Care Home Update, Help please!

[susanandliam]

Well we're still limping on!

Mum's still in the same care home as I'm worried to death that moving her will cause her to spiral down even quicker or worse. However I'm thinking that things can't go on as they are and maybe I should change things?

However things are not improving at the home, the last manager left, we then had the deputy in place with a manager who was shared between another home and Mum's. Another manager is to be shortly in place, at least four of the staff have left and there are agency workers in there. The homes CQC rating has gone down.

Again this weekend they didn't have Mum ready for the carer (who we pay extra for) when she went to pick her up at 10.00am, the carer said she had to take Mum to her room to get her properly dressed. This is despite being one of the issues raised at a meeting with the deputy and social worker that Mum isn't ready when the carers come to take her out. When I rang and complained on the phone later on in the day the HCA in charge said she didn't know Mum was going out as it wasn't written in the diary. Every month it's the same thing they seem incapable of writing in the diary that Mum comes to us on the same days every month!

Mum was more confused than usual, garbling and not walking well when she arrived at mine. She seemed to be having problems just putting one foot in front of another.

She didn't seem herself and later in the day went to sleep and we couldn't wake her up! We called 111 and an ambulance came out who thought Mum had had a TIA. After receiving oxygen and a large dose of asprin Mum rallied. I looked after her that night and the next day as she seemed very fragile. When we returned Mum to the care home the next evening she wasn't checked by the staff or anything other than a cursory how is she.

I took a sample of Mum's urine to the dr's for testing for a UTI as suggested by the ambulance crew. I asked the care home if they had tested for this recently and although a request for a sample of urine had been requested on the Friday morning for testing no one had actioned it. When queried they said they were unable to get a sample and it had been written in the book to try again on Monday. But surely if you suspect an elderly woman with Alzheimers has a UTI then it needs to be actioned quicker than this?

No one bothered (again) to tell me that they thought she may have a UTI had I known I would have gone and got the urine sample myself.

Picked Mum up from her club yesterday to take Mum to a TIA clinic to be told that the carer that morning had told the club that Mum hadn't had any breakfast when she picked her up from the care home!

When Mum was having an ECG it was discovered that Mum had a bra on that was inside out and not done up. So again the home hadn't checked she was dressed ok and Mum had neither her reading or distance glasses with her at the club so the home hadn't done that either.

The dr at the TIA clinic asked for a urine sample and it was found that Mum had a really bad UTI which could have caused most of the problem rather than a TIA.

I am beside myself we are paying a fortune to this home and they don't seem to be even able to get the basics right.

Please can you advise me whether this is 'normal' for a care home to be like this? It's really wearing me down and more than that it's the indignity of it all for Mum. When I was looking after her I always picked up she had a UTI but although the home had noticed a change in Mum's behaviour they didn't do anything about it or notify me.

My husband complained to the deputy manager about the above who apologised and said she'd look into things but we have heard nothing further. Believe me I don't like complaining but I don't know what to do now.

Is the next step to complain to either the head office of this home , the CQC or social services?

Is this the usual standard of a care home or should it be better than this, should I move her?

Sorry for all the questions but this is really really stressing me out. any advice would be appreciated.

 

[Katrine]

I don't think this is good enough and I don't think things will improve there. The standard of care is inadequate. You can complain, clarify the care plan, have regular discussions, but they don't care. Without a change in their culture and much better management they'll just potter along getting it wrong and putting your mum at risk.
Who will be ultra stressed by the situation? Not the care home. They will resist all your pressure to make them change, probably because they perceive your requirements to be unrealistic.

What I'm saying is - you won't get that CH to improve, so don't waste your energy on them. Keep insisting on high standards for your mum while she is still in their care, but at the same time work on finding a better home for your mum. She is at risk with these people, from what you've written. When you find the right place you will be able to identify exactly how these people have failed your mum. At the moment you don't have the experience to make that comparison. However, you already know what's not acceptable or safe, so trust your instincts.

 

[AlsoConfused]

I don't know whether this is the correct procedure BUT I think you should talk ASAP to the Duty Officer at Social Services and give them full details about what's happening to this home, both as regards its management and the defects in your Mum's care.

You need to give the organisational context - CQC rating gone down; no manager; 4 permanent staff leaving within a short time; reliance on temp staff - to ensure Social Services realise this is a home approaching crisis and it may be an unsafe home for all residents. Social Services will have the clout to investigate thoroughly I believe. They also need to know as soon as possible as they may have to find new accommodation for everyone they're responsible for in the event the home closes.

 

[susanandliam]

I don't think this is good enough and I don't think things will improve there. The standard of care is inadequate. You can complain, clarify the care plan, have regular discussions, but they don't care. Without a change in their culture and much better management they'll just potter along getting it wrong and putting your mum at risk.
Who will be ultra stressed by the situation? Not the care home. They will resist all your pressure to make them change, probably because they perceive your requirements to be unrealistic.

What I'm saying is - you won't get that CH to improve, so don't waste your energy on them. Keep insisting on high standards for your mum while she is still in their care, but at the same time work on finding a better home for your mum. She is at risk with these people, from what you've written. When you find the right place you will be able to identify exactly how these people have failed your mum. At the moment you don't have the experience to make that comparison. However, you already know what's not acceptable or safe, so trust your instincts.

Thank you Katrine,

I appreciate your reply, it's a fear of making things worse for Mum by moving her and making another mistake. I thought this home was good to start with and had looked at a number beforehand. I will start looking again. I just wasn't sure if this is the ,norm' and my expectations are too high

 

[susanandliam]

I don't know whether this is the correct procedure BUT I think you should talk ASAP to the Duty Officer at Social Services and give them full details about what's happening to this home, both as regards its management and the defects in your Mum's care.

You need to give the organisational context - CQC rating gone down; no manager; 4 permanent staff leaving within a short time; reliance on temp staff - to ensure Social Services realise this is a home approaching crisis and it may be an unsafe home for all residents. Social Services will have the clout to investigate thoroughly I believe. They also need to know as soon as possible as they may have to find new accommodation for everyone they're responsible for in the event the home closes.

O.K. thank you for this, I had already raised issues with a social worker who met with me and the deputy some time ago but things have not improved and the social worker never came back to me which I thought she was going to do. I will raise this again with her.

 

[stanleypj]

I can really relate to your concerns as we are in a very similar situation. I wrote about the latest problem we have had on my thread about Sue yesterday.

Both Sue's daughter and I have just about come to the decision that we're going to have to start looking at other homes. But after the experience we have had at the current home, I am not at all certain that we will find a home which will be significantly better. We have some concerns about the disruption but as our issue is serious and continuing weight loss due to poor feeding (itself caused by inadequate staffing) we cannot really afford to wait longer for the current home to improve. So I hope you will be able to continue this thread and let us and others know how you're getting on.

 

[CeliaW]

Stanley, obviously it has financial implications which are your affair but would live in carers work for you at home?

I have seen various feedback on different forums but there are agencies that specialise in that area and some seem to have it well organised.

Sorry if this is a totally ludicrous idea! x

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[stanleypj]

Don't want to hijack the thread Celia but I guess this might be of interest to susanandliam as well. The Nursing Home is largely CHC funded (we pay a top-up). Previously, as recently as last September, I looked after Sue at home with about 36 hours of help from carers (this was also CHC funded). Then Sue was in hospital with a serious chest infection and I saw how much harder it was going to be to carry on caring for her in future (thickened drinks, pureed food, constant worries, no help in the night etc etc) I made the reluctant decision that she needed to be looked after full-time by professionals.

It's a decision I've regretted many times since. She's not being directly looked after by professionals a lot of the time but by people just recruited, people off the streets. They are all nice and treat Sue well but I know now that I could do all the things they do just as well, if not better. I frequently fantasise abouty taking Sue back home. I could get the funding for more carers than I had before but I don't think I could recruit enough decent people (and use a local agency as backup) for enough hours in the week to really make it viable. The wonderful main carer, who I still pay to go into the NH four times a week (four occasions when I can be sure Sue is properly looked after) now has other jobs of course, it's her living. The 'second carer' post (evening and weekend calls) was always difficult to fill even though both posts were paying a much better rate than people could get elsewhere.

Live-in carers might help but as you imply Celia would probably be very expensive.

So I think we're stuck with care homes.

 

[CeliaW]

Stanley, will pm you as, although I have no direct personal interest with the company, I dont think I can name it here.

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[stanleypj]

Many thanks Celia.

 

[lemonjuice]

So I think we're stuck with care homes.

Pretty much sums it up.

There are some dreadful CH & NH out there.

Compared to others where my friends have relatives, my mother's NH really isn't that bad.
Far from perfect and I still have lots of complaints about things- mainly to do with management and riding roughshod over my mother's preferences as she is unable to protest. However generally the 'real' carers on the floor are wonderful and so I have to take comfort in that.

 

[cragmaid]

Susanand Liam, please start looking for a new CH now. I don't think that you are asking too much to have your Mum clean, welldressed and fed properly. Yes specs go missing sometimes, but medical matters need to be actioned immediately and not put in the diary for "Monday" - read for someone else to do!!!

Mum might react badly to a possible move, but she might also benefit from the quality of care she is entitled to and for which she is paying.

 

[fizzie]

It isn't ok on any level
you can email cqc on complaints@cqc.org.uk and put the name of the care home in the subject line - just copy and paste what you have written to us and ask for an update from the CQC.
Then I would phone your local adult safeguarding team and ask for an email address and send the same email to them - if you add that you feel it is an unsafe environment they have to trigger an inspection.
Personally i would be looking for another home or a live in carer (many agencies are no more expensive than a care home)
She is being badly looked after and they have no regard to dignity or respect - it is a disgrace - again!

 

[CeliaW]

Can I add to the excellent advice from craigmaid and fizzie - find out which councillor holds the portfolio on adult care and either include them on main mail or mention on main mail that you will also be emailing your concerns to Cllr X in their role as Portfolio Holder for Adult Services.

You can then preface your email to the councillor with phrases such as "I am sure you will be as concerned as I am"..."In your role of Portfolio Holder fot Adult Services, I am sure you would want to know about these serious issues " etc

Sign off something along the lines of looking forward to hearing from them and will greatly appreciate any help, support and advice they can give.

It can have quite an effect.

Good luck!

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[Amy in the US]

I would say it sounds clear that this care home is not providing acceptable care.

I understand about not liking to complain, but we do what we have to do to keep our PWDs (persons with dementia) safe and properly looked after.

As I'm not familiar with the UK system I defer to others' comments about funding and levels of care, but I would start looking at other options that are available to you.

I know that we all dread a move, and that there can be a downturn with a transition, but your mother needs to be safe and properly looked after and given the medical care she needs, and it needs to be a place you can work with, and the current home isn't ticking those boxes.

A move can be unsettling, yes, and then there is a transition and settling in period at a new place, but your mother could (I would be so bold as to say would!) benefit from better care and a more settled environment: more experienced carers, higher level of staff training, steady routine, better communication with family.

Infections can wreak havoc for a PWD and all care homes should be on alert for possible infections, especially UTIs, and test residents at the first sign of any symptoms or problems. The infection certainly could have caused the symptoms you describe. They can be difficult to clear, so be sure she gets her urine tested again to make sure the antibiotics are doing their job. You can also insist that they culture her urine, to make sure she is getting the correct antibiotics to treat the infection. Confusion, falls, difficulty walking, any sudden change in behaviour or personality, agitation, hallucinations, dizziness, can all be symptoms of UTIs as well as the more familiar urinary symptoms.

Try to bear in mind that at the end of the day it's the disease/dementia that is the problem, not you or your choices. Unfortunately dementia is a progressive disease and things do get worse over time, no matter what we do. The illness is the enemy, not you!

Best wishes to you and your family.

 

[susanandliam]

Thank you

Thank you everyone for your help, I really appreciate it. Had a call from the home today there is going to be a meeting for families next with the new manager and someone from head office, should be interesting I will let you know how it goes!

I am also going to report the latest to Social Services again.

 

[Rageddy Anne]

Thank you everyone for your help, I really appreciate it. Had a call from the home today there is going to be a meeting for families next with the new manager and someone from head office, should be interesting I will let you know how it goes!

I am also going to report the latest to Social Services again.

That's a positive step, susanandliam.

Like you, I have been increasingly upset by standards at my husband's care home, and am currently in the process of moving him to one I thought was better. Imagine my horror thus week, when I visited the new place to put some things in his new room, and saw The AgencyNurse From Hell being very unpleasant to a Carer, and then to a resident! Apparently, the regular Day nurse left recently, and they're having to use an Agency!

Meanwhile, his current care home seems to be making an effort to improve. But, with the same manager in place, I can only think things will return to being unacceptable after a flurry of activity.

It makes me wonder if standards generally are slipping, and I also cynically wonder if agencies ever have really good people on their books.

Frying pans and fires come to mind...

 

[stanleypj]

This is always the worry isn't it. I'm sure good care homes do exist. people regularly talk about them on TP. But even these homes may occasionally make bad appointments or have to use poor agency staff. Let's hope your experience was a 'one off'.