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.