How many carers for 8 residents?

[Amandabrandy]

I work in a residential home. Our shift is from 14.45-21.15. The staff have been cut - Unit 1 there is one member of staff and unit 2 there is 1 member of staff and agency staff from 16.30 - 20.30. Permanent staff have 20 minutes break for the shift. Can someone please tell me how many staff per resident unit is practical for giving proper care:-

Our duties in afternoon are as follows:-
Assisting and hoisting for toileting, assisting with feeding/drinking, activities, making tea, collecting food from kitchen, asking residents what they would like to eat at tea time and lunch the following day, making food for tea time, washing up, care plans, daily jobs e.g. cleaning sensor mats, cleaning cupboard etc, empting yellow bags, bin bags, sweeping dining area, administering medication, hoisting, showering (1 resident per night), personal care and getting reading for bed, putting washing in laundry,

Unit 1
7 residents
1 resident with walking stick, diabetic, needs assisting with personal care
1 resident, walking stick, needs help with personal care
1 resident, walking frame, needs help with personal care
1 resident, needs help with personal care, eating, drinking, double incontinent
1 resident, mobile, needs help with personal care, aggressive, hits other residents/staff
1 resident, uses catheta, incontent faeces, needs help hoisting, eating/drinking (very reluctant to eat drink)
1 resident, walking frame, incontinent urine, very aggitated and shouts for help all day and wont receive any help when offered, argumentative with staff/residents.

Unit 2
7 residents and 1 respite
1 resident, broken leg, needs help with personal care, needs hoisting, toileting, catheta bag, shouts at residents/staff
1 resident, needs assisting with personal care, walking, toileting, prompting to eat, registered blind and poor hearing.
1 resident, uses frame, catheta, incontinent faeces, needs help with personal care, needs observing when mobile
1 resident, uses hoist, double incontinent, needs assisting personal care, eating, drinking.
1 resident, walking frame, incontinent urine, needs help with personal care, needs assistance when in toilet.
1 resident, mobile, needs assisting with personal care
1 resident, needs assisting with personal care, transfering, can be double incontinent, very restless and rocks in her chair, has inflatable mattress on floor at night as prone to falling out of bed.
1 respite, some are mobile, some need hoisting.

[Jo1958]

Amandabrandy, hi
Oola well I don't know the answer to your question but I do know that any staffing level for people with these problems isn't eonogh. You would need a really good team of people working togesther to support and care for this number of people.
With best wishes from Jo

[JPG1]

Hello Amandabrandy,

And a very belated welcome to TP - your original post must have been missed by our moderators, who normally are there to welcome each and every newcomer to TP.

Have you asked your Manager about the required staffing levels? Because that must be your starting point, and if you get no joy there, then.....

Have you contacted the Care Quality Commission (CQC) and asked the same question? Because they will tell you that any care home is required to provide sufficient staffing to 'meet the needs' of the residents in any care home. But it you get no joy there, then.....

Have you asked your own Trades Union Reps, if you are fortunate enough to be a member of an organised union, that is, because they will be working to provide the best working conditions for you too. But if you get no joy there, then......

Have you contacted the Care Home Provider, and if it's a private care home you would need to contact whoever owns/runs the care home. But if it's a local authority owned and run care home, then you'd need to contact the Local Authority or even the Agency that employs you, unless of course you are directly employed by the Care Home Owner or the Local Authority.

But if you get no joy there either, you may need to contact your local MP.

But if you get no joy there either, well .... you will have joined the Club. The Club of those of us who have been asking the same question for years now ....

But our questions may have been connected with the qualifications of people working in care homes, the training that is made available to those care workers, especially dementia-related training, the supervision of those care workers, and the standards of care provided by each and every one of them. All together, not in isolation, but encompassing the staff, the manager, the care home provider, the local authority, the CQC regulator ........................ and so on.

If you crack it, please let us all know of your progress.

We are all almost exhausted by asking similar questions, about staffing levels and qualification levels and training levels and .... so on.

Wishing you every success in your quest!

[sistermillicent]

My own view is two staff for every eight residents, as a minimum, to look after the people you describe. However, I would be surprised if there is no official guideline, there are very strict rules about ratios with children on school trips for example.

It also sounds from the conditions you describe as if it is more like a nursing home and possibly an EMI one, than a residential home. This makes a difference bcause in residential I would say that one staff for eight residents may just be sufficient with extra help coming in if anyone is actually ill.

I don't know, but I would definitely be telling the management that I am not doing any cleaning or sweeping or laundry.
Good luck

[danny]

You will not know the answer to this question until a serious incident occurs,from what you are describing ,it won`t be long.

I would like to remind you about Safeguarding Adults Procedure and Policies. Has the home given you training in this and have they given you their policy on this important subject.

If you feel that any of your residents are at risk you must report it.Abuse is not just physical,neglect of meeting emotional and social needs is a form of abuse.Not allowing residents to choose when they have a bath,go to bed etc is a form of abuse.

If you can see that any of your residents are not having their basic needs met due to poor staffing levels you must act on this.

I hope you can sort this out,it will be difficult but try and look at this as if it was your mum/dad in this care home,would you be happy with these staffing levels.

[Tender Face]

Amanda, I echo what everyone else has already said and respect you have come here concerned about giving ‘proper care’.

For once, I am slightly more concerned about the staff, rather than the residents, in this situation (No, I don’t really mean that ....but I do.... )

To be responsible – single-handedly for so much time - for so many people with such a variety of needs ... well, quite frankly, beggars belief it can possibly be legal if not ethically, socially and morally acceptable for all concerned.

I am not sure how anyone can help at this point other than to support your questioning and to express almost disbelief at the scenario you present. It really is time our elderly and/or vulnerable adults received the same protection young children do, as Pippa points out, in terms of at least ratios of staffing, never mind consistency, training and not relying on ‘agency staff’ who – in fairness to them - could not familiarize themselves with care plans appropriately before it was time to to go off shift again ......(sorry, that was a 'dream on' moment!)

And that includes the expectations of what is humanely possible and reasonable to expect from the people caring for them.

My hat off to you, Karen, x

[kazza73]

As a nursery teacher I'm very aware of the strict policy on ratios of adults to children in different scenarios. These are both there to safeguard the children and the staff- for example no member of staff should be alone in the building with the children, if children are under a certain age the rato changes etc.
Perhaps I am naiive in assuming there should be similar policies and guidelines on ratios in care homes. The thought of the scenaro you describe horrifies me and I fear leaves both patiients and staff at risk. 1 member of staff in a unit withV vulnerable adults who need personal care, have mobility difficulties and many other problems sounds ridiculous-especially when I read your description of tasks the role involves.
Well done for asking the question! I'm assuming that in doing so you feel there should be more staff in order to provide appropriate care + fullfill the job description.
Good luck in finding answers!

[Charlyparly]

Hi Amanda – I’m aware your post has been here a while now but wanted to reply in case this one still isn’t resolved. If it isn’t, please get in touch with CQC and explain what your concerns are and give them the same info you’ve given on here.

There are umpteen issues here but just a few of the things that jumped out at me are –

Hoisting should always be done by two members of staff.

Confused / agitated or aggressive residents require the supervision of at least one member of staff at all times.

Unit 2 is a concern, given that at least one resident shouts at others and could pose a very real risk to the others, particularly the resident who is registered blind / deaf.

Again, with up to three residents requiring hoisting and others that need supervision when mobilising etc, it’s virtually impossible for them all to be cared for safely and properly.

Please get in touch with CQC and tell them what's going on.

http://www.cqc.org.uk

[spiderboymax]

The great problem at present in care homes is staff shortage. There is constant friction in the workplace regarding this issue. Managers and directors look at the balance sheet, the workers look at the delivery of quality care. We have (min) 1 carer to 10 residents and this is a task in itself, not a week goes by without someone being off sick and that effects the whole team who have to take on another 2-3 people each.

We really must address the issue of psychological and personality traits. The duties we perform often include laundry, cleaning, kitchen duties and other domicillary tasks which are not really a carers remit and undermine the professionalism involved in care work for the simple fact that the residents are always around the home and demand attention from you that you are not really in a position to give yet you have to as you cannot just ignore them. Owners want profit and cut corners on all levels and only see the tasks not the relationships involved in performing those tasks, no-one should run a home without at least weekly being hands on in the workplace and from a care background, this should be a statutory obligation.
1 staff to 5 residents seems a viable and manageable situation. I know this would be a great expense but there are plenty of middle-management positions that could be cut without affecting quality care. Too many careers are made on the backs of hard working and exhausted carers, who, in the main, do all the necessary work involved in providing quality care, this in turn brings a spirit of resentment in to the home.
The attitude toward carers must change and the law must step in to provide statutory rights and professional relationships on all levels. There are times at work carers are treated like chattel, it is positively 'victorian' sometimes. No wonder sickness levels are so high, it is exhausting to be daily burdened simply because the money is cut from front line service, whilst money is spent on glossy brochures promising the highest standards impossible to impliment under current levels.
Look at the gap between wages and salaries from bottom to top and it screams inequality and exploitation. Needs must change.

[handyjack]

Amanda, the care home you are working in is seriously understaffed. As others have suggested, you can contact the CQC. It's a waste of time going on their website and searching for minimum staffing levels though. The CQC won't commit to actually mentioning numbers, but mention "Sufficient" staff (pretty non committal then, if they don't have a baseline in the first place). But, they will listen to your concerns and won't tell your employer if you do decide to report them.

[thefireman]

Amandabrandy
I have researched this subject and have not found anything which says you have to have x carers to y residents and because of this I believe care homes etc are abusing their residents by reducing staffing to the minimum they believe they can get away with. After all if there's no definitive numbers given anywhere who's going to say or do anything? There is however a requirement to be able to evacuate everybody within a given time in the event of a fire. The Fire Safety Order 2005 has clearly placed the responsibility for evacuation on the 'responsible person' (normally the owner) and guidance documents have been produced to assist them understand their responsibilities. One such document deals with residential care premises. In most cases it is not possible or desirable to evacuate residents to outside, so the building will normally be divided up into 'protected areas' with fire resisting walls, doors etc. The document states that ' it should be possible under normal operating conditions to evacuate any given 'protected area' within 21/2 minutes using the staff present to assist residents, where necessary (page 69). With 30 years of inspecting experience I do not believe that the majority of care homes could do that with their current level of staffing. Its hard enough to impart urgency into persons who are not suffering from dementia! I believe it is this legislation that should be used to enforce greater staff numbers in care homes and this can be enforced by local fire authorities. The responsible person must and should have carried out a fire risk assessment covering all aspect of fire safety in the home. Ask to see a copy and challenge them to prove through a drill that they can achieve the requirement for evacuation with their normal staffing (not on a day / night when they bring in extra staff for the drill). If you're not happy contact your local fire safety department and express your concerns to them. I appreciate this is a long reply and slightly at odds with your original post but it can (and has been used) to address staff numbers therefore increasing residents care!