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Not much to go wrong if the OP limits the amount that the card has on it at any given time: it would be no worse than giving the carer a tenner before heading off to the shops.
Other than the carer being allowed to use a tenner, but not being allowed to use a card. Which is the case for many care companies.
Presumably the OP could get a second card for use by the carer, and agree this with the care company. The OP would be able to view all the transactions and top the card up appropriately. Unlike cash there would be an audit trail, and there's no problem with the carer forgetting to return all the change. The only slight drawback seems to be the charge for using an ATM, but this should seldom be necessary as the stepmother can use her debit card on the rare occasions when she goes out.