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Care home staffing

daisydi

Registered User
Feb 25, 2015
255
Norfolk
Hi all I know this has been asked before but I am going to arrange a meeting with the care home manager and I want to get my facts straight. Whenever I go into the home in the afternoon many residents are in the lounge with no supervision. There are 17 residents where my mum is and at least 4 that I have seen have dementia. These 4 along with another couple of frail ladies are always sitting in the lounge, as well as my mum. Yesterday when I went in there was a nasty smell and one of the dementia ladies had had an accident (no.2) and was wandering around willy nilly wafting the most disgusting smell about. Not her fault I know. There was another dementia patient wandering around, dismantling everything on a bookcase causing a shelf to fall off with another resident trying to tell the lady to stop. I have witnessed these 2 ladies bickering of many occasions. My poor mum was just sat there amongst all this and my heart sank and it was so difficult for me just to leave her there. I so wanted to bring her out of that environment. The 2 staff on duty were upstairs oblivious to all that was going on downstairs.

One of the other residents pressed the alarm and a member of staff came downstairs and took lady no.1 to the toilet and I told her lady no.2 was being disruptive. Didn't really get a response.

My question is shouldn't there be a member of staff supervising dementia patients at all times. I think I know the answer but just wanted to check before I go to see the manager. Even if the staff were on a break shouldn't there be someone else around, apart from the tea lady. My mum has vascular dementia but she is quiet and non demanding, her only real but massive problem is lack of short term memory. She could still be chewing her food but couldnt tell you what it was she had just eaten. She is incontinent most of the time and if it wasnt for that I would bring her home with me. I think I am reaching the stage of wanting to move my mum but it would be so disruptive for her and I'm not sure where to move her to. Frying pan and fire comes to mind.

What does everybody think? Help me please!
 

Bod

Registered User
Aug 30, 2013
1,219
What does their last CQC report say about staff levels?
Has the staffing altered since then.

Bod
 

Ann Mac

Registered User
Oct 17, 2013
3,693
Looking on-line, the levels don't seem to have changed much from the minimum required when I worked in residential care - it works out as (depending on time of day) roughly 2 staff for every 10 patients, though the guidelines, without givng actual figures, do say that the dependency of the client should be taken into account. But you have to remember that the staffing levels are only reccommendations, not set in stone - which isn't ideal!

However, there are ways round this - its not that unusual for staff to be sent on courses whilst on duty, leaving the other staff short handed - this, of course, saves having to pay staff overtime to attend courses (many of which are mandatory) on their 'time off' - what they should do is pay for cover, but in my experience that didn't happen often :( .

It may also be the case that other staff were on break when you visited - many care staff work 12/13 hour shifts, so of course need breaks, leaving the floor short staffed again :(

HTH x
 
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Saffie

Registered User
Mar 26, 2011
22,506
Near Southampton
If carers are on courses or off sick and no other staff will cover, then agency staff should be employed.
Thet were in my husband's home which was LA run.
Occasionally of course, the inevitable happens and no agency carer is available but it shouldn't be the norm not to try.
The same applied to nurses.
I suspect it's a case of costs and profit, the latter which, thankfully, didn't apply to my husband's home though the former of course did!
 

Sooty2

Registered User
Jun 1, 2015
30
Unfortunately CQC do not state staffing levels, merely only make recommendation, its up for the home manager to staff the unit according to need and risk assessment, sad to say but this is not uncommon.
 

Quizbunny

Registered User
Nov 20, 2011
108
After my mother had a fall that wasn't witnessed because the two carers on duty were upstairs doing a two handed hoist and change, we complained about the staffing levels and an apprentice was taken on to cover the afternoons/early evening. We have subsequently discovered that the apprentice left last December because she was fed up being paid much less than the other carers but doing the same job. When my sister tackled the manager she was told that they were looking for another apprentice. Apparently another little lass working for a pittance is the best we can expect.
 

daisydi

Registered User
Feb 25, 2015
255
Norfolk
Thanks for all your replies. I spoke to another resident today who is there for respite with no dementia and he agrees that there is a shortage and has tackled the manager who says they have enough staff. There are quite a few really dependant residents who need 2 staff for hoisting etc. and he says that both staff are so busy with hoisting etc. the able bodied (but demented) residents seem to be left to their own devices. I am definitely going to arrange a meeting to express our concerns but I'm not sure how much good it will do. Will keep you posted. Thanks for listening!
 

Beate

Registered User
May 21, 2014
11,906
London
Might be time to look at other care homes if you feel this one gives inadequate care?
 

robertsnicola

Registered User
Jun 11, 2015
2
portsmouth
id definately look for another care home im a nurse and we have a challenging behaviour floor and several dementia clients and staffing is relatively high and good and clients are not left to their own devices, you need to point out to manager that your mum brings in significant payement to them because of her condition and deserves better.
 

TinaT

Registered User
Sep 27, 2006
7,095
Bolton
I'm very sorry to read your post. Although the C QC cannot tell managers of care homes how many staff to employ, if they get complaints about a home relating to poor and unsafe staffing levels they will take the matter up and most probably bring an inspection forward.

Once they have established that staffing levels are unsafe, then they can take measures to force the manager to employ more staff.

I appreciate that this is not a quick solution to your problems but at least it is one way of getting proper attention paid to a serious matter affecting the residents.

Go onto the CQC website and tell them of your experience.

Best wishes TinaT
 

daisydi

Registered User
Feb 25, 2015
255
Norfolk
I just dont know what to do. Mum is reasonably happy there and the thought of moving her to a bunch of strangers absolutely terrifies me. I just wish I could bring her home
 

Beate

Registered User
May 21, 2014
11,906
London
It doesn't matter anymore whether she's happy there. It's closing. You need to find her somewhere else and fast so start ringing around. If she was fine in a care home before, she will be again.
 

daisydi

Registered User
Feb 25, 2015
255
Norfolk
It doesn't matter anymore whether she's happy there. It's closing. You need to find her somewhere else and fast so start ringing around. If she was fine in a care home before, she will be again.
Its not closing, I'm just concerned that there aren't enough staff
 

sistermillicent

Registered User
Jan 30, 2009
2,949
it sounds as though they might not be geared up as the ideal place for someone with dementia if they can't improve their staffing issues. It is certainly worth discussing things with the manager and expressing your concerns and saying that you feel your mum needs a bit more....not saying anything nasty. Perhaps you won't have to move her, they may take on board what you are saying. But if you do have to move your mum then it is for the best, so that she can be somewhere that they can look after her for the rest of her life....you don't have to do it urgently and could spend time looking for a nice place.
 

CHEZA27

Registered User
Jan 8, 2015
29
Talk to the manager

I can speak from experience as I've made a formal complaint to the CQC about my mums CH. It was taken very seriously and a safeguarding alert is now in place for mum as well as other residents due to the inspection that was carried out as a result of my complaint.
My mum was experiencing similar problems, she was just being left to her own devices and often soiled herself and had to wait to be cleaned up, this was unacceptable to me and they have since employed more staff on the dementia unit.
I would challenge the home manager and tell her what your expectations are, if you get no joy my advice would be to take it further. That's the only way I was listened to and care has begun to improve (slowly may I add)

Good luck

Chez x
 

daisydi

Registered User
Feb 25, 2015
255
Norfolk
I can speak from experience as I've made a formal complaint to the CQC about my mums CH. It was taken very seriously and a safeguarding alert is now in place for mum as well as other residents due to the inspection that was carried out as a result of my complaint.
My mum was experiencing similar problems, she was just being left to her own devices and often soiled herself and had to wait to be cleaned up, this was unacceptable to me and they have since employed more staff on the dementia unit.
I would challenge the home manager and tell her what your expectations are, if you get no joy my advice would be to take it further. That's the only way I was listened to and care has begun to improve (slowly may I add)

Good luck

Chez x
Thank you. Yes this is what I'm talking about. My mum and others walking around with wet trousers and it takes another resident to tell staff that she needs sorting out. It is not acceptable in my opinion. My mum is regularly wet after lunchtime so I am going to ask them to sort her out before she has a big wet patch on her trousers. Surely this is just common sense!
 

jan.s

Registered User
Sep 20, 2011
7,352
68
Hi

This was an issue that I raised many times with the manager at Rogers CH. The accepted level within the industry for dementia residents is 1:5. We actually had 1:4 because the needs were greater.

If there is no carer in the lounge for a long period, whethere dementia or not, that is an issue that needs addressing. There should always be a carer in the lounge with the residents, or at least within earshot. Even if one is on break, there should be someone available.

CQC take a very dim view of lack of staffing. In all care homes this happens, but I raised it as an issue so it didn't become the norm.

If it were me, I wouldn't hesitate to raise it with the management, after all, if someone has a fall and breaks their hip, that is a serious matter.

Having just read your post of today, in Rogers CH, it was normal practice for the staff to change all residents before lunch, that way there were no nasty niffs and everyone was comfortable for their lunch and for a couple of hours in the afternoon.

To be walking round either wet or smelly is not dignified.
 
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daisydi

Registered User
Feb 25, 2015
255
Norfolk
Hi

This was an issue that I raised many times with the manager at Rogers CH. The accepted level within the industry for dementia residents is 1:5. We actually had 1:4 because the needs were greater.

If there is no carer in the lounge for a long period, whethere dementia or not, that is an issue that needs addressing. There should always be a carer in the lounge with the residents, or at least within earshot. Even if one is on break, there should be someone available.

CQC take a very dim view of lack of staffing. In all care homes this happens, but I raised it as an issue so it didn't become the norm.

If it were me, I wouldn't hesitate to raise it with the management, after all, if someone has a fall and breaks their hip, that is a serious matter.

Having just read your post of today, in Rogers CH, it was normal practice for the staff to change all residents before lunch, that way there were no nasty niffs and everyone was comfortable for their lunch and for a couple of hours in the afternoon.

To be walking round either wet or smelly is not dignified.
Have a meeting booked for Monday morning to raise our concerns. Thanks for your input. I will suggest they change residents before the pad is saturated leading to wet clothes. It's not rocket science is it?
 

jan.s

Registered User
Sep 20, 2011
7,352
68
Great news about your appointment.

I totally agree and I can think of nothing worse than sitting in a wet pad (or worse) eating my lunch, or even sitting next to somebody.

So much about care is based on dignity and respect and walking round with a wet patch is not dignified.

It is also a safeguarding issue by not having a staff member in the lounge.

Good luck for Monday. x