BBC Panorama film exposes care home failures

Saffie

Registered User
Mar 26, 2011
22,506
Near Southampton
Up till April 2015 the simple answer was no one. There were the offences of assault, certain breaches of Health & Safety and some rarely used offences under the Mental Health Act. However following the Stafford Hospital and Winterbourne View enquiries new offences came into law in April 2015 and it is believed the first prosecution concluded yesterday.
http://forum.alzheimers.org.uk/showthread.php?97063-Carers-amp-Care-Providers-be-warned!
Not so if someone is in a LA owned nursing home. My first port of call if I was unhappy about something would have been the Adult Services of my local authority. I never had to but was witness to how quickly they get involved it there is a complaint of any kind. Meetings were arranged for all relatives immediately and matters were addressed with extra staff brought in and experts visiting at all times. The complain was nothing to do with abuse or care in any way either. It is one reason I was glad my husband was in such a home which I chose for a number of reasons but mainly because it was the only one of 15 visited that I really liked.
 

jimbo 111

Registered User
Jan 23, 2009
5,080
North Bucks
In my first post I made the comment

“I acknowledge the fact that there are some genuinely good care homes
n , depending on your point of view)but there can be no doubt that the problem is brought about by councils ( councillors ) who find it easier to pass the buck of their responsibilities to organisations whose first priority is Profit
When we come to our senses and demand that local authorities take back their responsibilities of direct care and financial matters , then we will perhaps get back to the days when mostly good care and compassion were the top and only priority


I have been in the fortunate position ( or unfortunate position depending on your point of view ) of experiencing social service home care from different perspectives
In my working experience I was for many years closely connected to Social Home Helps ( Carers) and homes This was before the advent of private companies being used for these services
Since then I had many years of dealing with Carers when my wife was ill with Alzheimer’s
I never dreamed that I would one day be in need of those services for myself ,but for the past three years I have been very dependent on the Home Care service
In the mornings to wash and dress and in the evening to help undress and ready for bed
The continual daily reports of ill treatment and neglect is so very depressing and worrying for those like myself who face the prospect of a future in care
I have in the past made representation to my local council , and even written a letter to the PM , but I feel strongly that all of these representations will come to nothing until we insist that those who are responsible should not be allowed to abdicate their duties by using Agencies
It is very easy for them to say it is more economical and efficient than direct labour
This is arrogant nonsense and can only be ‘passing the buck ‘
When they have to personally take the responsibility of answering the many defects in the service provided , then we should see an improvement
My local Authorities Direct Home Care service has been a perfect example of what we should expect (Unfortunately I suspect on recent developments that they are succumbing to the temptation of agencies )
One thing for sure is that the local authorities staff training is far more superior and on-going than that given by most agencies
The standard of care homes properly maintained and controlled
We should be more vociferous in our demands for Care of the Elderly and Disabled to be returned to the direct control of the responsible Council department and more crucially council members
It may well be more costly But what do you want ?????
Properly controlled care with people directly responsible to you ??
Or cheaper Agency care that may save money , but at a cost that in many cases denies the care that we want for ourselves and those in need
Briefly looking back on this post I realise it is not very well constructed ( even worse than normal )
But I do feel strongly that until we convince our councils that they should take back their duties and responsibilities we will not see any improvement on the present dreadful state of things
jimbo
 

Pete R

Registered User
Jul 26, 2014
2,044
Staffs
Not so if someone is in a LA owned nursing home. My first port of call if I was unhappy about something would have been the Adult Services of my local authority. I never had to but was witness to how quickly they get involved it there is a complaint of any kind. Meetings were arranged for all relatives immediately and matters were addressed with extra staff brought in and experts visiting at all times. The complain was nothing to do with abuse or care in any way either. It is one reason I was glad my husband was in such a home which I chose for a number of reasons but mainly because it was the only one of 15 visited that I really liked.
Because of the on going Police investigation I cannot say much about my Mom's case but my experience has been exactly the opposite of what you write with LA Adult Safeguarding conniving with the NH to make the matter "go away".:(
 

Saffie

Registered User
Mar 26, 2011
22,506
Near Southampton
I am surprised. I can only speak from my own experience but the home has a good reputation hereabout, as do the other very few other LA owned nursing homes in the area. Many of the residents were self-funding as was my husband for some time, so if it was otherwise I think some residents would have been moved.
I have no experience of their residential care homes but anyway I would expect that matters differ between local authorities in this as in everything else.
I did know our local county councillor well and he happened to be chair of the Adult Services committee so had a little inside knowledge of their attitude and response. He told me to let him know about anything about which I was unhappy but I never did, nor ever felt the need to do so.
I hope your situation is resolved.
 

LostBrother

Registered User
Nov 23, 2016
1
Shocking, good journalism but what next

i have a brother with advanced dementia in a nursing home and a daughter who works as a carer in a home too. The behaviour shown in the Panorama programme is shocking to see but sadly not surprising.

Let's not fool ourselves that the root of the problem are a few bad apples employed by care homes. It is absolutely clear that the fundamental issue is with the type of people and private companies who set up in this business driven primarily by making money. Providing good quality care is an extremely demanding job, very hard work for people who have a caring attitude, probably impossible for anyone not suited to this type of work, doing it because it's the only work they can find.

The economics of running a care home business is very much dictated by the cost of carer staff and hence care home businesses trying to maximise profit will be looking to minimise staff costs by keeping staff numbers as low as possible and paying the lowest salaries they can get away with. This toxic combination of low levels of staff and poorly paid staff makes it inevitable that the quality of care offered will regularly fail to meet expectations. There are many careers on very poor salaries doing a wonderful job, but Panorama didn't focus on the good carers, it highlighted the bad ones.

Blaming the CQC for the problem is like blaming HMRC for failing to prevent companies from committing tax evasion/avoidance or OFGEN from allowing energy suppliers to overcharge consumers. The regulators will have limited resources and they cannot hope to fix the failings of a system that is fundamentally flawed. Tax evasion could be largely eliminated by simplifying the tax system, energy companies could be forced to simplify their tariff structures and with care homes they should be run on a non-profit basis and very strictly regulated in terms of carer minimum wages, minimum training and far more attention given to staff selection to ensure that they have the appropriate human skills in caring for people with dementia.

One aspect of the Panorama programme I found quite frustrating is to have a GP and an academic passing judgement on provision of care, something that they most likely have no practical experience of. We do not need someone to have gone through 7 years of medical school to tell us that leaving someone in a urine/faeces soiled pad will lead to skin sores and infections or being left on a bedpan for an extended period will cause pressure sores.

Please use some common sense and consider what carer to patient ratios would be necessary to check sanitary pads regularly enough to avoid issues. If patients are not wearing pads, just consider the carer time required to shower and clean the resident's clothes and cleaning up any soiled areas. My brother has had Parkinson's for many years so he has no unaided mobility so he needs a lot of help with everything he does. He consequently does spend most of every day in a chair in front of a TV with very little stimulation. Yes there are some activities provided but this represents a very small percentage of each week.

Care costs are already very high, and if you do the sums using minimum wages, basic meal costs etc you will see that even the poorest care has to cost hundreds of pounds per week. To achieve the level of care that we would expect would almost certainly require an increase in costs but no significant part of the costs should be siphoned off as profits for the owners or to pay shareholders.

Going back to the shocking things we saw on TV, yes the staff responsible for unacceptable behaviour should be fired and not allowed to work in the industry again, BUT the owners/directors should face custodial sentences and heavy fines if their organisation is found guilty of operating as depicted on Panorama. Better still let's take the profit motive out of care and nursing homes and look at a rigorous study to define minimum resident to carer ratios.
 
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fizzie

Registered User
Jul 20, 2011
2,732
i have a brother with advanced dementia in a nursing home and a daughter who works as a carer in a home too. The behaviour shown in the Panorama programme is shocking to see but sadly not surprising.

Let's not fool ourselves that the root of the problem are a few bad apples employed by care homes. It is absolutely clear that the fundamental issue is with the type of people and private companies who set up in this business driven primarily by making money. Providing good quality care is an extremely demanding job, very hard work for people who have a caring attitude, probably impossible for anyone not suited to this type of work, doing it because it's the only work they can find.

The economics of running a care home business is very much dictated by the cost of carer staff and hence care home businesses trying to maximise profit will be looking to minimise staff costs by keeping staff numbers as low as possible and paying the lowest salaries they can get away with. This toxic combination of low levels of staff and poorly paid staff makes it inevitable that the quality of care offered will regularly fail to meet expectations. There are many careers on very poor salaries doing a wonderful job, but Panorama didn't focus on the good carers, it highlighted the bad ones.

Blaming the CQC for the problem is like blaming HMRC for failing to prevent companies from committing tax evasion/avoidance or OFGEN from allowing energy suppliers to overcharge consumers. The regulators will have limited resources and they cannot hope to fix the failings of a system that is fundamentally flawed. Tax evasion could be largely eliminated by simplifying the tax system, energy companies could be forced to simplify their tariff structures and with care homes they should be run on a non-profit basis and very strictly regulated in terms of carer minimum wages, minimum training and far more attention given to staff selection to ensure that they have the appropriate human skills in caring for people with dementia.

One aspect of the Panorama programme I found quite frustrating is to have a GP and an academic passing judgement on provision of care, something that they most likely have no practical experience of. We do not need someone to have gone through 7 years of medical school to tell us that leaving someone in a urine/faeces soiled pad will lead to skin sores and infections or being left on a bedpan for an extended period will cause pressure sores.

Please use some common sense and consider what carer to patient ratios would be necessary to check sanitary pads regularly enough to avoid issues. If patients are not wearing pads, just consider the carer time required to shower and clean the resident's clothes and cleaning up any soiled areas. My brother has had Parkinson's for many years so he has no unaided mobility so he needs a lot of help with everything he does. He consequently does spend most of every day in a chair in front of a TV with very little stimulation. Yes there are some activities provided but this represents a very small percentage of each week.

Care costs are already very high, and if you do the sums using minimum wages, basic meal costs etc you will see that even the poorest care has to cost hundreds of pounds per week. To achieve the level of care that we would expect would almost certainly require an increase in costs but no significant part of the costs should be siphoned off as profits for the owners or to pay shareholders.

Going back to the shocking things we saw on TV, yes the staff responsible for unacceptable behaviour should be fired and not allowed to work in the industry again, BUT the owners/directors should face custodial sentences and heavy fines if their organisation is found guilty of operating as depicted on Panorama. Better still let's take the profit motive out of care and nursing homes and look at a rigorous study to define minimum resident to carer ratios.
Thank you for posting this, it has really consolidated a lot of my thinking and brought together so many issues in a constructive and logical way. Much appreciated
 

fizzie

Registered User
Jul 20, 2011
2,732
Because of the on going Police investigation I cannot say much about my Mom's case but my experience has been exactly the opposite of what you write with LA Adult Safeguarding conniving with the NH to make the matter "go away".:(
I agree I have seen many cases of this collaboration and concealment - however I would still report to LA and CQC simultaneously and then to Eileen chubb at Compassion in Care
 

Pete R

Registered User
Jul 26, 2014
2,044
Staffs
I agree I have seen many cases of this collaboration and concealment - however I would still report to LA and CQC simultaneously and then to Eileen chubb at Compassion in Care
I did complain to the CQC on 24th October. They called me yesterday to say they are still investigating and that they had inspected the home twice at the beginning of November. They were unable to tell me much at all as to what was found but apparently all was not well.

I await the report.

:)
 

AlsoConfused

Registered User
Sep 17, 2010
1,953
Jeremy Hunt said something worrying today, about pushing CQC's to speed up their investigations with a view to re-opening the homes being investigated ASAP. He actually said the early completion of such investigations was necessary to reduce hospital bed-blocking.

I'm all in favour of CQC investigations being completed promptly, providing they're thorough and close down any homes that aren't safe. It may well produce a better investigation if it is prompt (less time for the home managers etc to become untraceable, for example). What I don't like is the fear that substandard care and nursing homes will be kept open when they shouldn't be to reduce the pressures on hospital beds.
 

Pete R

Registered User
Jul 26, 2014
2,044
Staffs
Pete did you get any feedback on this one in the end?
The CQC report was published on 30th December and despite the CCG claiming that all was well and the home was being monitored there were many failings including nearly all the ones I had highlighted.

Some medications were not being given, record keeping was poor including inadequate care plans, inadequate management/leadership, lack of understanding of Dementia and a kitchen had to be immediately closed due to lack of cleanliness and risk of spreading infection. From 5 "good" rating 3 now "require improvement" and only due to the good carers that stayed on did they manage to keep 2 "good".

They are also restricted from accepting new residents till improvements are made.

I have received an apology from the NH on behalf of my Mom and that 2 staff members have been dismissed and reported to DBS (although due to confidentiality they wont name them).

All I have to do now, at a meeting with Police this week, is to convince them to prosecute both the carers and the care provider.

So even though they have had 3-4 months to get things sorted things seems to be fairly much the same and as was being allowed to continue.
 
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fizzie

Registered User
Jul 20, 2011
2,732
The CQC report was published on 30th December and despite the CCG claiming that all was well and the home was being monitored there were many failings including nearly all the ones I had highlighted.

Some medications were not being given, record keeping was poor including inadequate care plans, inadequate management/leadership, lack of understanding of Dementia and a kitchen had to be immediately closed due to lack of cleanliness and risk of spreading infection. From 5 "good" rating 3 now "require improvement" and only due to the good carers that stayed on did they manage to keep 2 "good".

They are also restricted from accepting new residents till improvements are made.

I have received an apology from the NH on behalf of my Mom and that 2 staff members have been dismissed and reported to DBS (although due to confidentiality they wont name them).

All I have to do now, at a meeting with Police this week, is to convince them to prosecute both the carers and the care provider.

So even though they have had 3-4 months to get things sorted things seems to be fairly much the same and as was being allowed to continue.
Well done for getting this far. There are so few sanctions and no fines and rare closures that it is outrageous - basically these homes can do whatever they want o. I hope the meeting with Police goes well - we desperately need more prosecutions but often the Police just won't take them up x