Care Homes

elaineo2

Registered User
Jul 6, 2007
945
leigh lancashire
Dear Taffy,the policy in the home i work in is to ask the resident if they want their family informed of a fall.lIn another care setting the rules may be different.Between me an TP i would much rather inform the family than face a barrage of questions eg.wheres that bruise come from?.it's a home policy and resident preference perhaps?love elainezx
 

Cate

Registered User
Jul 2, 2006
1,370
Newport, Gwent
Hi Elaine

I understand why a NH would like to take into consideration the residents views on informing family of falls etc.,

I'm just thankful mums NH would inform me anyway, because if they asked mum, she would say "what fall", like she said, "I havent been in hospital or had a heart attack":eek:
 

Nell

Registered User
Aug 9, 2005
1,170
68
Australia
Dear Taffy,
About every six months the home our Mums are in has a "Families meeting". I didn't get to the last one due to work commitments so one of my sisters went instead.

At the next such meeting I am seriously thinking of raising my concerns over the one to sixteen ratio for care. It is obviously not sufficient. Even Mum (bless her heart!) says "these girls are overworked - it's just management being greedy"!! And she is RIGHT!!

As you said, it is a church run home and therefore supposedly not-for-profit. It is a beautiful building and the furniture etc. is lovely, but at the end of the day, it is the quality of care that counts. And it is just not possible IMHO for one person to give adequate care to sixteen people.

My Mum is fortunate in that her dementia is not yet at the stage where she cannot self-care - but it is becoming increasingly difficult for her. She gets up at 6am in order to be bathed and dressed for breakfast at 8am. I've urged her to ask for help but she insists on remaining independent for as long as possible, which I respect. Also, as she says herself, "they haven't got time to help me".

I am sure family members of other residents must be concerned about the care ratio, which I believe is at the heart of things not being done. Like you I dread the thought of having to move Mum, but if it becomes a matter of her care versus the home, it will have to be done.

I appreciate your point about your husband being straight forward - my dear hubby is a "Jack Blunt" too! But I would still consider asking him (or someone close to you and your family) to attend any meetings with you. It is hard enough to do it without trying to do it without support.

Your poor Dad is also unwell so this is an added burden for you. My heart bleeds for you - truly it does. Thinking of you as always.
 

Margaret W

Registered User
Apr 28, 2007
3,725
North Derbyshire
Hmmm. I can identify with some of this. Mum had a sore bottom (very sore, between the cheeks), the home was very quick to get the doctor (I had no knowledge of this), so that is a plus point. She was prescribed an hydrocortisone cream for a fungal infection, but no supervision was giving in the application, she applied too much (it should be very sparingly, mum thought the more the merrier) and ended up with a worse sore bottom. The doctor was called again (at my request, and came pretty fast, day after I asked), and prescribed a less severe cream, and the staff applied it for her. She seems to have recovered from that.

Washing. Hmm. There seems to be no system for residents to deposit their washing anywhere, so I keep taking mum a supermarket carrier bag and telling her to leave it by the door. That said, after two weeks, she had put nothing in it. I went through her drawers and found soiled knickers (mum had a bowel problem early in her stay), tights, and absolutely no outer clothes at all, no jumpers or tops. In the hospital previously, they were washing things that I didn't think were necessary, i.e. a quick sponge down would do, but in the home nothing like that is washed. Plus they insist that everything is able to be tumble dried - well it probably is, but it doesn't say so on the label. So I have been taking things home to wash. Mum doesn't seem upset by this, so I am not worried. But I do think they should check on outer clothes as well as underwear - and I am not aware that they check on anything. What would happen if I wasn't around?

Strange clothes have appeared in her wardrobe, not hers, and some of hers have gone missing despite being clearly labelled with her name.

Falls etc. I've never mentioned it, but I'd want to be informed about absolutely anything and everything that affects my mum. Some of you might have read my earlier threads that say I have absolutely no affinity or relationship with my mum, and I don't, but she is my mum, she has only me to look after her, and I will do it whether I want to or not. Well, I do want to. My dad (died 2004) would want me to, and I will do it for him - funny, though, I am now getting to like her, is that odd? I am becoming protective of her, I am pleased about that.

I definitely want to be told about falls. My mother in law went into hospital after a major stroke in 2004, and two days later we visited to find her head covered in blood. I went to ask the staff. "Oh, yes, she fell out of bed. We consulted the Neurosurgeon and he said she was oka". Sorry. A Neurosurgeon was involved and we weren't even told. I am still not happy that she was ALLOWED to fall out of bed following a stroke, it still haunts me that the poor woman experienced that.

Eh, we have to be on our toes, don't we?

What happens to those poor people with no relatives nearby, or as is the case with one lady in my mum's home - no relatives? There is another lady, who I know is a local person cos I used to work with her brother in law, and I have never seen a visitor for her at all. Never in 6 weeks.

Keep going everyone.

Margaret
 

Taffy

Registered User
Apr 15, 2007
1,314
Dear Elaine, thanks for your reply. I am new to the care home situation and it has been quite an eye opener for me. I was curious about the fall situation and what the practise was, as far as, relatives been informed. I have learnt so much through TP. I will ask the home what their policy is. Thanks. Regards Taffy.

Nell said:
At the next such meeting I am seriously thinking of raising my concerns over the one to sixteen ratio for care. It is obviously not sufficient. Even Mum (bless her heart!) says "these girls are overworked - it's just management being greedy"!! And she is RIGHT!!
Hi Nell, it is strange that you should mention the meeting as when I was leaving the care home today I was talking to, two of the carers in the car park and one told me about this meeting. I was urged to attend and speak out about the staffing level. Clearly these girls were stressed out and by the way they spoke, they get very little if any support from management. These carers will be very grateful for relative support on this matter. Regards Taffy.

Panda said:
I hope you understand what I am trying to say.
Hi Panda, I have often thought about how your mum was settling and am sorry that she hasn't settled yet. I do understand what you are saying and I only wished that mum's showering could of been sorted without me having to speak to the welfare officer, but, it wasn't through lack of trying. Mum is now on a shower roster so, I am thankful for that. Because, I also mentioned about the lack of care mum received after her previous fall where she injured her shoulder, the welfare officer said; that was a serious breach of care and it was her obligation to report it, so a formal complaint has to be signed by me. Regards Taffy.

MargaretW said:
Eh, we have to be on our toes, don't we?
Hi Margaret, this is so true, even though mum is at a stage in the dementia where she is unaware if her clothes are dirty or if she smells, she still has to be treated in a dignified way. We have to be reasonable in our expectations but these homes shouldn't offer services that they cannot honour. Regards Taffy.
 

elaineo2

Registered User
Jul 6, 2007
945
leigh lancashire
Dear taffy,i am sorry the home isn't giving their best.The care plan would need updating if changes in care are identified.You have the right to access the care plan and contribute to it.
Hope you are well.take care.elainex
 

Taffy

Registered User
Apr 15, 2007
1,314
Elaine said:
You have the right to access the care plan and contribute to it.
Dear Elaine, thanks for that information it's appreciated. Today I received a message from the welfare officer to contact her in regards about a meeting and when I phoned on the managers request I was put through to the manager. The conversation went as I had expected so there was no disappointment for me there. In a nutshell just buck passing, but, something good did come from it, ALL residents clothes at the end of the day will be checked and soiled ones put out to be washed, mum is on a shower roster now so that is a real relief. If I have any concerns I am to go to either her or the welfare officer. As for the medical side of things I just wont assume the right thing is been done I will make sure that what needs to be done is carried out. If or when the time comes for mum to need a higher level of care I will need to reevalutate the situation. Regards Taffy. :)
 

Grannie G

Volunteer Moderator
Apr 3, 2006
71,743
Kent
Dear Taffy
At least you`ve got some satisfaction. I know the buck was passed, it always, or nearly always is, but at least you were listened to, and they`ll know who you are next time.
Love xx
 

Taffy

Registered User
Apr 15, 2007
1,314
Hi Sylvia, thanks for the reply. You described it exactly how I see it. Regards Taffy.
 

elaineo2

Registered User
Jul 6, 2007
945
leigh lancashire
Dear Taffy,"buck passing" makes me fume!I know it occurs in every pathway of life,but when it comes down to care!!!!!.There shouldn't be a buck to pass!There should be ongoing care and reporting of needs.This way carers(in a home) all aware of needs and can perform accordiongly.I'm on my soap box now!lol love elainex
 

merlin

Registered User
Aug 2, 2006
139
Surrey
Hi all

I thought I was reasonably up to speed on care home care but all the recent threads have shown me I have to be a bit more to learn.

Most of the points raised have been covered by me, but with the talk of carer to patient ratio I am lost, what is the ideal ratio to aim for at a home (apart obviously from 1:1). I will in fact now ask the question of the manager/matron but from a rough calculation I would say it is certainly no more than 6:1 and probably less than that. At any one time there is always 2 carers and 1 RN day and night on the wing. Does that seem in the right order?

Very usefull thread, thanks to all.

Merlin
 

Brucie

Registered User
Jan 31, 2004
12,413
near London
what is the ideal ratio to aim for at a home (apart obviously from 1:1)
I guess it depends on the state of health of the residents as a whole.

Bit like schools maybe - a school that is selective and gets the students that it selects for best results may have better exam results than a school that takes what it is given and has a more challenging task in bringing some students up to a certain level.
[speaking purely from my own viewpoint]

Jan's home has, daytime, I estimate a ratio of around 1 care worker for 3 residents, with a number of additional floating care workers who pitch in when and wherever needed - meal and bath times, for instance.

There are also nursing assistants who also join in when needed.

I have also known the chef and her assistant to help feed residents mealtimes.

The cleaner is trained to help in certain situations as well.

Then family members can also pitch in.

Jan has 1-to-1 care on top of this, or rather, shared in this.
 

merlin

Registered User
Aug 2, 2006
139
Surrey
Care Ratio

Hi Brucie

Thanks for the info. I'm off to the home albeit a bit late and armed with the knowledge I now have, I'll ask a few questions. In a nice way of course!

Merlin
 

Nell

Registered User
Aug 9, 2005
1,170
68
Australia
Bruce and Merlin,
Thank you for raising this issue regarding Care Homes.

My Mum and Taffy's Mum are in the same Care Home - same wing! So all Taffy's posts are very relevant to me, altho' my Mum is not as far down the road of dementia yet as Taffy's Mum.

Bearing in mind that this is a dementia specific environment (where at least 95% od the residents have a dementia diagnosis), I find it very difficult to accept the 16 to 1 ratio of Carers.

To be fair, there is also an RN on duty (but only during the day) who covers all 4 wings (60 people). Also one Manager (stays in the office), one Welfare Worker (the best of the "hands on" people in my opinion) and various others who do cleaning, laundry, handy man work and bring the meals to the wings.

Also, there are 2 Carers to 16 people on the high care wing.

It is the care ratio that concerns me. Taffy's Mum and mine are NOT on the high care wing, so you can judge that the residents generally have pretty high care needs in ALL wings. The staff (mostly women but some men) are generally very good and caring people, but as they have to do EVERYTHING on the wing - help residents bathe and dress, serve and clear meals, make beds, etc. PLUS provide care, I just don't believe it is a reasonable ratio. :(

I'd be very interested to hear some comparisons with other Care Homes. I'm planning to bring this matter up at the next Families meeting (which happen about twice a year). I'll definitely research the Aussie side but would like to hear from TP members too.

When Mum and Dad went into the home I didn't realise how much care they and others would eventually need, so I didn't realise it was such a poor ratio. Also I was lead to believe that Care staff were not the ones making beds, serving meals etc. I thought the domestic staff did that. (Dumb, I know!)

I look forward to hearing from others about their Care Home experiences regarding staff ratios. Thanks!
 

Skye

Registered User
Aug 29, 2006
17,000
SW Scotland
Hi Nell, the ratio in your mum's home does sound very poor.

The home that I'm hoping to get John into has 1:6 in the residential/nursing section, and 1:4 in EMI.

I'm not sure if they have separate cleaning staff, but I would think so. I'll have to find that out. There are also separate catering staff, though the carers feed those who need it.

In the hospital ward John's on at the moment, the ratio is quite high in the morning, but lower in the afternoon, and abysmally low at nights and weekends. I feel so sorry for the staff at weekends, they haven't a hope of getting everything done. But that's NHS!
 

elaineo2

Registered User
Jul 6, 2007
945
leigh lancashire
Hi all.just having my 2pennoths worth!In the group i work for the ratio=residential care-1:10( 3 staff and a care team leader) Nursing care=1:6 (R/N included) EMI =1:5(team leader included). I have been told that the EMI units are well staffed and the care is at a level of needs.I couldn't possibly comment!not having worked in an EMI unit.Staffing levels are paramount I know,stimulation is too.I feel for homes that are understaffed or have levels of care beyond their capabilities.Care for our loved ones can become a viscious circle.love elainex
 

Taffy

Registered User
Apr 15, 2007
1,314
Hi everybody, Nell summed the staffing situation up brilliantly and as Hazel said it does sound poor. Well after reading the UK ratio I am flabbergasted. This facility is only low care, one of these wings house the poor souls that are extremely demented 16 in all. Three carers are needed along with a rover carer to have things manageable they have two carers only. On Sunday when I visited there were four carers needed to bring a situation under control in this wing, so this meant the three other wings (48 residents) were been cared for by one carer. Now, I don't know if the reason the home keeps these residents is because there is no where else available to house them or because they want to keep a full house themselves. On a good note, last two visits mum has looked lovely, clothes clean hair done, as fresh as a daisy. Mum once again looks like someone owns her. Regards Taffy.

Dear Elaine, your opinions are very valuable, only carers themselves know the true measure of these situations. In mum's case, management aren't acting on the carers concerns. I feel this is why the carers find the need to vent their concerns to relatives. But, from my point it makes things hard because knowing things that I do could have only come from the carers themselves. Regards Taffy.