02-2023 2:14pm

https://www.boards.ie/discussion/comment/120204188#Comment_120204188

Brian the issues arise because both the HSE and the management of the homecare agencies dont care what level of care is delivered. They are just interested in box ticking ie. Elderly person gets carer calling to them but management couldnt care less about the quality of the care.

Also the quality of the carers varies widely. The carer industry also seems to attract a large number of people who not at all suited to the role but just see it as a job. It seems that anyone who wants to be a carer can be - which is wrong in my opinion. It is such an important role and the good ones should be paid more. The selection process should be tougher and carers should only be selected based on their suitability not because they are available.

My parents in law had an excellent female carer calling to them who became a friend to them - she was happy to do little jobs around the house aswell as delivering personal care. She always turned up on time and actually cared about their welfare. She had the sense to see what actually needed to be done and would alert the family to any important issues or observations.

She was moved on and replaced by a male carer ( because father in law was deemed to need more care). He is completely useless - the best thing I can say about him is that he turns up. He comes in makes himself a cup of tea and sits down and chats. He probably does the same in every house he calls to. He does literally nothing and sometimes seems to irritate father in law alot. When you complain you are made feel that you should be grateful to have him. His management dont care what he does or what he doesnt do as long as he is there. The guy should not be in the caring profession.

BrianD3 · 05-02-2023 8:39pm

https://www.boards.ie/discussion/comment/120204711#Comment_120204711

Sounds like your female carer was one of those who didn't need managing while the male did. He might have been an ok carer had he been properly trained and managed. If nobody is managing the staff, the result will be that the quality of service depends on individual staff members' work ethic, diligence, morals etc.

We expect private companies to rip the piss, why bother managing the staff if you'll get paid out of public money no matter how bad the service. Cut corners, turn a blind eye to time card issues and get away with as much as you can.

The travesty here is the apathy of and incompetence of the HSE. If they're going to outsource services to the private sector, stringent oversight needs to be in place. It's not rocket science. E.g. Itemised invoices that contain details of exactly what is being charged for that are checked by HSE staff. Audits carried out regularly with documentation and time cards checked and cross referenced with invoices. Care recipients and their families proactively contacted by the HSE, encouraged to keep their own records and report issues to the HSE.

As someone who worked in the public service for many years including in auditing, procurement and contract management of outsourced services, I suspect that most of what I mentioned in the paragraph above is not being done, or is being done sporadically, by the HSE. If my experience is replicated throughout the country, given that the HSE spends 150 million p.a. on homecare, there is likely fraud to the tune of tens of millions happening every year Does no-one in the Dept of Health or HSE give a crap? Or do they care about as much about public money as they do about elderly people being mistreated.

it would also make me wonder what is happening in hospitals and other settings where the HSE is relying on agency staff.

What next, will we hear that FG and FF TDs have family members in senior positions in agencies that provide services to the HSE.

Homecare packages - yet another HSE shambles

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