Each day there are hundreds of people across Oxfordshire who cannot get out of bed in the morning.

There's nothing they would like more than to be able to spring up and get on with the rest of the day, but for many that is an impossibility.

Their ill-health or disabilities mean they must lie and wait for one of a small army of 900 care assistants to come to their home and help them get up, then wash and dress.

Care assistants are the unsung heroes of the welfare state.

They earn less than £5.50 an hour and provide cover for 365 days of the year, but you can barely put a price on the help they give their patients.

The dignity their care gives their patients is priceless. It means they can continue to live in their own homes without being shunted off into a residential nursing home. Care co-ordinator for Oxfordshire County Council's social services Mariann Jeffery says: "This is an exceptionally rewarding job as we know that in many cases clients would have real problems without the support we are putting in.

"The service makes a very real difference to people's lives. Our priority is that we are helping the client to live comfortably in their own home."

But the vital service that cash-strapped Oxfordshire County Council's care assistants provide is coming increasingly under threat as budget pressures mean that people are being asked to pay more for the service they receive.

The council's social services' committee has just agreed to increase the amounts it charges for home-care. Those with limited means currently pay a flat rate of just £15 a week which pays for whatever level of care they need - even if that means several visits a day. However, patients with savings of more than £16,000 are asked to pay full rate for their care at an hourly rate of £8.95. Others are charged at a staggered rate depending on their affluence.

An hourly rate of nearly £9 seems steep for pensioners or disabled people who simply want the basic right of living a normal life - especially to those who have paid into the welfare state all their lives hoping for care from the cradle to the grave.

The charges are set to increase by at least 15 per cent on April 10 when the week-day hourly rate rises by £1.55 to £10.50 on week-days and by £2.65 to £13.50 at weekends.

Social services bosses hope the higher charges will generate around £130,000 each year, which will help tackle a £4.6m cut in the social services' budget.

Director of social services Mary Robertson said nobody who cannot pay will be asked to pay. "This is a means tested charge. Sadly some people may opt to go elsewhere and get their care through an agency more cheaply," she says.

But she admitted more people would not have a choice because the care they received was so vital to their quality of life.

"Most of the people we are delivering care to are dependent on it. We would be concerned for anyone who felt they wanted to discontinue their care because of the increases."

The knock-on effect of the increases mean that many people who genuinely need a care assistant will be forced to ask themselves if they can afford to lose such a vital service.

Care assistants visit retired electrician Frank Wearing, 79, of Charlbury, each morning for half an hour to get him up and wash and dress him. He suffered a crushed hip during the Second World War's Battle of Britain, and underwent a triple heart by-pass ten years ago. He also suffered a stroke three years ago and finds it difficult to look after himself and get around the house.

Frank and his wife Gwen pay nearly £33 for the service each week and they say it is a lifeline.

Whatever the increases, the couple will find the money to pay for the service because it makes such a difference to their lives, especially since Gwen had an operation on her eye last year.

But though they are able to continue to pay for the service, they say, not everyone will be able to find the extra money.

"We will have to carry on because we have no other choice. Our care assistants are our lifeline. I would live on bread and cheese if necessary to pay for them. "I get excellent care and look forward to their visits because they are always so cheerful. I think it's wrong that ordinary people who have served their country are being penalised in this way with charges going up.

"It will make a massive difference to a lot of people and many won't be able to continue paying for the care they desperately need. I don't know what they will do," Frank says.

*A new report says that the basic human rights of thousands of disabled and elderly people in this country are under threat because of wide-scale cuts in community care services.

Researchers for the Out of Services report, which was compiled for Needs Must, a consortium of 30 disability and elderly people's charities, surveyed 1,550 people.

They found that between 70 and 90 per cent of people questioned had seen a reduction in the help they received with basic tasks such as washing, using the toilet, preparing meals, dressing and housework. A total of 72 per cent of people polled reported a reduction or a cut in help with bathing and 70 per cent in using the toilet.

A further 79 per cent reported a reduction in help with dressing and 90 per cent in housework.

This October the Human Rights Act comes into force and social services and their partners in community care delivery will have to ensure their policies are in line with the law.

However, the resources of social services departments across the country are coming under increasing strain as the number of people aged over 85 continues to rise. Research shows the number of people in that age bracket has nearly doubled since 1981 and will double again before the middle of the next century.

Those over the age of 65 make up 14 per cent of the population but account for nearly half of health and social services expenditure. *Jack Nobbs looks forward to his twice-daily visits by his care assistants. Grandfather Jack, of Chipping Norton, suffered his first stroke 17 years ago and then a second in 1991. The second stroke left him barely able to stand and unable to walk. He also finds it difficult to talk.

Jack, 74, a retired builder, relies on his care assistants, particularly Val Findlay, to get him out of bed, wash him and give him his breakfast, as well as put him to bed in the evening.

He pays the basic rate of £15 a week for the service he receives. Social services have so far only announced an increase in charges for those who pay full-rate and it is not yet known whether further increases affecting people who pay the basic rate are being planned.

Jack wears a round-the-clock personal alarm, which costs around £40 a quarter, in case he needs help when he is on his own. The alarm is linked up to a hotline run by the county council and help would be on its way to Jack within minutes if he triggered it off. Jack doesn't have to solely rely on help given by care assistants for his every need.

His devoted daughter Jackie Radbone, 41, and grand-daughter Dulcie, spend each day caring for him before he is helped into bed in the evening.

Care assistant Diane Fawdrey clearly enjoys working closely with Jack's family to make sure he receives the level of care he needs.

She says: "I've been doing this sort of work for about 30 years and wouldn't do anything else. I treat the people I care for in the same way I would expect my mum and dad to be treated. They deserve nothing less.

"These people have a right to the best possible care."

Stroke sufferer Teresa Coates, 63, of Woodstock, who is also confined to a wheelchair, said she believed that people under-estimated the value and importance of the work done by care assistants.

"I had a real humdinger of a stroke and if it wasn't for the fact that care assistants come into my home four times a day to look after me I would have to go into a residential home. "I would fight against that because I love the fact that I am able to stay in my own home.

" I can decide what I eat and when and can live my life exactly as I want to, without being patronised or told what to do. That is a basic right that I value more than anything else," she says.

Teresa's care assistant Diane Fawdrey says the bond between patient and carer becomes extremely intense.

"You never switch off with this job. When I get home I can't stop thinking about the people I've seen that day. Say for example, Teresa wasn't well one day I would worry about her all that evening hoping she would be alright during the night.

"You can't just treat this like a job - it's far more than that."

Story date: Thursday 23 March

Converted for the new archive on 30 June 2000. Some images and formatting may have been lost in the conversion.