Most care staff here are employed by local authorities (though deregulation under Labour allowed agencies and private firms a look in, by consensus, the sevice offered by local authorities is superior) I know many private firms work their carers too hard, do not allow time for interaction with the client, and frequently change carers at short notice - which is upsetting to clients with early onset dementia. My own local authority operates a strict system where creres must sign in on entering a house, and sign out on exit....and can be tracked by using some app installed on the mobile phones issued them by the employer, thus ensuring that they spend the set time with the client.