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Social care in the community
Social care in the community

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2.2 The service user’s perspective

We now switch from the care worker’s perspective to that of the service user – or client as they are referred to in our case study. The Local Government Ombudsman (LGO, 2012) highlighted the following points from complaints it had handled:

  • Unreliability: care workers did not always come when they were expected, or they were late.
  • Short visits: some as brief as 15 minutes, which did not allow time to complete the tasks, or exchange pleasantries.
  • Frequent changes of staff: this meant that service users did not get to know the workers.
  • Poorly trained staff: staff did not always have the right skills or attitudes, or did not treat service users with respect.

This creates a pretty bleak picture of home care. The next activity provides a different perspective on it.

Activity 3 Home care: the client's perspective

Timing: Allow about 1 hour

For this activity, you go back to the scenes you viewed in Activity 2, but this time, you look at them from the client’s perspective.

As you watch each case study again, consider the following questions.

  • What are the client’s reasons for having home care?
  • Is there any choice of care worker?
  • What does the client value about the care worker?
Download this video clip.Video player: Video 2 Case 1: Kevin and Elvis visit Brian
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Download this video clip.Video player: Video 3 Case 2: Liz visits Clarice
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Download this video clip.Video player: Video 4 Case 3: Elvis goes with Aerwyn to his class
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Download this video clip.Video player: Video 5 Case 4: Maria goes shopping with Lyn
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Discussion

Here are our thoughts. Again, don’t worry if they are different from yours.

Table 3
 Brian and June (Kevin and Elvis) Clarice (Liz)Aerwyn (Elvis)Lyn (Maria)
What are the reasons for having home care?Needed help at home to get out of hospital quickly after amputationKeeps her out of a care home, allowing her to stay in her own homeTo keep him company and attend classes, play snooker and have a laugh with himAllows her to be a free agent and live her own life, despite disability
Is there any choice of care worker?Brian does not always have the same care team (sometimes it’s two men, sometimes two women)Choice is important to Clarice, who complained when Liz was taken away, and got her backElvis says Aerwyn did not like the first worker he was offered, and asked for a changeLyn has a variety of workers, and seems to like them all
What does the client value about the care worker?Brian appreciates the work done for him, whoever does it, as it has got him out of hospitalClarice values Liz’s approach, and the fact Liz knows her so well, even down to the shopping listRegards Elvis as a friendSays: ‘All my carers treat me as a human individual’, and that Maria is kind, jolly, good company, and never rushes her

You have seen the value of home care as a way of enabling people to live in their own homes, with a reasonable quality of life, rather than in a residential home or, in Brian’s case, a hospital.

These service users get a higher standard of care than those who complained to the Local Government Ombudsman (LGO). There is some choice of care worker, some flexibility, and the fact that no one comments on reliability suggests that they can indeed rely on people arriving when they are due. They value people who get to know how they like things done, who are friendly, who treat them as human beings.

Meeting people’s needs in ways that are both professional and friendly, and flexible and reliable is not straightforward. It is, however, a very important responsibility. How would Clarice manage if for any reason Liz or another worker was unable to come? She might be in considerable difficulty and distress. To run a care agency that can provide the flexibility and, at the same time, the reliability of service that clients want is a significant challenge.