What do you need to consider when providing 24-hour care? Tips from eldercare expert J�rgen Griesbeck.
Nursing staff are in demand like never before. In the past, nursing homes were often the only solution when there were no relatives around, but now outpatient care is often provided by 24-hour caregivers, mostly women from Eastern European countries. Around 300,000 people in Germany are cared for in this way.
Long-term care insurance follows the principle of outpatient before inpatient care and has recently largely adjusted the benefits for home and fully inpatient care. This was very attractive for users of 24-hour crèches. Now a recent ruling by the Federal Labor Court (BAG) is shaking up this successful model.
24-hour care is an important supplement to outpatient forms of care and for many people the alternative to a care home, says eldercare expert J�rgen Griesbeck. �especially now during the coronavirus pandemic, conditions in care homes are very difficult: people who want to visit relatives often still need an appointment, have to get tested and can only spend a limited amount of time there. Many people are therefore happy if their relatives can be cared for at home, as this offers them better opportunities for visits and support.
However, the term "24-hour employee" is misleading. Even a receptionist may not work around the clock; the provisions of labor law also apply to them. Neither a day off per week nor daily rest periods can be converted into on-call time.
A ruling by the Federal Labor Court in July 2021 has now caused a stir. The case was brought by a Bulgarian care worker . She was required to be on call around the clock, even though her contract only provided for 30 weeks of work, for which she was paid. She sued for back pay for the work performed in accordance with the German Minimum Wage Act.
The Berlin Regional Labor Court ruled in her favor and awarded her back pay of more than 38,000 euros. The Federal Labor Court overturned the ruling because the working hours could not be proven in detail. However, it ruled that the minimum wage must be paid for 24-hour care, including for on-call times.
Even if a corresponding law is not expected until the next legislative period under the newly elected government, the ruling will have consequences. For relatives who currently employ 24-hour care staff, the ruling raises a number of questions. For example, the question of whether they may be required to make additional payments to their nursing staff, as wages must be paid back up to 3 years after the employment contract. The question also arises as to what impact the ruling will have on contracts that have already been concluded, says Griesbeck.
Presumably only 10 to 20% of 24-hour crews in Germany are legally employed, with a lot of undeclared work or marginal employment. Users and providers are therefore taking a great risk: Anyone caught not only has to expect a fine, but also considerable back payments, as this is considered an illegal attempt to circumvent the law. If additional payments are due from caregivers who were placed through agencies, it is the agencies and not the care recipients or their relatives who must make the additional payments.
Often, the caregivers do not have to be on duty all the time anyway. You should therefore think carefully in advance about the actual daily assistance needs of the elderly person concerned. In addition, is it more about domestic care, personal care, presence or night duty? The more you are clear about this, the better you can decide whether you can create a better and more tailored solution with a mix of different providers. After assessing your needs, you will also know whether the 24-hour caregiver is only needed for six or eight hours a day. If so, they will have the rest of the time off and you will not have to pay for this time.
It is essential to keep a timesheet (daily, weekly, monthly) of the hours worked, which is signed off by both parties. This allows you to see very quickly whether the actual and agreed working hours still match or whether adjustments need to be made. The care may then cost a little more, but you will avoid nasty surprises and dissatisfaction.
There are several ways to employ a caregiver. Firstly, the family can employ them directly. This saves placement fees, but the family must fulfill all obligations as an employer. Advice from the employment agency, consumer advice centers or the pme Familienservice is recommended here.
On the other hand, there is the so-called agency model via the Posted Workers Act. Here, nursing staff work as freelancers with a German trade license or as self-employed persons similar to employees. This costs a little more, but all legal risks are borne by the placement agencies. In any case, the A1 certificate for pension insurance must be submitted.
In addition to 24-hour crèches, there are now special care models (residential groups, day care) and care services provided by voluntary organizations via various service providers based in Germany, as well as affordable on-site care for the elderly. Aids from the field of ambient assisted living can also provide good support.
Regardless of what happens with the regulations for 24-hour care, there are also other options. �At pme Familienservice , we have always advocated finding interim solutions,� says J�rgen Griesbeck. �Our approach is very broad, 24-hour care is just one segment among several�. For example, pme Familienservice puts togetherindividual care arrangements that can consist of a combination of voluntary work, outpatient services and private caregivers, supported by technical aids and home emergency calls.
There is always more than just one solution. My recommendation for employees of our client companies and their relatives: Let us advise you, we will find the right care arrangement for you. And, of course, we are also the point of contact and advocate for our clients when it comes to the conditions of 24-hour care.
J�rgen Griesbeck, Homecare Eldercare Manager at pme Familienservice