1. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    I don't know if anyone remembers my posting last August about three local, privately run EMI units I had visited and how shocked and upset I was at the conditions EMI residents were living in. Each of these establishments was run by large, private health corporations, each had had a reasonable to good report from CSCI. I found residents all sat in one large room with the ubiquitous tv to keep them company, signs of dirt and neglect in the furnishings and above all an overwhelming stench of urine.

    I sent the CSCI a detailed report and criticised them as none of their reports published on the website were for full inspections; many areas which I was concerned about hadn't even been inspected. They replied that they did not complete their reports only on inspections but took other things into consideration when making their reports such as questionnairs sent to residents, relatives and professionals such as doctors, social workers etc., I then asked how many questionnairs were returned and was told that they did not have figures on this. Based on the level of incapacity which my husband has, I would suggest that the CSCI do not get any questionnairs returned from residents because they are physically and mentally incapable of understanding the questionnair let alone completing them!

    After writing also to my MP and the Secretary of State for Care, I got a letter from the Chief Inspector at the CSCI assuring me that the three homes I had complained about would be inpected again before December last. I looked on their website today only to find that no new inspections had been posted. I have now sent him another letter asking that he send me a copy of the December inspections he had promised.

    The CSCI have the power to close down homes. Sadly the logistics of moving sick, infirm and elderly residents, let alone the task of finding them new temporary accommodation must affect CSCI judgement in such matters. Failing homes are judged to be '2' - below standard but allowed to continue caring and admitting new residents.

    I know that the CSCI do have powers and can reinspect regularly if they chose to do so. I wonder how often they do their follow up visits?

    I think that such large corporate businesses would pay much more attention and get things right in the first place if the CSCI had the power to 'fine' homes with a financial punishment. Also I feel that any home which was given a rating of '2' should not be allowed to continue to advertise and take in new residents until they had proved that they had now rectified their failings.

    Sadly, this doesn't happen, and, to cap it all, social workers continue to direct new residents to such homes.

    xxTinaT
     
  2. rhallacroz

    rhallacroz Registered User

    Sep 24, 2007
    106
    merseyside
    Good For You Tina
    Well done you I wish more people would complain I thought it was only me. If people don;t complain then things just go by and everybody thinks its all hunky dory. EMI units in my experience are scary places and so far I have not found one that I would put a dog in. I hope you continue to complain.
    Dont give up
    Angela x
     
  3. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    #3 Skye, Mar 25, 2008
    Last edited: Mar 25, 2008
    Sorry, but I have to show the other side of the picture.

    John is in an EMI unit, a section of a larger care home owned and run by a large company, with homes all over the UK.

    I haven't seen any of the others, but I believe they are all run on the same lines. The guidelines and even menus are pretty well standard across the chain.

    I think John's home is fantastic. Of course I'd rather have him here with me, but that's not possible now.

    I'm sure there are bad ones, we've read about plenty here and elsewhere. But there are also some excellent ones.

    PS Of course you're right to complain about bad ones, Tina. And to follow up if your complaints haven't been acted on.

    Good luck,
     
  4. connie

    connie Registered User

    Mar 7, 2004
    9,519
    Frinton-on-Sea
    Well done Tina:

    At least you are complaining. So many people just think that having a say here on TP is good enough.
    Thank you for keeping us informed. You are so right. It is not saying it here that makes the difference, but out there in the wider world.

    There are good EMI homes out there, we just have to stamp out the bad ones when we find them.
     
  5. hendy

    hendy Registered User

    Feb 20, 2008
    506
    West Yorkshire
    Dear Tina

    Thank you for your post. Well done to all of those who have found a good home for their loved one! I know for a fact that Dad will not be taking up he latest offer of sub-standard care from a hospital health professional. Thank goodness I have done my homework! I just feel sorry for other patients who get packed off to places like the ones Tina mentions and like the one I have been advised to go an look at. I can feel a letter to my MP coming on...
    take care
    hendy
     
  6. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Yes to both Connie and Sky, there are good homes out there. Thank God I've found one for Ken. Sky, it must be such a huge relief for you to know that your husband is well cared for.

    What I'm trying to do is to make sure that this is the case in all residential homes be they EMI or general nursing. When any of us finds a home which we consider falls below standard, I personally feel it our duty to write and complain to CSCI. However, when we do find a good, caring environment, we can also write and give praise.

    The more good homes and good practice is highlighted, the better they are held up as an example of excellence for others to follow.

    xxTinaT
     
  7. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,875
    Kent
    Your post makes depressing reading Tina, but although you have identified the deficit, I doubt anyone will be surprised.

    When I viewed homes for my mother, there was no CSCI. Homes were inspected by Social Services and they produced the reports.

    I visited `suitable` homes listed by Social Services and found;


    • 5* decor smelling of urine and excreta
      People sitting in a circle staring into the middle of the room.
      A television on in one corner of a lounge and a radio on in the other corner of the same lounge.
      Overpowering smells of air fresheners and deodorants.
      Stained carpets.
      A locked main door, opened for me by a resident who had spotted me through the window.
      An enclosed garden, so tiny, it was fit for nothing
      Commodes in rooms.
      Unstaffed communal rooms.

    The home I eventually chose, following glowing reports from relatives of residents, and promises, promises from managerial staff, failed to meet expectations and failed to honour promises.

    The homes you mentioned Tina, were run by `large private health corporations` and this is the the problem.

    As long as care homes are run as businesses and not as a service, a healthy profit margin will take priority over the care of residents.

    The home I finally found for my mother was run by a charity. It was excellent.

    I would like to see all residential care homes become an extension of the NHS. If governments of all parties stopped wasting taxpayers money as they do, it would not need a magic wand.

    I know I might have a very simplistic and probably biased point of view, but as long as there are good homes, and thank goodness we do hear about some, they should set the standard. The less than satisfactory homes should be either made to pull their socks up or close down.
     
  8. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    Syvia, you must be able to read my mind!! I too cannot understand why everything has to be 'privately owned' nowadays. Ah well, perhaps I am a relic in this modern world. The home which Ken is going to is a Local Authority run home.

    Sorry to anyone who was depressed by my post. As already said, there are some wonderful residential homes. I have been visiting Ken's new home which he goes to permanently on the 10th April, and can hand on heart say the level of care is excellent.

    I stayed for lunch and saw staff sitting with residents, cutting up food, coaxing 'reluctant' eaters - and was very touched by the gentle, friendly and kind manner shown by the staff.

    Residents are obviously known on an individual basis and are clean and well dressed. The staff regularly and unobtrusively take residents for toilet breaks. Residents respond well to staff and obviously like them.

    The home is well decorated, space for residents to move from room to room and smells clean.

    Good luck to all who are slogging away, trying to find a good care home. Don't give up - there are some wonderful places

    xxTinaT
     
  9. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    69,875
    Kent
    Private contractors in public service, to my mind, are responsible for the decline in the quality of school dinners and the spread of infection in hospitals, to name just two.
     
  10. Skye

    Skye Registered User

    Aug 29, 2006
    17,000
    SW Scotland
    I'm so glad you have a date at last, Tina, something to look forward to.

    The home sounds lovely, and I hope it all works out well for you and Ken.

    Love,
     
  11. Mameeskye

    Mameeskye Registered User

    Aug 9, 2007
    1,669
    NZ
    Hi Tina

    I am so glad that you ahve found somewhere you feel comfortable with.

    The homes just vary so much don't they. I cannot understand why homes are run as profitable organisations. I know that there was a time when gorvernment run bodies became inefficient and wasteful and it was thought that by privatising this would cease. Well it has but the pendulum has now swung so far in the other direction.

    Mum's home (run by a corporate) is slowly getting redecorated, but can look a bit shabby, but the staff care. Another relative who has a MIL in the home told me about the home her own Mum was in who charged more (another big corporate) but who frequently found her Mum sodden etc and unchanged but where the standard of decor was excellent! She moved her out.

    I know that there have been problems in Mum's home with odours. They have worked slowly and steadily to remove them but certain things did not help. A resident who persistently soiled carpet (now has lino with her family's blessing!), inner corriders with no fixed ventilation, being unable to open doors and windows adequately due to safety regs to give the building the kind of airing that we give our houses. The best change though has been the scrapping of the peach air freshener which has been replaced with a de-odoriser! Once resident still causes problems as she will not be changed even when she is a littl "Over-ripe". It takes them a lot of tact ....how do you manage?

    For me the whole thing requires a change in society's perception of the elderly and the value that is placed on the caring professions. This is far too low but without a complete attitude shift I think this area will have problems. Here's hoping that we succeed with this over the coming months and years

    Mameeskye
     
  12. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    I googled EMI units, and back I came to good old Alzheimers Society. But please, WHAT does an EMI unit provide that a general care home does not especially as regards my mum's problem of night-time wandering.

    And how much more costly are they? Can you claim Continuing Care for someone obliged to go into an EMI unit? Who pays the extra? Suppose I say I don't want mum to move from her current home which has taken her over a year to settle in? Or do I just not care, shunt her out to a dog kennel and not worry about it? Seems nobody in authority cares at all.

    Margaret
     
  13. TinaT

    TinaT Registered User

    Sep 27, 2006
    7,095
    Bolton
    I hate to say this but it really is down to foot slogging and vbisiting all the places you can find. I must have visited 7/8 and got no help in finding a home from social services etc. When I did find the right place it was then a question of
    a) getting the manager to accept Ken (The consultant didn't think he could ever leave the ward)
    b) Badgering the Social Worker to make the arrangements in the home of my choice.

    I wish I could help you re: continuing care but I have no personal expierence of this. Ken had been on a 'section' and was automatically entitled to continuing care.

    My advice would be to find a home you are happy about, check the costs with the manager and then badger, badger, badger social workers to help you get some form of continuing care into place. I would suggest that EMI Homes/Specialist Homes should fall into the continuing care category as there is an element of nursing involved.

    Good luck to you. You have my sympathy and understanding. It is a hard and depressing task ahead. I know how much it took out of me at the time.

    xxTinaT
     
  14. EllieS

    EllieS Registered User

    Aug 23, 2005
    170
    SOMERSET
    Margaret

    Dear Margaret

    EMI homes doors are locked - this won't stop your Mum from wandering around the locked unit, but it will prevent her from coming to harm in the outside world.

    The added complication is the sheer frustration patients feel because they are not aware of what they've done to be locked in and so quite often bang on doors, walk the corridors - particularly early evenings. Not very nice but life isne't nice where AD is concerned is it?

    EMI homes canbe EMI Residential or EMI Nursing - and the powers that be will do everything possible to avoid saying your Mum requires Nursing care - because that means they have to contribute to these extra costs.

    You can claim Continuing Care - but be prepared for a battle. A starting point for the battle is best if your Mum is still in hospital - in which case she should be assessed for Continuing Care before she leaves the hospital AND until the decision has been made, the PCT is responsible for all of her care costs. Just remember that if your Mum has been diagnosed with AD (for example) any care she requires is due to the fact that she has that illness -ie if my Mum didn't have AD she would not need prompting to wash or clean her teeth nor to be prompted to take her medication.

    I am battling for continuing care for Mum - and have been successful for one period. Even though the local PCT advised that Mum's nursing care costs should be backdated to the day she moved into care, it's only within the last month that the PCT responsible for Mum has offered to backdate these costs - but only to August this year!!! It is a nightmare - is it worth the battle? I'm not sure - it's a bit of a killer!

    Sorry, just noticed that your Mum is already in a care home - ask your local Social Services if there is a suitable NHS emi care home available - if there is, maybe you won't have to pay at all. Have you had a financial assessment? This should NOT be carried out until the Continuing Care Assessment has already decided that your Mum is not entitled to CC.

    But it's one thing to know (having taken advice from people who seem to know what they're talking about - people who have succeeded in their battles) and another thing to have things done correctly!

    Hope this is helpful - my mind's a bit of a mess tonight!

    Take care

    Ellie
     
  15. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Dear Ellie

    I don't for one minute imagine mum is entitled to anything at all. They will contine to charge me £2500 a month to be paid for from her basic pension plus AA totalling £190 a week (out of which they are now deducting £3 for overpaid pension credit which I am crying about). I have a period of 28 days with which to appeal but they have already started deducting the amount. It is lose lose all the way.

    There will be no extra if she is admitted to an EMI unit. There is no EMI unit for 20 miles anyway - that is Becky Jan's advice, I don't know to find such a unit myself. The fees will probably escalate to £4,000 a month instead of £2,500, and within about 2 years mum will be only entitled to whatver the dog kennel can provide.

    It is ****, scuse my language, just ****.

    Best wishes

    Margaret
     
  16. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Further point. Mum's care home is locked at night, and most days too unless there is a carer on "door duty". I can't see how an EMI unit will be any better for mum, they still only have 2 people on duty at night, mum will still be banging on peoples' doors and a specialist unit will be providing nothing other than an extra ~£300 a week in fees. And for what?

    Love

    Margaret
     
  17. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Sorry folks, but I still can't see that an EMI unit is going to be providing anything that mums current care home doesn't provide.

    They do have security on the front door, but that is not an issue. My mum's sole issue is that she spends the night banging on other residents' door to get them up. How is an EMI Unit going to change that? If mum's current home say they can't cope with that, I cannot see how any other home is going to cope with it. It is not a medical or nursing issue, it is simply one of supervision. The home are currently accepting that she is whizzing up and down in the lift all night looking for people, and is banging on doors. I can't see any other home doing anything differently. Or am I wrong?

    Basically, no care home can cope with my mum, so I suppose she is better off dead.

    Love

    Margate
     
  18. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,438
    Margaret - it's possible that an EMI home would be able to confine her to her room at night. I don't know how you feel about that, but they can be (although are not necessarily ) more restrictive . While a regular home couldn't lock her in, I think you'll find that at least some EMI homes would be able to. Also, I think in many of them, the structure is set up so that this sort of behaviour would be minimized.

    However, I really would not even think about doing anything until you were pushed. If the home finally decides they can't cope with her, then social services will absolutely need to be involved, particularly as you have indicated that if she were in a more expensive place her resources would be drained pretty quickly. If that were the case, one of two things would happen - either social services would have to stump up the money, or they'd have to move her. Here's the important thing though: they can't just move her willy-nilly - she would need to be placed somewhere that could cope with her even if that was much more expensive that they would normally pay and they would have to pay the fees.

    My point is: I think you'll get more help with this if its a crisis rather than a planned move. It's wrong, but that's how the system seems to be set up - fighting fires rather than preventing them.
     
  19. lilacwarm

    lilacwarm Registered User

    Apr 5, 2008
    18
    u.k
    hi, continuing health care in my experience is very very hard to get. my mum has just entered an emi unit and my dad pays the max top up fee,. she has longterm health conditions but these have been determined as controlable. I anticipate maybe at some point she will need nursing care also. However many needs are determined as personal care. we looked at residential homes with emi places but they werent suitable and a couple of other emi units. Ilooked at nhs continuing care on the web,and spoke to social services. Also I requested a copy of my mums assesment carried out in hospital prior to entering the emi unit.
     
  20. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    3,725
    North Derbyshire
    Dear Sylvia, all well and good to have found a home run by a chartity, we have a couple in the area but we are talking of £50,000 a year, so it is not feasible.

    Love

    Margaret.
     

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