Meeting the Assessed Need

This is how our service works. We get most of our work through Social Services with a growing proportion through the Health Trust and some contracts from the Alzheimer's Society. The customer is assessed, the level of care they need is determined, and then we are contracted to deliver that care. We get a BPI - that is Basic Person Information, a great idea which was supposed to streamline information sharing and mean that all parties got a copy of the documentation and the customer only goes through the question asking process once. In practice the BPI is usually thirty sheets of blank paper with a page of basic info at the front - in other words, a ruddy waste of trees. We also get a care plan which details the time and duration of the call and the tasks we are to do. It is not unreasonable that the purchaser wants us to do only the tasks on the care plan, they are paying after all. Logical this may be, easy to do it isn't. People have needs and we all like to have our needs met....
Mary is not great on her feet. She uses a stick and various pieces of furniture to get around her bungalow and she needs help to dress, wash and get in and out of bed. Her life, like many of the people we care for, is damn lonely. Her son lives in Australia and her remaining siblings are not nearby and are as frail as she is. Mary doesn't mind too much though, because Mary has George. George is the biggest hairiest mongrel dog you could possibly imagine. His eyes glint behind a crazy mop of hair and his great plumed tail sweeps ornaments from tables and frequently has Mary swaying as it batters her when he leaps up to greet the carers. George is delighted to see everyone, if only the feeling was universally reciprocated.
Carers are like any other cross section of society and, as such, it isn't surprising that some of them are not dog lovers. In fact, some of them are downright terrified of dogs. We usually deal with this by asking the customer to ensure that dogs are shut away when carers visit but Mary is not quick or agile enough to put George away when we arrive. There is a further problem. Like his owner, George is not getting any younger and his bowels are not what they were. Mary cannot exercise George and sometimes George just cannot wait.
It's a dilemma. Social Services do not pay us to walk George and they certainly do not pay us to clean up after him. Some of the team do not want to go in to Mary at all and even those that do are less than thrilled when they step into a pile of dog pooh. Mary says she will do without care before she does without George and I don't really blame her. So - as so often seems to be the case - it is left to the Care Agency to apply some humanity and sense to the system. In practice this means that I pay the carers who are willing to do the call an extra fifteen minutes per visit to walk George. Mary is on a tiny pension, she can't pay, and I can't live with Mary not having care. It takes any profit out of the call but if I was in this purely for profit I shouldn't be here at all.
This would be a nice fluffy story if it wasn't for the fact that today I had to explain myself to the Care Assessor from Social Services. One of Mary's neighbours has complained to the Council that our staff are walking the dog...something along the lines of "Is this what I pay my taxes for?" I explained that Social Services were not footing the bill for George's service and that was fine by the Social Worker, though I think she was of the opinion I was a bit bonkers and would never be a millionaire (she is right on both counts) I just can't stop thinking about that neighbour, how could anyone be so mean?