Domiciliary care changes branded ‘cost cutting exercise’

The Western Health and Social Care Trust (WHSCT) has been accused of introducing major changes in the provision of domiciliary care in Derry’s cityside without prior consultation or agreement with service users or their carers.

People receiving domiciliary care were informed about the changes in a letter from the Trust’s director of community and older people’s services; they came into effect on Monday morning (March 10).

Sent on January 30, 2025, the letter referred to the changes as “Homecare Optimisation” which commenced in 2018/19 as part of the Trust’s “Delivering Value strategic policy”.

It continued: “Following the successful reorganisation of care rotas in other Trust localities, in partnership with our contracted domiciliary care providers, the Trust is now preparing to implement similar changes within the cityside locality. 

“It is intended that the changes will improve the efficiency and effectiveness of the service that you receive and increase accessibility to the service for other individuals.”

Service user Davy Cregan (71) described the changes as a “cost cutting exercise” which demonstrated a “complete lack of respect for the dignity, circumstances and in some cases age” of domiciliary care service users.

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Speaking to The Derry News Mr Cregan added: “From chatting to some of my friends who also have domiciliary care packages, I am also reliably informed that many of the carers who will be affected by these changes were not consulted; they have received little or no information about who they will be caring for after Monday or indeed where they will be expected to go, as a result they are quite upset.

“Like many others, as a person who requires domiciliary care, I have developed a great relationship with my carers over the years. I like them. I feel comfortable with them. They have gotten to know me. I would say they have become part of the family!

“I know a person whose mother has dementia and requires domiciliary care. He is very worried about her because there will be new people, people with whom she is not familiar, coming into her home. What if she gets a different carer every day? No-one knows what is going to happen under these changes. 

“These new rotas are designed to suit the WHSCT. People who require domiciliary care are human beings and deserve to be treated with more empathy. Our carers are not pieces of paper who can be cut out and pasted anywhere. I would ask the Trust to delay the implementation of these new rotas to allow everyone involved to have a say about how they will be affected. It didn’t think about the effect, the harm caused to people, especially those with dementia, of losing careers who have been coming into them for years and people with dementia,” said Mr Cregan.

A domiciliary care worker who contacted The Derry News said they were only told recently they would be getting a new rota.

They added: “Two weeks ago, we were told to come and collect our new rotas on Wednesday, four days before the changes come into effect. We were told it was all hush hush. Our service users do not know who their new carers are going to be.  They don’t even know what company is going to be providing them. Thankfully, the call times are remaining the same. 

“You would build up a relationship with the people we care for. My own family has carers coming into their home and they have built up a brilliant relationship with them. I understand their frustrations with the changes which haven’t been introduced in a thoughtful way. 

“I spent last week saying goodbye to people. It is sad. Service users are saying to me they don’t think the way they are being treated is fair. They are frustrated. People living on their own, people with memory problems, maybe dementia, are worried about different people coming into their home. 

“It takes a while to get used to a new face. This is a very upsetting situation all around. Service users will not know who their new carers will be until they step in the door next week. That is a worry for an older person. It is unsettling. Not only that, carers who might have been on holiday this week will not have had the chance to say goodbye to the people they care for,” said the carer. 

A spokesperson for the Western Health and Social Services Trust told The Derry News, service users would  not have a reduction in services.

“The project is predicated on generating additional service capacity from within existing homecare resources,” added the spokesperson. “This is achieved by consolidating service delivery arrangements within a locality, based on localised care teams.

“The independent sector homecare providers, whom the Trust has contracts with, have been working with the Trust on this initiative. The project also includes the Trust’s in-house homecare service.

“The additional capacity generated by the project allows the Trust to respond to existing demand pressures including hospital discharges, waiting lists, hard to reach areas and future growth in demand.

 “In rolling out the service changes there will be adjustments to service user’s care arrangements.  All service users were written to a number of weeks ago about the changes being implemented. Service users were encouraged to speak to their Social Worker should they have any concerns and our social workers continue to work closely with these service users to provide further clarification and reassurance. We would encourage any service user or family member who has concerns about the changes to make contact with their social worker,” said the spokesperson.

They added that the project team was “working in partnership” with social work colleagues who liaise closely with affected individuals and homecare providers to ensure any disruption is appropriately addressed. 

 “Homecare staff have been aware of the impending changes for some time and have been met with on a number of occasions,” said the spokesperson. “They continue to be supported by their managers regarding the change.  The care staff were consulted on the details of the new rotas in recent weeks.” 

 Derry News contacted North West Care for comment.