Advice on rights of family to support residents as meal times

Discussion in 'I care for a person with dementia' started by Ash_uk83, Jun 29, 2015.

  1. Ash_uk83

    Ash_uk83 Registered User

    May 21, 2015
    1
    Leicester
    Good morning,

    I am posting in the hopes of receiving advice to do with meal times at the care home my 66 year old mother is a resident in currently. I am a 32 year old whose mother has has suffered numerous strokes over the last 10 years and is now left without real use of her arms and legs and who also cannot speak without great effort though she is still alert, responsive, fully aware of her surroundings and able to hear fine still with a great grasp of English, Gujrati, Punjabi, Hindi and other languages. She also has early stage dementia but has always been a social person and loves spending time with others, even though she cannot speak herself, listening to general chit chat and is a keen people watcher now.

    She has been in care homes around 4 years and I used to go to see her every day of the weekend but had to increase that to as many meal times as possible (around 5 or 6 a week) so I could feed her due to issues with the current care home manager putting her on a liquid diet, with no variation in that meal, against the families wishes and the actual SALT team assessment which I've just had to have clarified and corrected to them. I and other residents families are now having difficulty with the care home she has been in for the last year as they have informed us they are introducing a rule that prevents family members feeding their resident relative in the main dining area and instead have advised we need to take the relative to their bedroom to feed them there.

    The care home have advised this is due to several reasons these being:

    1. Staff are distracted by additional noise and relatives making requests in regards to the meals being served to their relatives/friends
    2. Space in the dining room is limited due to the care home having now having the maximum number of residents possible
    3. Certain residents families have expressed the desire for their relative to not be observed dining by others

    No formal letter of this rule change has been dispatched yet but senior nurses and the manager have already began enforcing the rule, advising relatives who are trying to feed residents they can't be in the dining room and becoming quite rude with those not complying.

    It's extremely clear this rule change has come from the senior nurses and managers desire to avoid people seeing how long it takes their staff to get something a residents requires e.g. food, water, etc and to prevent family seeing what actually goes on at meal times e.g. how much people eat or what they do if a resident objects to what's served, as the actually careers are lovely , appreciating the help family give and have been ignoring the rule whenever possible or very obviously reluctantly asking family members to leave when senior nurses force them to. The residents themselves are friends with all the family members who regularly come to feed their relatives, having a great relationship where they usually converse briefly, catching up and checking how each other are, offering residents a nice extra social aspect they cannot get from carers as they are too busy through out the day.

    The following reasons have been raised with them why this is not right for residents or their family as per the Dignity in Care meal times guide lines:

    1. Certain residents family members need to feed them as they cannot communicate themselves properly what they desire and the care home just make the basic effort at meal times in order to get everyone put to bed by 7pm
    2. Family are not provided with a proper table and chairs in the bedrooms.
    3. Being sat at different heights prevents family seeing if the resident is eating food properly.
    4. It prevents family encouraging residents to feed themselves as with current table and chairs it is not possible for them to reach food.
    5. Prevents residents from socialising with the other residents.
    6. Family members who are friends with other residents and their family are unable to look out for their well being.
    7. If staff find it difficult to do their job with noisy family members than they should speak directly to those causing noise and politely explain why they should be more quiet.
    8. If family members are concerned about their resident family member being watched at meals than their family member should be fed separately instead of the resident who has no issue with being seen eating in front of others and who wishes to socialise.
    9. Obtaining food, drink, tissues is more difficult as it is not in the main dining area.
    10. Residents miss out on food options that are being given to others in the dining room.
    11. Staff unfortunately, as family members have discovered multiple times, lie about what residents have eaten and how much so cannot be trusted to look after residents at meal times without some checks by family.
    12. There are 4/5 staff trying to manage lunch/dinner for 40 with 2 or 3 starting to put residents to bed for naps / the night within half an hour of meal time leaving only 2 serving food who then also start taking residents to bed frequently leaving no staff in the dining area.
    13. As the senior nurse is dispensing medication during meal times and residents are left completely unattended frequently, family members in the same room can alert staff to issues such as residents dropping their tablets or spitting them out which has happened on 5 occasions I've been there.
    14. As residents are left without any staff monitoring them those with dementia or issues moving are more likely to get in to unwanted situations, e.g. falling over, dropping cutlery, eating other residents food or tissues, without family members who normally could be there, no longer around to alert staff, which has began to occur.
    15. There is more than enough space in the dining room with there being around 13 big 4 seater tables that are never all full and can easily fit at least 1 more person on them besides this (which I did fine before), who can sit on the sides next to the walls to prevent getting in the way of serving staff even though there are only 4-5 families anyway who regularly need to come to feed their relatives and the home already had a policy of only have one person being present during a relatives meal time.
    16. When families were choosing a home for the residents the dining rooms were part of the service offered and this is now being denied.
    17. From what I've observed the requests family make have been perfectly acceptable and they have never caused additional noise with the main noise coming from staff arguing with difficult residents.

    These reasons however have all been dismissed by the care home and residents family members who are disputing the rule have been told to now look at moving residents to other care homes or to speak to the owner of the care home which I will be doing today. The fact that this is ignoring what's best for residents and forcing those with dementia to move, with the true reason it's being done, which is less hassle for staff by allowing them to neglect residents needs, is not being accepted by the care home and I wanted to see if you were aware of any rules or regulations that prevent them doing this please?

    Thank you for reading this,

    Ash
     
  2. Cat27

    Cat27 Volunteer Moderator

    Feb 27, 2015
    9,765
    Merseyside
    Welcome to TP Ash.
    I'm not sure about your question but if that was my relative I'd look to move them ASAP.
     
  3. tryingmybest

    tryingmybest Registered User

    May 22, 2015
    612
    Female
    #3 tryingmybest, Jun 29, 2015
    Last edited: Jun 29, 2015
    I am so sorry to hear you are going through this. It really doesn't seem right at all. I havent any experience really to offer on this other than when my late Father was in a home for a short time a couple of years ago, I was appalled by the way in which the two senior nurses seemed to rule the place with a rod of iron and not in the best interests of the residents. At the time I did not report my concerns but wish I had now. Unfortunately it was out of my control him being there as my awful Step Mother moved him without my knowledge and then didn't want me visiting or being involved, although I visited him twice a week regardless. It was a very difficult time. On the whole the carers were not too bad although the ratio of carers to residents was too low. The management changed twice in a short space of time and seemed to be detached and quite content to let the two "dragons" rule the place.

    I certainly would suggest if you do not get anywhere in your meeting today to your satisfaction, contacting the CQC I think it is? The people who do yearly checks on care homes. It may be interesting to read their last couple of reports on this particular home too and to find out if anything they were unhappy with has been followed through and appropriate changes made previously and also if anybody else has complained about anything.

    Good luck and sorry not to be able to offer more help. Xx
     
  4. Bod

    Bod Registered User

    Aug 30, 2013
    1,112
    Hi Ash
    Welcome.
    I fear you will have to use what ever complaints procedure the home has in place, including as advised talking to the owner. Contact the Quality Care Commission, to check their rating for the home, and let them know what is going on.

    You will also have to try to find another placement for your mother, talk to Adult Social Services they have a duty of care towards vulnerable adults, which your mother certainly is.

    good luck
    Bod
     
  5. starryuk

    starryuk Registered User

    Nov 8, 2012
    1,299
    Gosh, Ash, this sounds so unfair on the residents and families.

    We were certainly welcomed into the dining room at my mum's CH and in fact encouraged to come an and have lunch with our relatives. We were considered extra help!

    I absolutely agree with all your points and think you should contact CQC as soon as possible. They must have guidelines.

    Good luck today.
     
  6. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,593
    Yorkshire
    I used to feed my mum - and the lady who usually sat next to her. The staff were only too glad to have an extra pair of hands.

    In your circumstances, I would probably have tried to take my mum to a separate table or area in the dining room if at all possible to ensure I wasn't getting in the way of staff or other residents. If the family member is sitting at the same table, effectively as a squeezed-in extra place, then that is perhaps not appropriate. Nor is demanding special attention or treatment (not that I'm suggesting you're doing this) A family member should be there, sitting quietly, to help feed them, nothing more, otherwise I can see how their presence might come across as intrusive, or even slightly intimidating, to other frail residents seated at the same table, esp if it's several times a week.

    However, the idea of other families being concerned at their relatives being 'watched' is, quite frankly absurd. I loved it when other visitors interacted with my mum.
     
  7. cragmaid

    cragmaid Registered User

    Oct 18, 2010
    7,963
    North East England
    At my late mother's care home, help was always accepted at meal times if there was a need. However, as Mum became less able to manage her cutlery, she was encouraged to eat in her room so that SHE was not embarrassed. As long as there was sufficient staff, someone would stay with her, but I was always welcome to stay and feed her, morning, noon and night.
    I think that I would be looking at other Care Homes to see if I could find one with a more sympathetic attitude, although I can understand that having extra visitors in the Dining Room could cause space problems.


    Sent from my iPad using Talking Point
     
  8. tryingmybest

    tryingmybest Registered User

    May 22, 2015
    612
    Female
    How did you get on Ash?
     
  9. Anotherdamnlol

    Anotherdamnlol Registered User

    May 2, 2015
    23
    My goodness, I visit my mum several times a week after work which coincides with dinner time. I always sit at the table, and am even offered dinner.
     
  10. Witzend

    Witzend Registered User

    Aug 29, 2007
    4,282
    SW London
    #10 Witzend, Jul 1, 2015
    Last edited: Jul 1, 2015
    There are no mealtime restrictions at my mother's CH - relatives are always welcome. One old chap comes every day to my mother's section to have his lunch and help his wife to eat.

    Over the years I have visited three relatives in.several different care homes and the only time I have known such restrictions was when OH's old aunt put herself into a CH while her cleaning lady/carer was away. The CH was very smart on the surface with fantastic sea views, but the atmosphere was not at all pleasant - staff were surly or miserable-looking and the aunt couldn't wait to get out. I was told very brusquely that I was 'in the way' when I happened to visit at lunchtime - I was not in anyone's way at all.
    I have to say I would not be happy with any CH that didn't want relatives at mealtimes.
     

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