Care Quality Commission www.cqc.org.uk/
Clients: Range of Client Care
As a domiciliary care agency, we introduce carers to cater for a wide range of needs, where specialist or nursing skills are not required.
see Carer's Job Description
Limits:
Trinity Homecare is not a nursing agency, and is of the opinion that it is best if the client's regular community nurses carry out any specialist tasks, if these are required.
Extracts from our policy guide-lines for best practice are:
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Medication:
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Movement and Handling: |
Our approach to Dementia
As our carers are not necessarily trained in dementia care our philosophy is to:
- obtain and maintain a deep understanding of the client's situation,
- select carers matching clients' temperament and needs,
- provide training involving videos and our care plan, which includes a dementia diagnostic and risk assessment section,
- provide the carer with comprehensive written details of their placement, and
- maintain ongoing close contact with the client, the carer and the family, problem solving as we go along.
Francine Lawrence, the daughter of a client, wrote an article in the March 2009 edition of Women & Home magazine about her experience with her mother, who has dementia, and of the battle she fought for funding. The article was extremely well received and is reproduced here.
Clients: Understanding Clients' Needs
In order to ensure successful placements, two points should be born in mind:
- Unlike nurses, carers are not trained to a consistent standard. Many do not have any formal training at all. We cannot supply an experienced carer who is suitable and has the right personality without having a thorough understanding of our client's situation. Therefore we will need to ask for a lot of information about the client and their circumstances, both at the outset and also on an on-going basis.
- A physical environment must be present in which a safe system of care can operate. Even the most qualified carers cannot carry out their work satisfactorily on an ongoing basis if the right layout and equipment is not present. We are trained in risk assessment and can advise how best successful care can operate. We do need to understand the physical environment in order to select carers with the appropriate training.
The agency will ask for the necessary information on the telephone, and then at a later stage by the return of a completed registration form. Trinity Homecare has a confidentiality policy and is registered under the Data Protection Act.
Home visits:
In the majority of cases, we visit our clients in order to meet you personally and to ensure that we select the best carer for you. It also enables us to carry out an assessment to ensure that the client and the carer are in a safe working environment together.
Clients: Recruitment, Selection and Placement of Carers
Factors affecting who we choose: In order to provide continuity for our clients, we recruit carers who positively wish to save the expense of food and accommodation and do something worthwhile at the same time. We find that most suitable English carers have homes of their own and do not want to do ongoing live-in care work for clients who may be located anywhere in the UK. Who they are: The majority of our carers are from such countries as Australia, New Zealand and South Africa. Most have working holiday visas and are between 23 and 32 years old. Some, including older carers, have British or other European passports or a UK Ancestry visa and wish to work while visiting relatives. Our attitude is to select carers for their best overall qualities. We have also been able to place successfully a few carers from the European Union, as more are able to speak colloquial English fluently enough for our clients than in the past. Some may have previous experience as nurses or carers; most have obtained a degree or other qualification. With their positive, practical, cheerful and hardworking attitude, they make excellent all round carers.
Their suitability:
Each new applicant is interviewed and assessed comprehensively and individually.
Fresh verbal and written references are obtained by the relevant Care Manager.
Criminal Records Bureau Enhanced Disclosures are carried out for each carer by Trinity Homecare, which is a CRB Registered Body.
Each client has their own Care Manager, who will discuss the placement of carers with their client or representative, and ensure that we have a good understanding of each client's personal preferences, temperament, circumstances and requirements.
We see it as being in the interests, both of our clients and the carers, that we get the selection right first time.
We can arrange for clients or their relations to meet a new carer in advance, if they would like to.
A two week trial period can be arranged, if this is felt to be a good way to reduce any anxiety. Other clients might prefer the reassurance of a commitment to stay for a minimum period of six weeks, for example.
The arrangements are flexible to suit each client and it is the client's choice regarding who they accept as a live-in carer in their own home.
See Carer section
Clients: Time Period
The period of care can be short to meet a contingency. For long-term care we ask the carers to commit to a minimum of 6 to 8 weeks. Carers can stay as long as both parties want and sometimes stay for a lot longer with one client. However, please bear in mind that many of the carers will have travel plans.
Most carers live-in for 6 to 7 days a week. Sometimes the carer lives in for 7 nights and has 12 hours away on a half day off. We are unable to recruit carers for less than 6 days unless the client lives near London. The reason this is considerably more difficult is because the carers usually do not have alternative accommodation, and also prefer a higher income.
In the London area, we are sometimes able to recruit a non-resident or night-time relief carer to support the live-in carers. Carers who work 7 days week, often have a 5 day break in the middle of a placement. We are able to provide relief carers for this, or for weekends, particularly Saturday morning to Sunday evening.
We recommend that all carers should have a minimum of two hours break a day and 8 hours uninterrupted sleep at night. Extra care needs to be arranged if this is not possible.
See Carer section
Clients: Agency Support
To help clients manage care in the home, we provide each carer with up-to-date comprehensive individual Placement Details containing information drawn from your Registration Form, our enquiries and anything else you would like to add.
We also provide each client with a comprehensive Care Plan. This contains guidelines and general information for carers and clients.
The Care Plan is a valuable tool for ensuring that the carers carry out all the care related duties expected of them, and that they have all the information about their client that they need.
Each client's Care Manager will keep up to date with the client's situation and will be happy to discuss individual circumstances on the telephone.
Clients and carers may contact us out of hours if the situation is urgent.
See About Us and Contact Us
Clients: Fees and Availability of Financial Help
We believe that to grow our business we must remain affordable, and whilst we are not the cheapest, we have been able to keep our charges in the middle of the range of our main competitors. You might find it surprising that some introduction agencies are still more expensive than the cheapest employment businesses. See Choosing an Agency.
It is best to discuss the estimated cost with the agency as each situation is different according to the amount of help a person needs, how many days per week and also where they live.
There are two levels of care depending on each client’s needs, difficulty and level of carer experience required:
Level 1, where carers may not have care experience, is for clients who can walk unaided, needing minimal help with physical and mental health needs. Duties usually involve housekeeping: cooking, light cleaning, laundry, driving, shopping, helping with all activities of daily living and giving companionship.
Level 2, usually requiring experienced carers, is for clients needing more "personal" care with mobility, washing, dressing, elimination (bowel and bladder functions), continence, decision making, and any other difficulty with mental health, including difficult behaviour, social isolation of the carer, and where for difficulty of recruitment reasons it is necessary to pay the Level 2 rate.
Age Concern has some extremely helpful and informative Fact Sheets about how to obtain Attendance Allowances, Direct Payments or NHS Continuing Care Allowance. Age Concern
See About Us and Contact Us
Clients: Choosing An Agency
Trinity Homecare is an Introduction Agency, whereas agencies that employ the carers, are known as Employment Businesses. Which type you choose will have a very significant impact on the cost of care.
Since April 2003, all care agencies have been subject to regulation under the Care Standards Act 2000. Detailed regulations have been developed regulating how care agencies should conduct themselves, and these are set out in what are called National Minimum Standards for Domiciliary Care Agencies.
The Standards recognises the two distinct types of agency: Employment Businesses, and Introduction Only Agencies.
The main features of the two types are as follows:
Employment businesses
Employment businesses employ the carers. They are required under the National Minimum Standards among other things to:
- Visit clients annually to conduct risk assessments and to ensure that the carer is working in a safe environment.
- Provide a minimum of 3 days induction training for new carers recruited.
- Require all carers to register for, and gain, NVQ Level 2 In Care within three years, and to have a minimum of 50% of carers on the staff to be so qualified by the year 2008.
One factor to bear in mind, is that as employers, employment businesses will pass on to their clients all the costs of employment, including employers' National Insurance contributions (12.8%), and costs of maintaining a payroll.
Introduction Agencies
Trinity Homecare Ltd is included in this group, which place self-employed carers, and is exempt from the above requirements.
Costs to clients should, therefore, be significantly lower than the charges made by employment businesses.
The vast majority of homecare in the UK is carried out through daily visits by carers organised by local agencies. The full National Minimum Standards have been drawn up to address these agencies.
Although the requirements set out above appear to be very beneficial, apart from the extra cost, they are actually restrictive towards the functioning of high quality individual live-in care, for the following reasons:
- In order to carry out frequent home visits, many agencies have had to restrict their client base to within easy reach from the agency office. It is our opinion that each client’s circumstances are more important than where they live. To attain high quality carers, the office should be placed in best possible location for recruitment. In addition, we feel that risk assessments are best carried out by the carer working in the position, and by the client's own healthcare professionals. It is also our opinion that the client should provide a safe environment for the carer, with the help of these professionals.
See Agency Support
- Three days of induction training is a good thing, but may not be as good as it sounds. The National Minimum Standards were designed for social services. The training requirements cover such a broad spectrum of subjects, that certain aspects of knowledge, that may be essential for individual clients, will not be covered adequately in such a general training.
- When a carer is living in with their client, it is our opinion that, firstly, they must already be well matched to the client's requirements and, secondly, that induction should be carried out on an individual basis in the client's own home. We agree that some general induction training is important and do carry this out, in spite of our exemption, as well as individual client briefing. < see Training > [internal link to Carer Page FAQ 32 Will I be given any training….]
- Agencies that recruit carers from Australia, New Zealand and South Africa are unable to fulfil the NVQ requirements imposed on employment businesses, as these people, who make excellent carers, are not eligible for a number of reasons. Unlike the introduction agencies, employment businesses will, therefore, be restricted in their ability to recruit these carers.
- Most British people doing care work have homes of their own and do not want to live in another person’s home. Those carers who are prepared to live-in are usually only prepared to work on a two weeks on, one week off basis, or similar. To overcome this problem, we recruit carers from overseas who want to save up money without incurring the costs of food and accommodation. They are also usually available for reasonable periods of time. We choose to be an introduction agency partly because it gives us much greater choice regarding whom we recruit at any particular time, whereas otherwise we would be limited to whoever is on our payroll.
Other points to consider are:
- Clients are responsible for directing their own care. This gives the client autonomy and choice. It is Trinity Homecare policy that each client has a family member or friend who can help them if need be, preferably with power of attorney already set up. The agency keeps in very close touch and will give support - it is usually a team process! see < Agency support > [*internal link to section below]
- Clients, or their representatives, will need to pay both the carer and the agency separately. It is more labour intensive for the clients, but it keeps the cost of care down, there are no hidden expenses, and the client has more control. The carers are responsible for paying their own tax and national insurance contributions.
Clients: How To Proceed
Please Call Trinity Homecare on 020 8307 7662
We will be delighted to discuss your circumstances and between us decide on whether having a live-in carer is the right solution for you, and also which level of care is best.
We will send you a Registration Form to complete, together with our Fee Rate Schedule and our Terms of Business, which is also available in PDF format via email if preferred. In the meantime we will begin selecting the right carer for you.
If you do contact us by email but please bear in mind that we will still need to speak to you to discuss your situation.
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Office hours: 9.00am - 5.00pm Monday to Friday
Clients: Testimonials
“H leaves us today, sadly. She is absolutely first class. Never misses a trick and all done in a cheerful and unobtrusive way. My mother has felt entirely comfortable and well supported, and has the highest quality of life possible. Your back-up system, selection process and method work very well. Many thanks,”
"Thank you as always for your help, but most particularly at this time for looking after M who often says that she just couldn't imagine how she would manage without the affection and understanding of those around her".
"Firstly, thank you so much for your very comprehensive assessment dated 28th December. S, J and I, after a huge amount of careful consideration, have decided, as I mentioned on the telephone on Tuesday, to place my mother into a nursing home. I would like to thank you, and Karin and all at Trinity Homecare for your efficient handling of all the girls over the two years we have been with the agency. We have been extremely grateful for the care you have shown my mother and I will always recommend Trinity."
"Dear Rosie, I was so touched by your kind letter. You know better than most that T's death is a blessed release and we can only give thanks that this truly remarkable man is now free from all his difficulties. As you know he slipped most peacefully away and died in his deep sleep. N, who literally has been a godsend, tended to him with utmost care and love right on until the end. I will never be able to thank her for what she did for him - and for me and my children too. She is cheerful, intelligent, efficient and skilled. Of all the wonderful girls you have sent us, she was the perfect one to be with him at the end. She is the most wonderful person and I wish her all of the best in the world - she certainly deserves it. All the girls you have found for us have been first class carers, and not only that, they have fitted into our home and domestic life so well too. You at the agency have a real gift for matching people with people. I and my children thank you and Karin, and indeed everyone at Trinity for all your kindness, tact and sensitivity and for making these last difficult years, both for D and the family, so much less sad than they might have been. With my gratitude and very best wishes to all at Trinity, Yours ever,”
“Dear Mrs Hodgkinson, thank you so much for sending me E - she has done a lovely job and been both conscientious and kind, both efficient & a pleasure to have around. I hope she has been as happy here as I have been with her company."
“Rosie - did you say, helpful? That is the most insightful, thoughtful, clearest and altogether MOST helpful report I've ever seen about my mother - or anyone! My brother , who has the power of attorney, will be staying with me on Monday night, and I will go over it with him. Thanks again, dear Rosie, for taking so much trouble,”
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Member of the United Kingdom Home Care Association
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Member Recruitment Employers Confederation
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| Attachment | Size |
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| Dementia F Lawarence article.pdf | 151.99 KB |
