Josie Moore gently lowers 97-year-old Doris Seaman into her armchair and lays a blanket over her lap.
“We’ll be back to see you later,” the carer promises, eyes smiling warmly above her mask.
But her expression changes to a mix of stress and weariness as she removes her PPE while we dash to her car, conscious of getting to the next house a mile away to fulfil 10 scheduled visits by the end of her seven-hour shift.
“It would be great to chat to Doris more,” she sighs. “But you have to get on to the next person.”
For Josie, 60, there’s no time for a break. She will eat on the go. All in a hard day’s work for this cheery domiciliary carer, and thousands of others who provide home care to the vulnerable.
“There’s no way of dressing up this job, but it is rewarding,” she says. “When you see people’s faces so pleased to see you it’s one of the best things,” she tells us, later. “But I do get tired and I stress about getting from one to the other on time.
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“I eat and run. I bring two flasks of coffee, bananas, crisps, chocolate. I can’t have a break when I’ve still got people to get up in the morning.”
Josie is one of just 26 staff looking after 67 people in Norfolk for PCT Care. Years ago the firm had 60 staff doing more than 1,000 hours of care a week – but this has now almost halved to 550.
Director Michael Millage tells me people with care needs that aren’t being met in Norfolk have risen from 100 to 600 due to shortages. And he warns “people will die” unless action is taken.
“We had to hand back two contracts after someone left at short notice and we couldn’t cover the care,” says Michael. “Imagine one of those people with nobody going in and they have a fall and are stuck there for a week in winter with no heating. No medication, fluids, foods – and no dignity.”
About 70% of carer vacancies in Norfolk advertised in the last three months are still open, he said. Other care firms are in the same boat – with 120,000 jobs unfilled as staff seek better-paid, lower-stress jobs after working through the height of the pandemic.
And a further 42,000 unvaccinated carers will be gone on November 11 under the No Jab No Job rule.
It is why the Sunday Mirror wants a review into staff pay and for care to be brought into line with similar NHS roles in our Stop the Care Crisis Campaign.
We also want an end to unpaid travel time for home carers, a register for them in England, and care added to the Shortage Occupation list so migrant staff can fill roles.
Michael says: “We absolutely support you. Because social care is a lower-paid workforce they’re not seen as the professionals they are. A hospital healthcare assistant does less responsible work than social carers do.
“They won’t be dealing with medication, stomas, peg feeding, and they wouldn’t do it alone.
“Social care workers go from house to house in the winter snow and dark, in rural areas. That’s a hard job.”
We joined Josie on her 10 visits to eight elderly people to experience the pressures first-hand. In a seven-hour shift in which Josie barely pauses, it is plain to see how the old and frail brighten under her care.
While Josie prepares 69-year-old Alan Crane’s lunch, he tells how one of her colleagues saved his life after he caught Covid in December.
“They found me on the floor and called paramedics,” he says. He was ventilated at Norwich Hospital and Alan says doctors at first thought he’d die within two days.
“The carer who got me off the floor saved me.”
Josie was at a hub for adults with learning disabilities when Covid struck. She returned to six shifts a week of home care when lockdown shut it.
“I was exhausted,” she says as we change masks between visits.
“PPE was hard to get hold of. At first we had silly tie-up masks that would get stuck in your hair and fall off. My main worry was taking Covid to other homes or back to my husband.”
Looking back at her 25 years as a carer, she says: “When I started I got an hour for lunch visits. I’d cook proper food for them, now it’s microwave meals. It would be nice to stay for social time, but we still do a lot of talking while I’m working.”
We move on to former florist Fiona, 75, in a wheelchair with MS.
After Josie has washed and dressed her she says: “They have worked so hard in the pandemic.
There was a team making sure nobody was left out. These carers have become my friends. If I had a fall they’d wait with me to make sure I was OK.”
Josie, a mother of one and stepmum of four, adds: “I got all these lovely ladies and can’t leave them so I have to stay at PCT.”
Staff at PCT Care earn either £11.43 an hour which factors in mileage and travel time or, in Josie’s case, £9.11, with travel costs on expenses. PCT pays petrol costs as council funding only covers “care hours”.
During the shift we cover 25 miles, about £2.20 in fuel. So without travel costs, Josie would be just slightly above the £8.91 National Living Wage.
“The pay is rubbish though you don’t do this just for money. But I support your campaign as a rise would help. We’re the poor cousins of healthcare.”
To ease pressure on workers like Josie, PCT manager Tracy Bibby and co-ordinators Jane Coles and Julie James have stepped in to cover care shifts on top of their office work.
PCT is advertising “constantly” with £50 bonuses for staff referring new full-timers who stay for three months.
Experts forecast up to 627,000 extra social care staff – a 53% jump – will be needed by 2030. But Michael says: “We compete with supermarket roles – no running around and more pay.”
He fears the Tories’ £162million to fund workforce retention and recruitment is unlikely to make a significant difference to individual carers.
And he says the proposed “staff banks” to address the issue demonstrate a lack of understanding of the sector.
“Where are they coming from – is there a people tree?” he asks. “Pools of agencies will take away the bond carers have with people and families.”
As we say goodbye to Josie’s final client – a 91-year-old widow who we leave watching a quiz show – the carer heads off to begin her own housework.
“I’ll play games on my tablet later to unwind,” she says. But she admits she will be asleep by 9pm before her alarm goes off at 5.30am to do it all again.
A day in the life of a carer
It’s dark when we arrive at 91year-old Susan’s home so Josie can get her up and dressed. She makes her sweet porridge and settles her in front of the television while she sorts out her medication.
“I haven’t left this place in two years,” Susan says. “I wouldn’t dare go out with this virus. I sit here watching television all day. I wish Josie could come more.”
Doris Seaman hasn’t been able to walk since she broke her left leg in a fall three years ago. Josie gets the 97-year-old up and dressed, then wheels her into the room and uses a transfer device to move her into her armchair. Handing the great gran a cup of tea, a flustered Josie tells us: “I’m getting hot now – I’m sweating.”
Cynthia Ladbrooke tears up as she tells us how much she looks forward to Josie’s visits. Her husband of 55 years David died of leukaemia three years ago, and her sisters and brother in law have also passed away. “It can get very lonely,” she says as Josie gently wipes crumbs of toast from the 84-year-old’s face.
Josie gets former florist Fiona, who has progressive MS, up and dressed. The 75-year-old beams at her. “Think of all those people who are bed-ridden and alone and wouldn’t see a soul all day if it wasn’t for your team.
Josie helps retired publican and shop worker Pauline James to get up and dressed before handing her a cup of tea and taking notes about her meds. The 90-year-old widow tells us: “I can’t do much now. I’ve been diagnosed with age-related macular disease so I’ve only got one eye that’s any good and worry that something should happen which is why it’s nice to have people like Josie.”
Next we head to see Anne Roney, who Josie helps out of bed and dresses. The gran of two relied on carers massively during the pandemic. “I have COPD and came out of hospital after double pneumonia just before covid, so nobody else was allowed near me,” she explains. “I don’t know what I’d have done without them.”
We’re back at Doris’ home so Josie can help the pensioner to the toilet and make sure she’s had her lunch. The carer tells us: “Doris loves getting her nails done so during parts of the pandemic when she couldn’t get out I’d bring my own polish over and give her a manicure, which she loved.”
Josie moves seamlessly between checking Alan Crane is comfortable, chatting away and giving the 69-year-old’s home a quick tidy. He tells us how another carer saved his life when he collapsed with covid in the pandemic.
Jack Kemp’s eyes fill with tears as he explains he cared for his late wife Barbara for 13 years as she battled Alzheimers because she didn’t want to move into a care home. The dedication of domiciliary carers provide him with the same opportunity to keep some independence, the former RAF photographer says.
Josie empties the 90-year-old’s catheter and prepares him some cheese on toast. “Carers care when it feels like nobody else does,” he says. I moved in here two years ago just before the lockdown so I didn’t know any of my neighbours or have friends here, though luckily my son is nearby. It was a pretty lonely life.”
We return to Susan, who is happy to see us after six hours alone. Josie makes her an ice cream cone and sorts her laundry, then settles her in with a hot chocolate – chatting with the same energy and kindness after seven hours of graft as she was this morning.