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Dad's care home- Am I being Petty???

Gwendy1

Registered User
Feb 9, 2016
414
Glasgow
Just returned from my daily visit to care home.. Daily, because I'm worried they won't notice if he becomes ill again. This is my choice, but I feel I need to go as dad has been seriously ill twice in last 2 months with pneumonia and I had to tell staff he was ill. I've read all the research and know that the outlook for him isn't good, I accept that and want to spend as much times as I can with him. I rush down after work planning to be there with him for dinner- to assist him when he needs it and so he can eat in a quiet environment- his room. Today, I arrived at 4.30pm- all the residents were already eating- again. Visitors not allowed to interrupt mealtimes, so I wait the 40 mins it takes for my dad to struggle thru his dinner, with a staff member assisting/prompting him now and then. The mealtime seems to change daily- is this normal? The meals are not always puréed and they are meant to be. Today, the staff were eating their dinner at the same time as the residents!! My dad is funding his own care, with me making up the shortfall. My dilemma is that he seems content in this home.. I have concerns, dad is frail and no longer able to tell me if anything else is not as it should be. Is it me??? If dad seems content, should that be all that matters? I'm stressed and exhausted. I have other concerns re the home, but if I move dad- well, is that right if he seems content and may be nearing the end of his life.? Hope this makes sense. I feel like I'm losing my mind. :-/
 

sue38

Registered User
Mar 6, 2007
10,854
51
Wigan, Lancs
The two things that jump out at me from your post are:

- the staff are having their meals at the same time

- the food is not always puréed when it should be.

As for the first issue, if all the residents are able to feed themselves unaided then it might be sociable for the staff to eat with them... but most homes will have residents who need assistance or encouragement with their meals.

The second issue is more concerning, as presumably your dad's meals have to be puréed because of problems with swallowing and the risk of aspiration. I would ask for a meeting with the manager to discuss your concerns and no, you're not being petty.
 

fizzie

Registered User
Jul 20, 2011
2,730
No you are not being petty, the care is not good enough if they are not noticing that he is unwell. It is falling below standards that would be expected and I'm really sorry that you and your Dad are suffering this.
Protected mealtimes should be a thing of the past - but they are not sadly. Often residents eat better if they have family with them. I would make it very very clear to the care home manager , preferably in writing so that they can't ignore it, that you wish to be with your father at his evening meal whether that is in the dining room or in his room. Add to the letter that his meals are supposed to be pureed and they need to ensure that this happens. No it isn't normal to keep changing mealtimes, residents like routine and 4.30 is very early for an evening meal as often residents don't get breakfast until 9 or so the following morning. A long time to go without any other sustenance. Sometimes staff do eat with residents to make it more of a social occasion and facilitate communication - in some homes this works brilliantly but sometimes not.

It sounds as though you are very worried about the care - not just the food but the 'other concerns', sometimes we know something is not right but can't quite put our fingers on it. A care home should always be able to spot an illness quickly, it is part of their duty of care.

If you do want to move him that isn't a problem except you would need to be very sure that the home you are moving him to is better than where he is now and that depends a bit on your other concerns. Depending on how serious the other things are and if it is possible for them to be sorted out, it might be better to write them all down in the form of a letter, point by point and add a request to meet with the manager (preferably with someone to support you) and go through it point by point and see if they can put the things right. Would that be an idea?
Keep posting, we are all here to support you, you will get through this xxxxx
 

Aisling

Registered User
Dec 5, 2015
1,806
Ireland
Just returned from my daily visit to care home.. Daily, because I'm worried they won't notice if he becomes ill again. This is my choice, but I feel I need to go as dad has been seriously ill twice in last 2 months with pneumonia and I had to tell staff he was ill. I've read all the research and know that the outlook for him isn't good, I accept that and want to spend as much times as I can with him. I rush down after work planning to be there with him for dinner- to assist him when he needs it and so he can eat in a quiet environment- his room. Today, I arrived at 4.30pm- all the residents were already eating- again. Visitors not allowed to interrupt mealtimes, so I wait the 40 mins it takes for my dad to struggle thru his dinner, with a staff member assisting/prompting him now and then. The mealtime seems to change daily- is this normal? The meals are not always puréed and they are meant to be. Today, the staff were eating their dinner at the same time as the residents!! My dad is funding his own care, with me making up the shortfall. My dilemma is that he seems content in this home.. I have concerns, dad is frail and no longer able to tell me if anything else is not as it should be. Is it me??? If dad seems content, should that be all that matters? I'm stressed and exhausted. I have other concerns re the home, but if I move dad- well, is that right if he seems content and may be nearing the end of his life.? Hope this makes sense. I feel like I'm losing my mind. :-/
Gwendy, I agree with replies from Sue and Fizzy. Talk to management and take someone with you.

Huge support

Aisling
 

Paradise08

Registered User
Jun 19, 2014
8
Care home concerns

I absolutely understand your concerns and want to reassure you, you are not being petty. Dysphagia is carries a high risk of choking if the PRESCRIBED care plan is not adhered to. This is a safeguarding issue and one that needs reporting without delay to your local safeguarding adults team and CQC.
Your Dad will settle again if moved, unfortunately it is not easy to find a care home with the adequate staffing to provide the required level of support for people with additional eating and drinking needs, consequently, many family members feel they need to be present to make sure that their loved ones either eat or eat the PRESCRIBED stage diet.
I speak not only from a professional point of view but also from the point of view who has needed to access respite for the first time for my much loved Mum. I approached a care home which according to CQC good in 4 areas and outstanding in responsive. I have not witnessed this to be the case so far. I provided a comprehensive likes/dislikes/ interests list. My Mum has never liked or eaten bananas, physically baulking at the smell. This is clearly identified in the information but today when I asked about her nutritional intake, was informed that my Mum had been given ice cream, jelly and bananas. I informed the carers that my Mum has never liked bananas to be informed "well she's eaten them today" My Mum was also wearing shoes without pop socks. Last night Mum had torn her blouse from the hem up to the breast area. When I asked how Mum had done this, was told, they had "no idea" To add to my concern, I was informed " she's one of the better ones" this by the senior in charge of the shift.
My Mum is supposed to be on one to one support when walking as she has fallen recently. There were no staff in or around the lounge area with the exception on a tea lady who brought drinks in.
I consider myself an astute judge of care providers, I am also a deprivation of liberty best interest assessor liberty. I am so very disappointed that CQC are failing to see beyond the surface with care providers and disappointed in myself for placing my Mum in this care home.
 

Paradise08

Registered User
Jun 19, 2014
8
Care home concerns

P.S., sorry for any typos, I feel so frustrated. I have heard somewhere that you judge a society on how they treat their most vulnerable. Well God help us all!
 

Gwendy1

Registered User
Feb 9, 2016
414
Glasgow
Thank you all for your advice and support.. I struggle with my other concerns with the home-dad unshaven, clothing soiled with food etc, as I try to find a balance between dad refusing shaves etc and I would hate for staff to force him to have a shave ( for example) to make me 'happy'. My only wish is that my dad is comfortable, and treated with respect. My dad is a complex mix of knowing his family, yet not really knowing anything else that is going on, I have whole visits when he doesn't open his eyes. I will speak to the home manager- dad has been resident a year and I have met her once- briefly. His diet is a real concern, I have witnessed my dad with aspiration pneumonia in January, he was given hours to live but fought back. I think I'm still trying to recover from that experience which was frightening and heartbreaking. It is so terrible to see someone you love so vulnerable and struggling. X
 

fizzie

Registered User
Jul 20, 2011
2,730
Paradise - It is really really hard to gain outstanding in any areas of a CQC inspection so although I appreciate your concerns the home must be very good at providing activities, ensuring residents are engaged and so forth. If your Mother didn't like the bananas in her desert she presumably could have pushed them to one side or perhaps they would have provided her with something else if she had indicated she didn't want it. In my experience families are often surprised at the different things relatives will do when in a different setting. Did your Mother settle in - it is notoriously difficult to provide respite in care homes that are mostly permanent residents so if she had a decent time then they must be fairly good. I would be concerned about no member of staff in a room with several residents though.
 

fizzie

Registered User
Jul 20, 2011
2,730
Thank you all for your advice and support.. I struggle with my other concerns with the home-dad unshaven, clothing soiled with food etc, as I try to find a balance between dad refusing shaves etc and I would hate for staff to force him to have a shave ( for example) to make me 'happy'. My only wish is that my dad is comfortable, and treated with respect. My dad is a complex mix of knowing his family, yet not really knowing anything else that is going on, I have whole visits when he doesn't open his eyes. I will speak to the home manager- dad has been resident a year and I have met her once- briefly. His diet is a real concern, I have witnessed my dad with aspiration pneumonia in January, he was given hours to live but fought back. I think I'm still trying to recover from that experience which was frightening and heartbreaking. It is so terrible to see someone you love so vulnerable and struggling. X
My heart goes out to you Gwendy. Yes do meet with the manager but please do take someone to support you and please, please, please put your concerns in writing, including the aspiration pneumonia.
 

Paradise08

Registered User
Jun 19, 2014
8
Care home concerns

I believe in picking my battle carefully with my Mum. If it's not needed to keep my Mum safe, and emotionally and physically well, I don't press her. If it's nutrition, meds or incontinence, I persevere.
I hope you manage to resolve the care issues that are causing you so much worry but please look after yourself because if you don't, you can possibly be an effective advocate for your Dad.
 

Paradise08

Registered User
Jun 19, 2014
8
Care home concerns

Again, apologies for typo, should have read " can't possibly"
It's the predictive text.
 

Paradise08

Registered User
Jun 19, 2014
8
Care home concerns

I received 2 conflicting replies to my request for information about what Mum had eaten. I fully understand that people do try different foods when in a care. However, I have tried to provide Mums care according to her likes, dislikes and preferences before losing the capacity to do this for herself. I also do not see the point in the care homes asking for likes and dislikes if these are not used to meet the individuals needs. My parents are also self funding to the tune of nearly £700 a week so do expect the care to be good
 

tigerlady

Registered User
Nov 29, 2015
427
I am surprised the home has a policy of not letting family visit during the meal times. I often visit and purposely stay during a meal time at my husbands home, as he often gets extremely anxious about sitting with the others in the dining room and I can usually settle him to sit there if I sit with him. Other families also sometimes come and sit with their relatives at meal times, assisting them if necessary.

I am extremely surprised and shocked that your Dad's food isnt pureed - it should be on his care plan and there should be a list in the kitchen of people's food requirements.

I am also quite shocked that you have only met the home manager once, even though your Dad has been there for a year. Is she manager of a chain of homes and so isnt there all the while, or is she just shut in her office inaccessible. Is there someone else there who is responsible for the day to day running of the home?

I agree with everyone else - write a list of your concerns and see the manager or whoever is responsible when the manager isnt there. If your Dad settled there quite quickly, he would probably settle at another home, but I expect you would rather not put him through any more stress, but you cant go on like you are - you and your Dad are paying a lot of money for him to have 24/7 good care, and its not working if you have to rush there every night after work to check on him.
 

Ginny Hendricks

Registered User
Feb 18, 2016
17
Hello, I'm new here but not sadly new to the problems of care.

General response to various points:

A home rated 'good' might not have been inspected by the CQC using their latest criteria. My father's nursing home (he has LBD) was inspected last autumn and is now 'inadequate' (we aren't surprised) and is in special measures. It continues, illegally, to display its former rating. I have informed the CQC of this and its continuing failings.

It doesn't matter how much or little someone is paying for care. The home has an absolute duty to do its job properly for all residents.

Anyone with concerns about care should speak first to the home but also, if they persist, to the CQC and local authority.

I presume most people here know this, but you can sign up for email alerts from the CQC which will tell you when a particular home has been inspected and link to the report. I wouldn't know about my father's home's inspection had I not done this.

Good wishes to all.
 

fizzie

Registered User
Jul 20, 2011
2,730
Tis true Ginny, depending on the level of worry i would put in writing to the manager and inform the cqc and if appropriate adult safeguarding at the same time. If it is a safeguarding issue it needs to be reported straightaway because it won't get better without intervention usually
 

Gwendy1

Registered User
Feb 9, 2016
414
Glasgow
Thinking back, dad chose the home himself- it was round the corner from his house. Incredible, really, how much he has deteriorated mentally in the past year. When I remember him at his initial interview there, talking about his hobbies- church, weekly pint in pub, bookies, watching football... He barely knows who his family are now, no interest in any of the above. The nurse told me that they 'try' dad with other foods than the puréed diet- to see how he 'manages'. I was too late from work again tonight to take him to his room for dinner. Watched him pick up a tumbler of milk in the dining room, put it to his lips then put it down again about a dozen times, without realising he had to tilt it to drink... The same with his spoon and his dessert. Finally, a Carer assisted him with his food, but not the drink. I was then able to take him to his room, when 'protected' mealtime finished, where my partner and I made sure he had a drink and was comfortable. I have taken a day off in the week next week to discuss my concerns with home manager- I am usually a capable person, but feel so, so lacking in control of this situation. I need to trust, but.... :-/
 

fizzie

Registered User
Jul 20, 2011
2,730
Kassy that is such a good idea - to keep a diary.

Gwendy I think that is dreadful. I think you need to be really clear with them that they must not give him anything but pureed food and tell the carers that they need to make sure he drinks because he is not understanding how to eat and how to drink. I would actually speak to the cook and tell the cook clearly too. I think you are right not to trust - you can't trust until they prove that they can look after your dad. I think you need to point out to them that he had aspiration pneumonia and that they 'don't want to be the cause of his illness again , do they?'. They are clearly not getting the message

You are right caring addles your brain, for a long time I thought I was losing my memory too but it is just because we are juggling so much. I lost control too but don't forget we are all here to support you. One day at a time xx
 

Aisling

Registered User
Dec 5, 2015
1,806
Ireland
Thinking back, dad chose the home himself- it was round the corner from his house. Incredible, really, how much he has deteriorated mentally in the past year. When I remember him at his initial interview there, talking about his hobbies- church, weekly pint in pub, bookies, watching football... He barely knows who his family are now, no interest in any of the above. The nurse told me that they 'try' dad with other foods than the puréed diet- to see how he 'manages'. I was too late from work again tonight to take him to his room for dinner. Watched him pick up a tumbler of milk in the dining room, put it to his lips then put it down again about a dozen times, without realising he had to tilt it to drink... The same with his spoon and his dessert. Finally, a Carer assisted him with his food, but not the drink. I was then able to take him to his room, when 'protected' mealtime finished, where my partner and I made sure he had a drink and was comfortable. I have taken a day off in the week next week to discuss my concerns with home manager- I am usually a capable person, but feel so, so lacking in control of this situation. I need to trust, but.... :-/

You are right. Go to meeting and have a copy of your concerns written down. It is an awful traumatic time for carers. When will our vulnerable elderly people be treated properly after a lifetime of hard work? Our young people are our future, our elderly people are the cornerstones of our past and present and deserve respect and excellent health care when they need it. In between are thousands of carers doing their best.

Aisling
 

fizzie

Registered User
Jul 20, 2011
2,730
I do like that Aisling, so very very true and wonderfully phrased - thank you x