Maybe about ten months later, into an assignment the toilet got blocked. It was later revealed that the plumbing system in the block of Maisonettes, were communal. If one toilet got blocked it then affects the whole block. A plumber employed by a resident, had some information that a baby's nappy escaped into the system. There were compromises where manhole covers about ten yards from the front doors could be accessed temporarily for waste. Joyce's son employed a plumber who notice that her toilet also had a leak.  The case manager suggested buying buckets so that when the commode is used, empty the contents into the buckets, take the buckets downstairs and out to the cast iron manhole, lift the very heavy cover and and empty contents down the drain. 

It was baffling that none of the pantheon who made dutiful, albeit infrequent visits, the Occupational Therapist, the Physiotherapist amongst others, seemed unperturbed by what they saw and was equally unwilling to get involved.  The General Social Care Council, started in October 2001, for the regulation of the care workforce in England,  would no doubt take a different view. Section 3, 1.2 is concerned with the protection of the public, preventing both direct intentional and unintentional abuse, neglect of social care service users, including  the elderly. The GSCC maintains that the Social Care Workers are in a unique position of responsibility, working with some of society's  most vulnerable members. In cases where the carer have approached the employer, with detailed, unsafe, unhygienic reports, why is the carer's information given no credence. The indisputable evidence unfolding at Joyce and Alan's home, was an obvious case where exigent actions should have been the priority.    
 
As a trained live-in carer, I was shocked at the advice. I was sure the case manager knew about the Health and safety at work Act 1974 updated 2015.  The Moving and handlings Regulations 1992 amended 2002.  When I pointed out the obvious pitfalls, the unsanitary and highly offensive conditions that would ensue such a solution.  I was told quite firmly that it was a temporary situation and if I was not willing to do the work then someone else probably would.  The family seemed ok to leave this dignified  mostly affable couple in this despicable situation, as both the couple's son and daughter-in-law agreed that Joyce and Allan would not be there much longer so it was a waste of good money. Such comments said only in the presence of the live-in carer, with annotations that it would be emphatically denied if I told anyone. At one such comment, Joyce glared at him, to which her son laughed and said she would soon forget what he said. Again she would calmly stand with her bag, walked serenely, if a little unsteadily to the kitchen and stood inside the mop cupboard until they leave..

Amidst all the chaos, of course the actual daily work of caring for the couple must be carried out. Personal care, assisting with medication, laundry, meals, cleaning and activities they like such as small shopping trips. Alan's health slowly deteriorated and he could not go for his well liked walks to the nearest park with Joyce as often. He would be so slow Joyce would tease him saying "next time we'll bring the baby push chair for you". They would both laugh. 

On the odd occasions when Joyce had a small amount of clarity of thinking , she enjoyed baking.  She was always an important contributor to local fairs and different events in the different parks near her home.
Usually after dinner while I cleared the kitchen, Joyce would proceed to take things out of the cupboard and put them on the kitchen floor.  Baking pans, different sizes of sieves, whisks, she sat on the floor a little later then look up and asked "do you think that's enough" laughed. At these times Joyce lights up as the Dementia allows. Of course she needed a lot of help, but wearing her favourite apron that she won in a local cupcake contest, she made a dozen cherry cupcakes. Alan always complimented his wife on her baking. They enjoyed homemade cupcakes with their tea several days. 

As live-in carers we are living in someone else's loved sanctuary, which for the most part encapsulates a lifetime of hard work and irreplaceable memories of family generations. I had different assignments with the Joyce and Alan ones. over an eighteen month period. Alans health deteriorated, he became more violent as the Dementia dictates. It was about that time Joyce started to stay close to the live-in carer especially when there were visitors, including family members. She would tell them that I was her friend. On one visit, her teenage  granddaughter was very quick to try and correct her, but Joyce was adamant.

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Alan's  management gradually necessitated a two-carer position, for personal  hygiene.  Unfortunately not all the carers would do the work needed.  The carer would turn up at lunch time and then the afternoons, for the morning session to help get Alan out of bed. Apparently word got around the carer circle about the horrendous working conditions at Joyce and Alan's home. So it became difficult to procure the extra carers needed.  The case manager seemed reluctant to approach the Care Agency. So the twice daily bucketsful of effluence, continued to be carried out to the manhole for disposal, for another four and a half months.  Until a new Occupational Therapist visited, so utterly outraged that these two unfortunate, vulnerable 
people were left in this awful state, intimated to the case manager, who she asked to meet her there, that she would get the news papers involved as well as Social Services among other local services, if immediate actions were not taken to fix the plumbing. When the Care Agency was contacted, the live-in carer was blamed for somehow prolonging conditions in the maisonette. All daily reporting, with the unbelievable suggestions and advice via the case manager, were recorded in the clients daily records.  It seemed unnecessary for carers to be treated with disdain, by the agencies who employ them to perform in an industry with clearly so many different facets. The dangers to both clients and carers are verifiable, which is why the many laws, rules and regulations are in place. The Standard Infection control Precautions,(SCIPs), is part of mandatory requirements, for clients, staff and visitor safety in the care industry as well. One of the ten elements, no. 9, points to the safe disposal of waste.

Unfortunately. in my experience, local councils, guardianship departments, tended to rely on the views of several carers before deciding whether or not to investigate any reports. This can prove almost impossible, as there might not be a brave, honest conscientious carer mindful of losing their job, who would be willing to come forward. The perceived culture of misinformation, inactivity with an inimitable degree of apathy, from some agency managers, care co-ordinators and directors, negates the effect of the dedicated carer. this can certainly make for overwhelming, discouraging dynamics for the caring carer, trying to do the best for the client,