Foreign staff in care homes..

[Charly]

This post is not a racist one - rest assured.

I just wondered if any resident's or family members, have had difficulties with any foreign staff providing care?

I have personally found that concerns and complaints go unanswered, on the grounds that it is a racist comment (when it isn't at all!!)

I have complained about this many, many times, but have been told that residents and/or their families, have not complained - and so nothing has been done.

I then argued that residents and their families are unlikely to complain, for fear of home closures and/or causing offence to staff members.

Does anyone feel that they have, or have had, problems in this area?


Charly

 

[KarenC]

Any kind of language barrier is, I think, a very legitimate concern. My mom is now so unable to carry on "normal" conversation that it no longer matters if the staff speak good English. However, there is a stage of confusion at which a person may be able to communicate with a staff person who speaks clear English, but not with someone with a pronounced accent or awkward idioms.

It has occasionally been a problem for my husband or me, trying to communicate with a paid care-giver whose primary language was not English. The area where my parents' care homes (dad in a nursing home, mom in a dementia home) are has a high immigrant population so we do see a lot of staff for whom English is not the first language.

Karen

 

[Brucie]

Probably 50% of the staff [maybe more] at Jan's home are either from Kenya/South Africa, or are Filipinos.

As such they are probably - in caring terms - some of the best folks we could hope for as they have the family orientation that has been lost to a great extent in the West. [gross over exaggeration but there is truth in it]

Their language skills may not be 100%, but I also have difficulty understanding the residents [Jan most of all].

The most important thing is the care standards.

I do find that the situation is best where supervisory staff are from this country, primarily because the language element here is critical - the ability to be understood by all the people in the home.

 

[Mjaqmac]

I had this problem each time mum went into hospital, the majority of nurses here in Belfast are now Filipino, mum couldn't understand a word, and they couldn't understand her. Dad and I stayed in hosp as much as poss because of the language problem, it was sad but just the normal state of affairs in the hospitals here in Northern Ireland.

I am not being racist either, but I found in such a stressful situation when your loved one has this illness, that having at least someone with a good command of the English language looking after them is a great advantage.

 

[Charly]

"However, there is a stage of confusion at which a person may be able to communicate with a staff person who speaks clear English, but not with someone with a pronounced accent or awkward idioms"

This something which I found a major problem!

I live in Lancashire where of course, the older person's accent tends to be very broad indeed, and whilst the foreign staff could not be expected to understand in any way what was meant, it could be quite amusing to hear a resident asking them "'Ey up luv - where's mi brew?" or "Noss!! (nurse) "will'ta get mi' a pot so's I can do mi' business?"

On a more serious note, another problem was that they were often unable to write reports or administer medication. Quite often, they lacked patience and understanding of confused residents and, unfortunately, some of our residents were unnecessarily sedated because of "increased aggression"

I brought this up with an Inspector from the Commission for Social Care Inspection, who agreed with me that this was a common problem.

The Inspector had also found themselves having the racism book thrown, but shared my views that good communication is the single, most important tool in providing good care.

Many residents and their families used to comment that the foreign staff couldn't understand them and vice versa - but of course, "they dont want to make a fuss"

It's frustrating as hell, but what can you do?

Wishing you all the best,

Charly x

 

[Sandy]

Just a little anecdote on this topic.

When my husband and I were looking at potential care homes for his father, we were reading Commision for Social Care Inspection reports for all the EMI homes near my in-laws.

One report had the note that the home's owner had been having difficulty recruiting staff and hence had hired six nurses from India. It went on to say that the standard of nursing care that these ladies were giving was very good. the fact that the inspectors thought is significant enough to include in the report was interesting.

Looking at the other comments about this same home (and reading the lastest report some six months later), it has a number of shortcomings regarding record keeping (not noting residents likes and dislikes, not having details of individual plans in the event of death, etc.) and also lack of sufficient opportunities for staff development.

I have to say that when I went to visit this home, it did not have the same "positive vibe" of other homes that I had seen. I couldn't have a quick chat with some of the staff as I had done in other homes, though they all seemed friendly.

Perhaps if the economics/growth of care homes requires a large proportion of non-native English speakers, it would be better to tackle it head-on with actual training on local dialect. As a native English speaker, originally from California, I find my in-laws from Oldham have been an eductaion in themselves for me.

Take care,

Sandy

 

[Canadian Joanne]

I'm in a suburb of Toronto and here it's very multicultural. Quite honestly, I find it more so than anywhere else I've visited. (As another of my digressions - my girlfriend & I were in London in 2002 - her first time - and she said to me "London's a rather white town, isn't it?" It is compared to where we live.) There are some staff in my mother's home who have heavy accents but the ones who are the best with her are Chinese and Polish. I think it comes down to having a natural talent for caring for AD patients. These women take my mother's hand, look her straight in the eye when speaking to her and don't speak too fast.

However, none of the staff handling meds have any lack of understanding of English - they simply have an accent. I do find some of the support staff - kitchen, cleaners etc have stronger accents.

But as Charly pointed out, some local accents can be very heavy. We all have accents - it just depends where we are.

 

[Brucie]

Of course, you have to look at the situation for care.

Carers may be paid around £5 per hour for a very demanding task.

Your average - and capable - white English person tends to veer away from such jobs. So we find the white English carers we do see can be very good and dedicated because they are career carers - or in a very small minority may be those who have no-where else to go and get accepted as employees out of desperation.

Carers are people - regardless of anything else, and come well and less well equipped for doing anything, really. We are lucky when we get the good ones.

I'd have thought that personal development programmes [if in place] could cover the needs of spoken and written communication. Staffing levels may not permit time off for that, however!

It is not easy to find good professional carers as the best are already snapped up and in employment.

So there is the challenge that, when a carer is needed, is it better to leave a much needed post open until the ideal candidate comes along, or to select the best of those who come along, even if they have language difficulties?

Clearly there needs to be a reasonable level of English spoken and written!

I have seen good and less good care assistants from the UK and from abroad.

It all comes down to people and importantly to the level and quality of management.


Thus, it isn't easy by any means!

 

[jc141265]

My experience

I live in Australia and there doesn't appear to be such a large proportion of non-English speaking background carers here though there is probably a larger proportion in aged care than there is elsewhere. I understand how frustrating the language barrier can be as I've experienced it myself with one of Dad's main carers but note there is a happy ending to this tale.

I'm not sure what country she is from originally but the lady that cares for Dad comes across as extremely rough and uncaring, I'm starting to think it is the language barrier that causes this perception though and that if she were able to use words I am familiar with, I would have realised much quicker that she has a heart of gold and looks after Dad very well.

This lady when we first put Dad in, used to shoo us away if we tried to help change him and even shut the door in our faces. This was very upsetting when we were still coming to terms with the feeling that we were abandoning him. She often sounds like she is barking at the patients she is caring for because I guess she doesn't know how to use the nicieties we are all used to. But I've spent many a day at the home with Dad now and I am starting to learn that my first impressions were very very wrong. I am shocked that my instincts let me down so badly they are usually pretty good, and I've learnt a lesson from this.

These days this lady will even ask me if I can help change Dad if she knows I want him out of his soiled clothes and there are no other staff available. I think initially she shooed us away because first of all she probably thought we needed the break and secondly I think she is used to people dumping their loved ones at this home and never coming back and thought she would get the transition over with quickly for dad's sake. Over time she seems to have decided that I am not one of the uncaring ones and is much much warmer towards me. I also see in my hours visit how she goes and chats with each of the residents, she's loud but that is probably because she's got so many with hearing problems in there. And I'll say this for her, she has got energy and vibrance that must help them all so much. Yesterday when I got to the home at 5.15 instead of 5pm (I go at all different times but the previous day I had come at 5pm) when dinner starts she passed me in the hall and said gruffly 'You're late!' and if I didn't know her I can see how easily that could have upset me, but then she went on to say 'But don worree, heesa hadda goood meal an eeten idall up, reeely goood' with a pleased smile....and I just grinned the rest of the way down the hall, glad she was watching out for my Dad.

I also spoke about her in another post of mine another day:

One of the carers came over, she must have seen my sad face and was very nice and told Dad he was a wonderful Dad, (it meant more to me that she said it to Dad instead of me) she knew because she had one just like him, unfortunately this made me cry even harder! But it was very nice of her, I hope she realises how I appreciated it, I will try to tell her next time, so long as I can manage to keep the tears back when I do.

So I know there are disadvantages that come with having to deal with foreign staff but don't do what I did and judge a book by its cover. It may be the language or culture barrier at fault, try to get through this and then if there is still a problem by all means take action.

 

[Brucie]

The challenge is to be there enough and long enough to get an accurate impression.

The best of care staff will get rattled if their team is short on the day, it is mealtime, and there are too many 'feeders' - that is, people who need to be fed their food. Then the door bell rings and no-one goes to answer it....

I find that these staff, in particular the Filipinos, don't just do the necessary [feeding, changing] but they also seem to build a relationship with the residents, and they give them time. Few English carers get into the patient's world, but the Filipinos do, in particular the Filipino women.

It is interesting to note the differences in care levels of all the staff when I arrive to take over for my time with Jan.

• some are just sitting there reading a book
• some bring their own music
• some are interacting with Jan all the time
• some do the paperwork chores
• some just chat among a group that forms around the 1-to-1 carer that Jan needs and tend to ignore Jan unless something happens
• some get on the floor with her and talk with Jan

The Filipinos really enter into all the activities, and they are the ones who decorate the home for Christmas and any other remotely interesting season.

 

[Nel]

Foreign Staff

This post is not a racist one - rest assured.

I just wondered if any resident's or family members, have had difficulties with any foreign staff providing care?

I have personally found that concerns and complaints go unanswered, on the grounds that it is a racist comment (when it isn't at all!!)

I have complained about this many, many times, but have been told that residents and/or their families, have not complained - and so nothing has been done.

I then argued that residents and their families are unlikely to complain, for fear of home closures and/or causing offence to staff members.

Does anyone feel that they have, or have had, problems in this area?


Charly

Hi Charly

My Dad's home have recently employed quite a number of care assistants from Poland. At first I was unsure of how this would work given the fact that they didn't speak alot of English and the residents didn't really comprehend very much either. I have to say from experience now, they are very hard working and so pleasant to be around. Nothing is too much trouble for them and the care and gentleness they show is second to none. Dad's key worker is Polish and he goes out of his way to ensure Dad's comfort and well being. I personally cannot speak highly enough of them on the unit.

Nel

 

[Elise]

I fully appreciate that we as relatives should not judge these people who are "caring" for our loved ones when we are no longer able to do so ourselves. And should appreciate the job that they do. I do appreciate this, but it would make things a lot easier if members of staff even if they did not speak very good English behave in such a manner that was of some kindness. I have come across some carers recently that do not speak very good English but seem to be very caring. Just watching them handle my dad in a gentle manner and other residents, taking their time with them, this gives a sense of reassurance that they actually like their job and people they are caring for. In other cases I have witnessed carers being very abrupt when speaking to residents because that is their way and culture. I know this, as my Nan was French and very abrupt in her manner. A lovely lady and caring but sometimes you would think she was a sergeant major. When she was being helpful I used think that I was being told off. If caring for some one who has lost a lot of their faculties and abilities I believe it is important to be able to try to communicate with them in a gentle manner, soft voice, reassuring voice, rather than a harsh and demanding one. The response that they would get would be better surely. Even if the language is broken but spoken in a much gentler manner the result would be much calmer. I herd a resident telling a carer the other day that she could not understand the carer "What are you saying dear I can't understand you, please dear I can't understand you". The carer was trying to get her to sit on the bed to put her socks on. Easy for me to understand just about! But for this little old lady who’s hearing is not so good anymore and the carer is speaking harshly and fast. No wonder the poor lady was unable to understand the simple task asked of her.
Yes, its ok if the language is not so good but what has to come with this is a caring and understanding manner. It is all down to training in this field of work. Carers in this field should be trained to a much higher degree. It is not necessarily the case, if someone speaks good English then this means the level of care is better. Some carers with very good English spoken back grounds can be of some what not very nice, and understanding is still of difficulty for residents, but is purely through lack of time and energy given to the individual. Carers should be trained on how to speak to residents.

Sorry for going on but feel quite strongly about this
Thank Elise

 

[Sandy]

Hi Elise,

I agree completely with your comments that the way in which someone communitcates (patience, tone of voice, body language, etc.) can be just as important as what is actually said.

I fully appreciate that we as relatives should not judge these people who are "caring" for our loved ones when we are no longer able to do so ourselves.

Hmmmm...I would worry a bit about that statement. I suppose that part of the problem is the deep and complex feelings that come from having to put someone in to care. But it's seems that to "judge" the staff of care homes, in their paid capacity as carers, is a duty of care we owe our loved ones, and other residents of the home for that matter.

Take care,

Sandy

 

[Brucie]

Hmmmm...I would worry a bit about that statement. I suppose that part of the problem is the deep and complex feelings that come from having to put someone in to care. But it's seems that to "judge" the staff of care homes, in their paid capacity as carers, is a duty of care we owe our loved ones, and other residents of the home for that matter

Brucie back into words again...

I think we need to understand the challenge posed in the caring - and that is a moving target - and the situation of the people who are now caring for our loved one, we need to evaluate how their caring meets the basic needs, evaluate how it may exceed those needs [in terms of inter personal communication], also think whether what they are doing is in fact more effective that what we might do [or less effective, of course].

Once we have the information, then we can judge the standard of care.

If it doesn't meet what we can reasonably expect, then we have another journey to make - to identify how we can address that situation.

All of this is regardless of the origin of the care assistant.

Yes, we do have a responsibility here.

 

[Stimpfig]

Thought I will add my 2 cents to this thread. I agree with Brucie when he says that 'Carers may be paid around £5 per hour for a very demanding task. Your average - and capable - white English person tends to veer away from such jobs.'

Have seen it here that the 'privileged white' would rather live on welfare than do such 'dirty' jobs - hence privileged nations tend to import cheap workers who, in turn, do it to escape horrible conditions back home in the less privileged parts of the world.

However, am wondering if the care homes actually have training, motivation and self-enchancement programmes for such carers ? Wouldn't they be able to function more effectively or efficiently if these were made part of their employment terms but I guess they are too desperate to ask for the cake when they ought to be content with the bread. I would hold the management of the care homes responsible and not the carers themselves.


Sue Stimpfig

 

[Brucie]

The place where Jan lives is extremely good in staff development, both in helping them with their qualifications - they all require to get NVQ's - and in terms of their computer and caring skills.

I don't know if they do anything about language and communication skills - or, more correctly, elocution. Thye know the English reasonably well, it is often the speaking of it - and also the writing of it - that can cause difficulties.

At the end of the day there is a balance to be struck between the caring and the training. While the latter is important, the former is critical!