Humbled by our care home heroes: Ed Balls’s own mother has dementia. But when he worked for two weeks in a care home, nothing could prepare him for the desperate struggles of patients – and astonishingly selfless staff
Ed Balls, one-time Shadow Chancellor of the Exchequer, is kneeling on the floor in a plastic pinny, washing an elderly care home resident’s feet.
He does so with the level of gentle care and attention you’d accord to cleaning a priceless Ming dynasty vase.
He asks 94-year-old Phyllis if she likes the water hot — ‘or, like Goldilocks, just right’ — whether there are any products she prefers and, as he soaps her feet and legs with a flannel, if she is comfortable. ‘Oh yes,’ she says.
We’re now accustomed to seeing Ed, who served in Gordon Brown’s administration and was an MP until he lost his seat 2015, in a variety of guises.
Contestant on Strictly — his Gangnam Style dance with Katya Jones was a surprise sensation — and Celebrity Best Home Cook (he won earlier this year) are just two of his TV incarnations. But the 54-year-old’s latest transformation has more pressing implications.
Ed Balls has swapped the red box for the white apron as he works in a care home for a fortnight to see the strains on Britain’s care system
As Britain’s social care system teeters perilously close to collapse — a quarter of the country’s 17,600 care homes are reported to be facing bankruptcy, with the sector enduring unprecedented staff shortages — Ed has donned mask and apron to work at the sharp end.
For a two-part BBC Two documentary, he became a carer for a fortnight, joining staff at two of Saint Cecilia’s Care Homes in Scarborough, to learn exactly what it is to administer personal care to residents who have complex and varied needs.
He changes incontinence pads and cleans up urine. He washes and shaves residents; he brushes hair. He gently cajoles the obdurate into eating. He encounters some with dementia who are resistant and aggressive. And above all he is humbled by the sheer dedication of the staff.
But perhaps his most significant admission is that — although his own mum Carolyn, 83, has vascular dementia and is herself in a care home in Norwich — he had not realised just how exacting care work is.
‘The big revelation for me was that the work was much harder, much more skilled and more exhausting that I’d realised,’ he tells me.
‘I thought I was pretty informed but I didn’t know how personal the care is and how much importance is placed on putting the resident at its centre.
‘You have to understand that you are a visitor in their home and once you start thinking like that it changes everything: how they eat, dress, and if they need help with washing and continence, how that is done.
As part of his work, Ed had to care for residents like Phyllis (pictutred) in a Scarborough home
‘There’s a fine balance between respecting someone’s humanity and keeping them clean.
‘I imagined that things (like washing and feeding) were ‘done to’ residents, but the skill of the care worker is to make them happen without the resident ever losing their agency or self-respect.
‘It’s subtle and difficult to navigate the fine line between coercion and gentle persuasion.
‘You might feed a toddler by putting the food on a spoon and pretending to be an aeroplane but you don’t do that with an adult. I used to read my mum’s care notes and think, ‘How can it have taken her an hour to eat her lunch?’ But now I know the act of eating must be the residents’ decision.’
We see that dementia affects everyone differently: resident Frank can be physically aggressive.
‘He gripped [carer] Alison so hard. He inflicted a lot of pain,’ says Ed, who is charged with shaving and washing him.
‘Outside the boxing ring, how many jobs require you to absorb pain?’
Meanwhile, Kathleen, who has vascular dementia and rarely speaks, is overcome by abject terror when she tries to walk downstairs. ‘Having seen it with my mum I really understand the combination of strength and bewilderment dementia can bring.’
While Kathleen struggles, another resident, Charlie, needs to go to the loo. Ed arrives just too late and ends up swabbing the floor with a mop. It is the first of many such occasions.
Ed’s own mother – Carolyn, 83, (pictured right) – has vascular dementia and he has said he did not realise how exacting care work is despite his mother’s illness
The documentary Ed is making is his latest TV turn since leaving politics. He is best remembered for his surprising performance of Gangnam Style on Strictly Come Dancing
Charlie’s wife Lorna also has dementia and lives at Saint Cecilia’s with her husband. Her needs are different again. ‘She thinks she’s on holiday and a car is waiting outside to take her home.
‘You don’t contradict but you don’t lie either. I’d say to her, ‘Do you really want to go home? You’ve got such a lovely room upstairs’.’
Lorna is appeased, too, when Ed — deploying his Strictly skills — dances with her. We see, repeatedly, how proficient and patient carers are — yet they’re typically paid just £9.30 an hour, little more than minimum wage.
Little wonder that in 2019, even before Covid, almost 500,000 workers left the care sector. And a dire national staff shortage will be compounded when a government directive preventing carers who have not been doubled jabbed from working is implemented in November.
It is expected up to 40,000 could be forced out of their job.
This month, a report by the Care Quality Commission revealed one in ten essential jobs in care homes is now vacant as former staff take up better paid work in supermarkets, retail and hospitality.
But Ed believes the problem of recruiting and retaining carers can only be fixed if they are valued — as well as paid — more.
Inside The Care Crisis With Ed Balls sees the former Chancellor take up work in Saint Cecilia’s Nursing Home, Scarborough
He talks to carer Alison, who feels this acutely. ‘We’re not valued are we? We’re unskilled workers. You don’t have to go to university to be a carer.’
She speaks both to society and government when she says: ‘You need to look after us. Stop putting us at the bottom of the list. You may well need care yourself one day and I’m not wiping your bum.’
The solutions are multi-faceted: to focus on developing a clearly defined career path for social care staff, including better training and higher pay — and that all-important recognition for the profession.
Covid had a catastrophic effect on care homes, the over 80s being 70 times more likely to die from it than those under 40.
Yet government policy — to protect the NHS at the expense of those in social care — proved calamitous.
Hospitals discharged patients into homes without testing them for the virus, with the disease running riot among the vulnerable.
More than 40,000 care home residents have died. For Ed, the statistics have a personal resonance; half those on his mum’s care home wing lost their lives. At Saint Cecilia’s, ten died in just two weeks.
‘And you want to save everyone,’ says manager Donna, through tears. ‘It was the most difficult two weeks and it doesn’t get any easier.’
Yet, despite the valiant attempts of staff to keep their charges safe, they were blamed for outbreaks. ‘Alison told me, ‘They thought it was our fault residents were dying of Covid because we were not looking after them properly’,’ reports Ed.
As part of his work, Ed met the owners of Saint Cecilia’s, the Padgham family (pictured), who despite having multiple homes do not rake in vast profits.
‘No one celebrates success in social care. It’s taken for granted.
We see it as low-wage, unskilled but it’s incredibly skilled. And it isn’t just a case of paying more money. Carers need to stay in the job and view it as a career.’
He cites 19-year-old Cameron, a carer working with dementia patients in one of Saint Cecilia’s specialist nursing homes.
Cameron is capable, empathetic, diligent, yet he does not feel society values his contribution and has his sights set on becoming a paramedic.
‘Social care must find a way of attracting and keeping people like Cameron. The trouble is, there is no obvious career path for him in care, no pay structure.
‘There is a great danger that people with his natural skills will do something else, because they see care as a dead-end job.’
Saint Cecilia’s has four homes in the Scarborough area. One of the homes where Ed worked employs 60 staff and houses up to 44 residents. Those funded by the local authority pay £3,000 per month and private residents £4,000 to help balance the books.
Some like Frank, whose needs are particularly challenging, pay more still. His niece Jenny discloses it has cost £582,000 to keep him at Saint Cecilia’s for the past three years — and the money has come from his estate.
Ed and wife Yvette Cooper MP have three children and have been married for 23 years
Her uncle, she says, really needs one-to-one, round-the-clock care but the cost — £15,000 per month — is prohibitive. As a result, he sleeps unattended and often falls out of bed.
Yet Saint Cecilia’s owners do not rake in vast profits. It’s owned by Mike Padgham and his family who live in an unpretentious home in Scarborough.
‘I just want enough money to give my staff more pay and the residents a good life and to have a reasonable living myself,’ Mike tells Ed.
Yet his business, beset by the problems that face care homes nationally, also has vacant rooms because Covid has deterred families from putting their loved ones into care.
Within a year, Mike will know if it is still financially viable or whether homes must close.
At present, people in England pay the full cost of social care until their assets — including the value of their own homes — fall below £23,250. Almost one in three care home residents self-fund their care.
But, following a two year Daily Mail campaign against this inequity, Boris Johnson announced last month that an £86,000 cap on lifetime care costs will be introduced in 2023, reducing the pressure on pensioners to sell their homes to afford care.
Experts say nearly 40,000 workers could leave the care system when mandatory vaccination rules kick in next month
Ed welcomes this initiative: ‘It clearly makes sense that the catastrophic costs someone like Frank faces are collectively managed — but it’s still two years away and doesn’t get a single pound into social care to help close the funding gap.’
Ed admits that when his own mum got dementia the family foundered, unaware of where to seek help.
The early intimations that all was not well came 15 or so years ago when Carolyn — an accomplished home cook — made her signature dish, lasagne, without the pasta.
Then she served up a chicken casserole that was almost raw. Ed’s dad Michael, 83, ‘coped brilliantly over the years and Mum never acknowledged she had dementia; Dad did not want to either.
‘Then it got to a point where it was very, very difficult to manage and keep Mum safe.
‘Suddenly she started to disappear. She’d say she wanted to see her parents, who’d died many years earlier. Dad had no confidence she wouldn’t wander off.
‘So we reached this crisis point and it was really hard to know who to talk to. We cast around for information; we made mistakes. Then the daughter of one of Dad’s friends who knew about social care helped us.’
Ed, who is married to Labour MP Yvette Cooper — they have three children, aged 22, 19 and 17 — confesses he has rarely been so confounded. What is the answer? ‘I don’t think the solution is putting social care into the NHS, but I think GPs should be the first port of call. Dementia is an illness yet we often don’t think of it as such.’
Carolyn now lives in a small, comfortable care home in Norwich and Michael has moved into a flat nearby so he can visit often. Yet still there is residual guilt.
Ed says he felt guilty that his mother had to go into a care home but also that he desired to delay the moment because that put more pressure on his father
‘I feel guilty Mum had to go into a care home, but you also feel guilty because your desire to delay the moment when she had to go meant that Dad had to cope for longer.’
Millions of families face a similar dilemma. One in 14 people over 65 in the UK has dementia; in the over 80s, it’s one in six, with cases rising as people live longer. All this at a time when Covid has exposed decades of underfunding and neglect of the social care system.
Yet still, against monumental odds, a dedicated, if dwindling, band of staff across the country continue to do their jobs with diligence, compassion, love.
As soon as Covid restrictions were lifted, Ed and sister Joanna went to see Carolyn for the first time in a year. The visit is filmed and we see Carolyn — who rarely speaks — with her hair newly styled in her wheelchair. A faint glimmer of recognition and the hint of a smile lights her face as her children greet her.
Care homes have been heavily hit by the coronavirus pandemic despite the Government’s early insistence that the facilities would have a ‘protective ring’ around it
‘I leaned over, gave her a hug and said, ‘Mum it’s Edward, your eldest son,’ and she said, ‘Yes’ in a tone that conveyed, ‘I know that.’ When we visit we have low expectations — Mum is often asleep and unresponsive — then if anything happens, it’s an upside. We looked at the family photo album and sang Mum’s favourite hymn, Jerusalem, and some Abba songs.’
It was a good visit. Their hearts were lifted. And Ed left with renewed respect for the carers who look after her.
‘I always knew Mum had personal care but I did not understand what that meant until I became a carer myself. And now my respect for the people doing this subtle and difficult job is boundless.’
Inside The Care Crisis With Ed Balls airs on Monday November 8 at 9pm on BBC Two and iPlayer.