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Louise7

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Mar 25, 2016
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Trying times for anyone involved in care as 'the guidance' isn't really directive and places the onus on CH's who are not well versed in dealing with these kinds of risks, so they make blanket decisions. The reality is that its is now a part of our lives and we have to find ways of managing it so that life goes on as best as possible, which clearly isn't happening in many care homes, my mums CH included. The time will come when Covid-19 becomes accepted as a part of our lives (just as flu is) and we will have moved on to other problems. I seriously think that the way CH's are designed and built is going to have to change if these kinds of pandemics are inevitable, because as many of them are, they are not fit for purpose.

@Palerider glad that you can start to visit your mum again but it should't have taken pressure from you and writing to the MP to get things moving. I don't know if you heard it but there but there was a radio 4 interview by John's Campaign (who are pressing for a judicial review of the visiting guidance) last week, with someone representing care homes too, and the issue of accomodation problems, and the failure to treat care home residents as individuals, was raised. It's worth a listen - the interview starts at 1:18:05: https://www.bbc.co.uk/programmes/m000m4pd
 

Palerider

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I am really happy that I get to see mum. Its her birthday at the end of this month so will be taking her present in rather than leaving it at the doorstep. I have my own PPE that fits properly too!
 

Palerider

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@Palerider glad that you can start to visit your mum again but it should't have taken pressure from you and writing to the MP to get things moving. I don't know if you heard it but there but there was a radio 4 interview by John's Campaign (who are pressing for a judicial review of the visiting guidance) last week, with someone representing care homes too, and the issue of accomodation problems, and the failure to treat care home residents as individuals, was raised. It's worth a listen - the interview starts at 1:18:05: https://www.bbc.co.uk/programmes/m000m4pd

Thanks @Louise7 I will have a listen to it now. I looked up the Johns Campaign website because I want to donate to there campaign for judicial review.
 

MartinWL

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Jun 12, 2020
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The guidance is just guidance and in theory can be disregarded by a care home as it is not legally binding. However the reality is that if a care home diverged from the government guidance to any significant degree they would be exposed to a lot of criticism at best and potentially civil litigation for negligence at worst when a resident dies. They might also have trouble with getting insurance. So unless the care home is run by a barrister who relishes a legal fight, it is understandable that they stick to the government guidance.
 

Louise7

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Mar 25, 2016
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I think that it's recognised by most that the care homes are in a very difficult position, hence the attempt at judicial review. It won't be an easy process though, and the first hurdle will be getting a Judge to rule that there are grounds for a judicial review.

For info, there's also a separate attempt ongoing to try to get a judicial review relating to placing hospital patients in care homes: https://www.theguardian.com/society...ction-over-covid-deaths-in-english-care-homes
 

Palerider

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The guidance is just guidance and in theory can be disregarded by a care home as it is not legally binding. However the reality is that if a care home diverged from the government guidance to any significant degree they would be exposed to a lot of criticism at best and potentially civil litigation for negligence at worst when a resident dies. They might also have trouble with getting insurance. So unless the care home is run by a barrister who relishes a legal fight, it is understandable that they stick to the government guidance.

Its not so simple, there are many interests at stake here and private CH's aren't necessarily thinking of the best interests of their residents. It all depends on which risks organisations are basing their decisions on -i.e. risks to the organisation or risks to the residents themselves. But this is why a judical review is been sort and there is growing contention over decisions some care homes are making. A duty of care exists, whether the home is ran by a barrister or not and regardless of guidance, because the onus is placed on the carer to make such decisions, it is they who carry both responsibility and accountability for their actions or omissions regardless.
 

Palerider

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Aug 9, 2015
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I think that it's recognised by most that the care homes are in a very difficult position, hence the attempt at judicial review. It won't be an easy process though, and the first hurdle will be getting a Judge to rule that there are grounds for a judicial review.

For info, there's also a separate attempt ongoing to try to get a judicial review relating to placing hospital patients in care homes: https://www.theguardian.com/society...ction-over-covid-deaths-in-english-care-homes

It will be interesting to see how this all unfolds -thanks for sharing
 

MartinWL

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Jun 12, 2020
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Its not so simple, there are many interests at stake here and private CH's aren't necessarily thinking of the best interests of their residents. It all depends on which risks organisations are basing their decisions on -i.e. risks to the organisation or risks to the residents themselves. But this is why a judical review is been sort and there is growing contention over decisions some care homes are making. A duty of care exists, whether the home is ran by a barrister or not and regardless of guidance, because the onus is placed on the carer to make such decisions, it is they who carry both responsibility and accountability for their actions or omissions regardless.
Yes you are right a duty of care exists. If I were to sue a care home and that care home had not followed the government guidance, I would be telling the judge that they had been negligent by not following the guidance. Yes they might have justified reasons but I would have a stick with which to beat them in my hands.
 

anxious annie

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Jan 2, 2019
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Exactly, that's why people are writing to MPs, signing petitions, asking the big dementia charities for their support to gain media attention, as this government only seem to act when they are shamed into it by public outcry.
The guidance to care homes needs changing. It's absolutely disgraceful to expect residents in care homes , our frail, elderly, to go out into gardens , or be by an open window in the cold, wet Autumnal weather to be able to have a visit from their loved ones.
And what about the residents who are bed ridden, they can't go into the garden or sit close by a window, particularly if not on the ground floor!!
They can be bedridden, but not end of life , so no indoor visit?!!!
Nobody wants to go back to the situation of the atrocious number of care home deaths, but the risk to mental health is so great that the risks just need to be balanced.
In my opinion care home staff are just as much of a risk to bring in coved, give families the same aprons, masks, sanitisers etc, visits in resident room, cleaning etc. It could be done.
I just want to see and hug my mum, whilst she still has the time ( only my sister is the "consistent" visitor as she lives closer), so no luck with that either!

So sorry to have ranted on your thread @Palerider , but I just can't understand why the government is not acting now to give new guidance. Vivid is not going away anytime soon, how long do they expect the I humane care home situation to go on.
Quality of life surely!
 

Palerider

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Aug 9, 2015
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Yes you are right a duty of care exists. If I were to sue a care home and that care home had not followed the government guidance, I would be telling the judge that they had been negligent by not following the guidance. Yes they might have justified reasons but I would have a stick with which to beat them in my hands.

But we are not talking about negligence which you can only know after the fact. We are talking about the rights of CH residents and their families:

In the UK all public authorities, including NHS organisations, have a duty to respect and promote peoples’ human rights.


Public authorities include:
  • social services
  • private care homes funded by a local authority
  • local authority and NHS funded care homes
  • NHS health services like hospitals, GPs and dentists
  • other NHS bodies like NHS trusts in England, Local Health Boards in Wales or NHS Health boards in Scotland
  • private healthcare organisations providing NHS services
  • the Care Quality Commission in England, the Care and Social Services Inspectorate in Wales and the Care Inspectorate in Scotland.

The following rights are the most relevant when you receive health or care services:
  • article 8 - the right to respect for private and family life
  • article 3 - the right not to be tortured or treated in an inhuman or degrading way
  • article 5 - the right to liberty
  • article 2 - the right to life
  • article 14 - the right not to be discriminated against.



 

Palerider

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Aug 9, 2015
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Exactly, that's why people are writing to MPs, signing petitions, asking the big dementia charities for their support to gain media attention, as this government only seem to act when they are shamed into it by public outcry.
The guidance to care homes needs changing. It's absolutely disgraceful to expect residents in care homes , our frail, elderly, to go out into gardens , or be by an open window in the cold, wet Autumnal weather to be able to have a visit from their loved ones.
And what about the residents who are bed ridden, they can't go into the garden or sit close by a window, particularly if not on the ground floor!!
They can be bedridden, but not end of life , so no indoor visit?!!!
Nobody wants to go back to the situation of the atrocious number of care home deaths, but the risk to mental health is so great that the risks just need to be balanced.
In my opinion care home staff are just as much of a risk to bring in coved, give families the same aprons, masks, sanitisers etc, visits in resident room, cleaning etc. It could be done.
I just want to see and hug my mum, whilst she still has the time ( only my sister is the "consistent" visitor as she lives closer), so no luck with that either!

So sorry to have ranted on your thread @Palerider , but I just can't understand why the government is not acting now to give new guidance. Vivid is not going away anytime soon, how long do they expect the I humane care home situation to go on.
Quality of life surely!

Rant away! Your welcome

Interestingly Amnesty International have noted a huge rise in the erosion of rights in vulnerable groups since coronavirus
 

Baker17

Registered User
Mar 9, 2016
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Its taken a lot of pressure to get the CH moving and sort itself out
@Palerider tell me about it I feel like pressure cooker, we shouldn’t have be through this. If they don’t get their acts together there’ll be a whole other group of people needing help. I had a big row when I went to window visit my husband today, but that’s another story?
 

Palerider

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Aug 9, 2015
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@Palerider tell me about it I feel like pressure cooker, we shouldn’t have be through this. If they don’t get their acts together there’ll be a whole other group of people needing help. I had a big row when I went to window visit my husband today, but that’s another story?

I'll be honest I have come close to loosing it on a couple of occassions, but managed not to and would advise the same. Don't get drawn into arguments as it fuels the CH's reasons for being more obstructive.

Last week I had the monthly phone call about mum (they do this thing to see if there is anything they can do to improve on), which irritates me as I haven't been able to visit. Anyway the person on the end of the phone was agency staff and clearly didn't know my mum very well. She said she had gained weight and was eating well. Really I thought thats a miracle! So without a quibble I said i don't think she is based on the pictures I recieved at the weekend plus the weight gain is probably due to her heart failure and retention of fluid in her legs and arms. Not to mention mum is refusing food apart from milkshakes and coffee. I asked how her mood was. A pause followed (as she read the shift reports) then I got a 'she's ok' -what do you mean by ok? etc etc etc. There is more to it than just making the phone call to tick a box and the difference to one of mums regular staff was very obvious.
 

Bikerbeth

Registered User
Feb 11, 2019
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Bedford
Pleased to hear that you will finally get to visit your Mum @Palerider especially with her birthday coming up.
sorry @Lynmax to hear that you are no closer to obtaining visits even if you are happy with other aspects of the Care Home.
I contacted Mum’s local authority for information having been sent a copy of the LA document by the CH that said absolutely nothing. They have advised unless I provide Mum’s details they cannot send me their general guidelines regarding visiting.
 

Baker17

Registered User
Mar 9, 2016
3,382
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I'll be honest I have come close to loosing it on a couple of occassions, but managed not to and would advise the same. Don't get drawn into arguments as it fuels the CH's reasons for being more obstructive.

Last week I had the monthly phone call about mum (they do this thing to see if there is anything they can do to improve on), which irritates me as I haven't been able to visit. Anyway the person on the end of the phone was agency staff and clearly didn't know my mum very well. She said she had gained weight and was eating well. Really I thought thats a miracle! So without a quibble I said i don't think she is based on the pictures I recieved at the weekend plus the weight gain is probably due to her heart failure and retention of fluid in her legs and arms. Not to mention mum is refusing food apart from milkshakes and coffee. I asked how her mood was. A pause followed (as she read the shift reports) then I got a 'she's ok' -what do you mean by ok? etc etc etc. There is more to it than just making the phone call to tick a box and the difference to one of mums regular staff was very obvious.
@Palerider it wasn't so much a row, it more me trying to get my point across and I got myself upset. When window visiting on most occasions bar two no one has said put a mask gloves and an apron on. It’s the same person would has said twice to do this, it was different person yesterday and she said put them on, bearing mind my husband doesn’t know who I am when I wear a mask. So I said why, she said it’s government guidelines funny I’ve not seen that bit. Anyway to cut a long story short she phoned an operations manager, another manager? so I asked to speak to her and she said to me if the window is shut you don’t need a mask, fair enough. Ended the call and told her what the manager had said, she said are you telling me the truth!!!! Sorry but then I lost it. Anyway I got to see my husband without a mask Nd another more senior manager at C...... county council is ringing me on Monday supposedly and the saga continues..............
BTW have you seen the full page article in the Mail on Sunday, well worth a read
 
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MartinWL

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Jun 12, 2020
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But we are not talking about negligence which you can only know after the fact. We are talking about the rights of CH residents and their families:

In the UK all public authorities, including NHS organisations, have a duty to respect and promote peoples’ human rights.


Public authorities include:
  • social services
  • private care homes funded by a local authority
  • local authority and NHS funded care homes
  • NHS health services like hospitals, GPs and dentists
  • other NHS bodies like NHS trusts in England, Local Health Boards in Wales or NHS Health boards in Scotland
  • private healthcare organisations providing NHS services
  • the Care Quality Commission in England, the Care and Social Services Inspectorate in Wales and the Care Inspectorate in Scotland.

The following rights are the most relevant when you receive health or care services:
  • article 8 - the right to respect for private and family life
  • article 3 - the right not to be tortured or treated in an inhuman or degrading way
  • article 5 - the right to liberty
  • article 2 - the right to life
  • article 14 - the right not to be discriminated against.



The trouble is here that the human rights - which I agree are relevant - are in conflict with the measures being demanded to protect residents from disease. For example the right to liberty means a CH resident can if capable of it leave the building and meet others socially then return to the CH, but this would conflict with the right of other residents to be protected from the spread of the virus. CH managers fear a future accusation of negligence (after the fact, as you say) due to not following guidelines, more than they fear accusations about human rights. Balancing these conflicts is far from easy and the government is not helping at all.
 

Palerider

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Aug 9, 2015
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The trouble is here that the human rights - which I agree are relevant - are in conflict with the measures being demanded to protect residents from disease. For example the right to liberty means a CH resident can if capable of it leave the building and meet others socially then return to the CH, but this would conflict with the right of other residents to be protected from the spread of the virus. CH managers fear a future accusation of negligence (after the fact, as you say) due to not following guidelines, more than they fear accusations about human rights. Balancing these conflicts is far from easy and the government is not helping at all.

It is a mess!. To clarify for anyone trying to follow, there are a number of laws that govern care home provision e.g Consumer law. In cases of negligence this reverts to case law in which a test has to be proved in order for negligence to have taken place. Negligence cases are unique in that each test or standard of measure is adapted to the particular matter in question. So any test of negligence by a care home would be proportionate to that which is accepted as an acceptable standard of care. On that basis the claim would not be on whether the care home was opened to visitors, but what foreseeable measures were taken to reduce the risk of harm to other residents who were not being visited at the time. (in a nutshell). I think there is too much emphasis on only one factor here rather than weighing all of the issues at stake and coming up with a balanced approach.

Even so, the rights of CH residents have to be balanced, even under the Coronavirus Law 2020:

Under section 6 of the Human Rights Act 1998, public authorities have a legal duty act compatibly with our human rights in all they do. The duty also applies when a resident’s care is being funded or arranged by the NHS or a local authority. In this case, care home staff must respect, protect and fulfil people’s human rights in their work, including service delivery, policies and decision-making.

Qualified rights (Source: Citizens Advice, 2020)

A public authority can sometimes interfere with your rights if it’s in the interest of the wider community or to protect other people’s rights. These rights are qualified.

The following rights are qualified:

  • article 8 - your right to respect for private and family life
  • article 9 - freedom to manifest your religion or belief
  • article 10 - freedom of expression
  • article 11 - freedom of assembly.
Qualified rights may need to be balanced against other people’s rights or the rights of the wider community to achieve a fair outcome. It’s the courts who decide how to balance these different interests.

Some rights can never be restricted. These rights are absolute. Absolute rights include:

  • your right not to be tortured or treated in an inhuman or degrading way
  • your right to hold religious and non-religious beliefs.
A public authority can never justify breaching an absolute right.
 

Palerider

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Aug 9, 2015
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Pleased to hear that you will finally get to visit your Mum @Palerider especially with her birthday coming up.
sorry @Lynmax to hear that you are no closer to obtaining visits even if you are happy with other aspects of the Care Home.
I contacted Mum’s local authority for information having been sent a copy of the LA document by the CH that said absolutely nothing. They have advised unless I provide Mum’s details they cannot send me their general guidelines regarding visiting.

Yes long may it last.

Its interesting that the LA won't send you details on visiing without your mums details?? Whats that about?
 

Palerider

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@Palerider it wasn't so much a row, it more me trying to get my point across and I got myself upset. When window visiting on most occasions bar two no one has said put a mask gloves and an apron on. It’s the same person would has said twice to do this, it was different person yesterday and she said put them on, bearing mind my husband doesn’t know who I am when I wear a mask. So I said why, she said it’s government guidelines funny I’ve not seen that bit. Anyway to cut a long story short she phoned an operations manager, another manager? so I asked to speak to her and she said to me if the window is shut you don’t need a mask, fair enough. Ended the call and told her what the manager had said, she said are you telling me the truth!!!! Sorry but then I lost it. Anyway I got to see my husband without a mask Nd another more senior manager at C...... county council is ringing me on Monday supposedly and the saga continues..............
BTW have you seen the full page article in the Mail on Sunday, well worth a read

Hmm there is a lot of confusion in some quarters on what everyone should and shouldn't be doing, even though the guidance is relatively simple. I also worry that everyone has become so fixated on masks that they are forgetting other important things to do such as hand washing. Hoping the phone call on Monday brings some solutions. I'll have a look at the Mail on Sunday
 

MartinWL

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Jun 12, 2020
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It is a mess!. To clarify for anyone trying to follow, there are a number of laws that govern care home provision e.g Consumer law. In cases of negligence this reverts to case law in which a test has to be proved in order for negligence to have taken place. Negligence cases are unique in that each test or standard of measure is adapted to the particular matter in question. So any test of negligence by a care home would be proportionate to that which is accepted as an acceptable standard of care. On that basis the claim would not be on whether the care home was opened to visitors, but what foreseeable measures were taken to reduce the risk of harm to other residents who were not being visited at the time. (in a nutshell). I think there is too much emphasis on only one factor here rather than weighing all of the issues at stake and coming up with a balanced approach.
Everything you say here is correct but you have put your finger on the conflicting issue, which I have made bold in the quote. What is currently regarded as an acceptable standard of care may very probably be strict adherence to government guidelines. Of course, before you take me to task, that has not been tested in court, but it would be reasonable for a care home manager to make the assumption that falling below the standards set out in government guidance would expose him to a future risk of litigation, the claimant basing his case on that non-adherence. There could also be a prospect of criminal prosecution under health and safety legislation. Here I think the care home manager might be able to defend himself more easily as all risks, not just those of covid, need to be considered including the welfare of residents. However it would be a bold care home manager who defied popular coronaphobia and defied government guidance, and the local authority quite possibly, to take a balanced risk-based approach that took full account of the damage to residents' mental health and their welfare by denial of family visits, for example. Actually, now I think about it, there could be a case made that denial of family access constitutes a breach of S.4 of the Health and Safety at Work Act 1974 but I can't see any local authority having the guts to persue that in the current climate.
 
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