Issues with getting the right care at home

[LizzyA]

I don't think that this is anything that I can be helped with but it may help to share. My mum has had carers coming in 3x a day for a year now. She has vascular dementia. They seem to be doing very little. Their role is to prompt meds, encourage clean clothes, hairwashing etc but nothing is really getting done and whenever I see mum she's in her dirty old clothes with unwashed hair.

She will let me help her change and put on appropriate (warm) clothing. If she doesn't take her tablets or if she's feeling ill etc I'm not being informed although I have asked to be (I'm at work f/t). We're receiving a big bill each month for this which would be fine if mum was getting looked after!

Mum is self-funding but the care is arranged via social services and so I have asked for a care review. I'm not being irrational to think that this isn't an acceptable situation am I? The carers just don't seem to do anything really. How can I improve things? Are all agencies like this?

 

[Daisy Duck]

You need to write down everything that's happening (or not happening) and take photos to back up what you are saying. Then complain to SS as this counts as neglect. You should also demand your money back as you are paying for a service that you are not receiving.

 

[Quilty]

Some are better than others. A review sounds like a good idea. Maybe clearer expectations going forward? Best of luck and let us know how it goes.

 

[dannyem]

Home care

I will be following this post with interest as my Mom has carers in now but it is sadly a bit hit and miss, some seem to do everything and some do nothing!

I have not said anything as yet as dont want to stir things up and make things difficult for Mom when Im not there.

I also work full time and find it very frustrating that the things arent getting done that were on the original care plan. This was supposed to be put in the folder that they fill in that is always at Moms, so I do wonder how they know what to do as its no good asking Mom as that was the original point of getting them in as she wasnt looking after herself particularly well.

 

[min88cat]

Are the carers completing a detailed log at each visit? This should explain whether your mum is refusing help/washing/changing/medication.

The first care company we used for mil went bust over an August bank holiday (that's a whole other story) . They unfortunately were brilliant, experienced and helpful. The company that SS eventually used to replace them were useless. Hardly any were stoma trained, they turned up late, actually missed some visits which almost had disastrous consequences and falsified the log.

All carers should be aware of your mum's care plan.
I would ring the manager and complain.

 

[LizzyA]

Thank you for your responses. I agree that a list of issues/expectations would be sensible. There isn't great continuity of care, in some cases poor english skills are preventing effective communication (both in speaking and filling in the book/log) as well. I've spoken to the managers but the response has been defensive, rather than helpful. I couldn't get hold of them on the phone on xmas eve/day and mum was being discharged from hospital so it was all a bit of a nightmare. We've also had issues of the log being falsified. The more I think about it, the angrier I am getting!! I think they have to be replaced.

 

[bemused1]

replace would be my advice. I have battled with our agency for over a year now, not because the carers are poor or in fact with issues of care but with making assumptions that they know best with regard to my husband ( I care for him full time with help from carers). Also with the problems of not realising that dementia and certain carers are never going to work.

Its not possible to replace them in this area so its a compromise, I am unlikely to get full cover of the calls I request but the carers I do get now are as good as you are going to get with the quality of management they cope with.

Poor care I would not tolerate, your mother is vulnerable. If your mum is self funding and you can find the time, research an agency yourself, you may find something more suitable. It is time consuming and in my case I was amazed to discover that there just was no alternative. But it did teach me that I was going to have to maximise what help I do get.

 

[whileaway]

Some are better than others. A review sounds like a good idea. Maybe clearer expectations going forward? Best of luck and let us know how it goes.

Can you "name and shame" delinquent agencies? Or do they stick together, and, so, one must be discrete? I am sorry you have this happening. Maybe it depends on the relatives, whether the client gets care worthy of the name..

 

[cat6214]

If you are paying out of pocket, change agencies

I have an excellent home care agency for my parents. Two mornings a week, the aides wash them, dress them, feed them and clean up my parents' room. But the aides have told me that other home care agencies are not that good. You need to shop around until you find a good one.

 

[fizzie]

You need to do as others have said and write down the things that are happening and report it to Adult social care safeguarding at your local social services BUT meanwhile I would put what you have said to us in writing to the care agency and copy it to the Care Quality Commission (and put a cc on the bottom of the letter telling the agency that you are copying to CQC) - I would be surprised if you don't see an immediate positive change in attitude. You need to follow this by complaining about every single thing in writing to the Agency (email) and ask for an ackowledgement otherwise they will just say you haven't complained. If there isn't a pretty quick change then I would be inclined to change agencies - there are some very good ones out there and one of the ways of finding them is tapping into your local carers cafe (I know you work full time but this would be worth taking a couple of hours for if you can because they are a wealth of local information).


You can email the CQC and request an acknowledgement and an update (don't let them get away with just filing it!)
l: 03000 616161
Email: enquiries@cqc.org.uk


This is absolutely NOT acceptable - whether you are paying or social services is paying is irrelevant the staff are there to keep your mum safe, to preserve her dignity, to enable her to be independent, to be caring and responsive to her needs and effectively help her to live independently. They have a duty to follow the care plan and to inform you of any deviations and never to miss a call or be late for calls (sometimes this is vital in terms of medications) and if they are going to be late to inform (you as your mum may not remember a call from them)

You need to mention the words vulnerable, at risk and neglect in your letter at regular intervals - the agency are not fulfilling their duty.

You are right you are paying for a service you are not receiving but more importantly your mum is suffering because what could be a quality experience and enhance her life is actually a terrible experience for her and for you too.

 

[nae sporran]

This is probably one of the most stressful part of being a carer, for me. The parts OH won't let me help with, which i expect trained carers from approved agencies to help with. We are on our second care agency after the first one messed about with times, sent people who were disinterested and generally added to the stress. The new lot are not much better, when I complain about dirty pants left on the bed or wet towels on the bathroom floor they promise to look into it then send the same old chancers to make the same old mistakes. Many of our problems have been fairly minor compared to yours LizzyA, but if they are not doing the little things can we be sure they are doing the rest of the job properly or would be if I was not here.

My advice would be to persist with a formal complaint to Social Services, a formal complaint to the agency and a formal complaint to the CQC. That seems to get some gradual improvement over time.

 

[doodle1]

My parents have had home care ( self funded) for two years now. The good agencies come in ,agree a care plan with you, have a daily log etc. I would not be happy with your state of affairs and would be ringing round other agencies ,sadly not all agencies are equal. I insist on a reasonable quality of English otherwise it just doesn't work

 

[LizzyA]

Just as a little update, I've been to see mum, leaving at 4pm. She should have had 2 care visits today but nothing is written in the log book and I couldn't tell if meds had been taken. Mum isn't feeling well, but is downstairs and would certainly have heard the doorbell. If the carers can't get in, they are meant to call me anyway. I agree with the steps suggested and won't be tolerating this any longer.

I greatly appreciate all your comments and advice. It is nice to feel less alone. X

 

[fizzie]

Actually 2 missed visits is now a proper safeguarding issue and as such should be reported urgently to adult care services - thank goodness you checked but imagine how they are treating the people who have no relatives or advocates.

It also needs to be reported to the manager as a flagged up safeguarding issue (and told it is now going to be reported) and to the CQC. This is so dangerous for people. All about profit not about care.

Yes there are good agencies out there and I really suggest that you change (but please report them to everyone first). You will probably find their reputation goes before them!

So sorry you are going through this - there are thousands of people in their own homes receiving poor care (equally there are thousands with good care).

It is worth checking back through to the log and noting all other 'absences' that is if they haven't already been filled in.

Do keep posting, you and your mum will feel so much better when people who do care are going in xxx

 

[DMac]

Just as a little update, I've been to see mum, leaving at 4pm. She should have had 2 care visits today but nothing is written in the log book and I couldn't tell if meds had been taken. Mum isn't feeling well, but is downstairs and would certainly have heard the doorbell. If the carers can't get in, they are meant to call me anyway. I agree with the steps suggested and won't be tolerating this any longer.

I greatly appreciate all your comments and advice. It is nice to feel less alone. X

LizzyA, I too have carers visiting my father-in-law daily. I too was concerned about the quality of care and was curious about the training they received, as my father-in-law has complicated care needs due to inguinal hernia, bowel cancer/ faecal incontinence, and an indwelling catheter! In order to get some training and experience for myself, I became a care worker. See my thread: 'Carer and care worker' in the Tea Room section of the forum. You will see that my experience was not exactly a success!

I'm left wondering whether my FiL's care agency is the best that is available, or whether it is worth shopping around. My worry is that I could go to a lot of effort to make a change, when actually I believe it is the whole model of care working that is faulty, and maybe there isn't a better alternative. Care workers (in my experience) are treated terribly, are under-trained, under-supported especially at weekends, and over-pressurised to deliver an impossibly tight schedule. However, that does not excuse neglect of your mum. As others have said, it is worthwhile documenting your complaints and being prepared to escalate to the CQC if necessary. Meanwhile, keeping regular and open communication with the agency will help you, your mum and them. Keeping any instructions (from you) as simple and obvious as possible will also help the care workers to fulfil the requirements of the call. I wish you much success in finding the right care 'formula' for your mum.