Meeting with Care Home Manager on Thursday

Discussion in 'ARCHIVE FORUM: Support discussions' started by Margaret W, Feb 17, 2008.

  1. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Hi folks

    I have this meeting, the manager is leaving the following day, there will be no new manager in place, so I am at a loss.

    Anyway, I will be discussing the following, grateful for anyone's advice.

    Mum has said one of the night staff "hates me" and "would thump me if she dared". I have already raised this with the manager and the next thing I know is that the care worker says to my mum "I've been told you don't like me, why is that?" which I find appalling.

    Cutting finger nails, mums are very long and dirty.

    Applying ointment to sore bottom. The doctor insisted that staff do it, staff do not do it, mum has therefore had none applied for several weeks and is very sore.

    Applying ointment to sore face. Staff seem to be doing that okay, not sure as prescribed, but face is sore today and no doctor has been called, as I requested if flared up again. No communication as to what is causing it, but I now suspect it might be Stress.

    Activities co-ordinator seems to have gone. Should I be informed? Perhaps nit-picking, but the presence of such was a reason for us choosing the home (and paying well over the odds for a care home).

    Trips out, stated as once a fortnight, mum has had one in 6 months. Ditto, a reason for us choosing the home.

    Can I expect a reduction in fees?

    Mum had blood tests taken last week (the enormous bruises on her hand prove it), I was told they were due 28th Feb, why last week? Who is supposed to tell me? Anyone? No-one? Am I not entitled to know? Do I ask the GP or the home?

    Baths. No idea when mum has one, but not often. I was told the aim was two baths a week but I know mum has gone for several weeks without either a bath or a shower.

    Drinking water. Water in her room is not drinking water. None is provided. She brushes her teeth in the sink and the water is non-drinkable. Could be an alternative cause of the facial rash.

    Dirty clothes. Mum is frequently in filthy clothes. Are the staff supposed to keep an eye on that and organise washing? Her dressing gown is filthy, given that it takes about 5 days to have anything washed I have bought her a second dressing gown, but still the first has not been washed.

    Missing clothes. Lost track of how many have gone missing, despite being clearly labelled with her name. One week she had no bra to wear at all, all three had disappeared.

    I buy her a comb at least once a fortnight, they disappear too. I add that her bedroom is locked during the day.

    Lost teeth, £800, lost glasses £80 x 2 pairs. What do I do? Getting replacements involved (a) finding a dentist and (b) organising trips thereto, which the home said they would do, but now say they can't.

    Just wonder how I should approach this meeting with the manager on Thursday. Advice gratefully received.

  2. Taffy

    Taffy Registered User

    Apr 15, 2007
    Hi Margaret,

    I hope that you get some satisfaction from the meeting on Thursday. Sorry that I can't advise you with any suggestions with your approach even though I have approached management myself where mum is, concerning personal care....I felt that it all fell on deaf ears except the part when I asked how could they offer me services that were clearly not there and let me sign into a contract believing that mum's needs would be meet. Having said that.... I found them to be spin doctors.

    All I can offer you is support in knowing your difficulties with all this, if there is going to be no new manager in place then surely there will have to be people above management that you can approach. I feel for you best of LUCK! Love Taffy.
  3. ishard

    ishard Registered User

    Jul 10, 2007
    Margaret a lot of these concerns I would put in writing and stipulate a time frame for the response, that way you have 'the managers' words to fall back on.

    State in your letter that you signed a contract and remind the manager that so did the home to provide whatever was stated in the contract. Provide a copy of your contract to 'remind' him/her.
    Ask to see proof of whatever is stated by the manager (and Contract) and ask for new ways of working to be implemented for washing etc and a chart to document it.

    At the bottom of the letter put

    CC Social Services/Doctor/MHT/etc (even if you dont send copies on I find that this helps get the managers attention)

    You can write this letter prior to the meeting if you wish as it will give the manager an idea of what you want to discuss.

    Remember although this is a careing enviroment it is still a business and so you should use business tactics.

    Oh and BTW in this situation YOU are the boss.

    Good luck :) My thoughts are with you
  4. Grannie G

    Grannie G Volunteer Moderator

    Apr 3, 2006
    Send a formal letter of complaint to the company that own/run the home and the CCSI. The home does not seem to be providing adequate care.
    Sorry Margaret but it sounds awful. I`d be looking elsewhhere.
    Love xx
  5. Natashalou

    Natashalou Registered User

    Mar 22, 2007
    Frankly my view is this has gone past saving and I would find a new home. Easier said than done I know and probably disruptive for your mum but it sounds a lot better in the longer term
  6. Skye

    Skye Registered User

    Aug 29, 2006
    SW Scotland
    #6 Skye, Feb 17, 2008
    Last edited: Feb 17, 2008
    Margaret, you say the manager is leaving, and there is no replacement. The activities co-ordinator has left and not been replaced. The staff are not doing their jobs -- and where there is a medical requirement this is surely breach of contract? (Sorry, I'm no legal expert).

    My reaction would be that the home is failing, and may be about to close. I'd be with Natashalou on this one, and be looking for an alternative.

    If the manager is leaving the day after your meeting, I don't see what the meeting will achieve. She can promise the earth, but there will be no come-back.

    If you really don't want to move your mum, I'd be writing to CSCI, SS, MP, anyone you can think of.

    It's a horrible situation, I hope you can find some resolution.

  7. gigi

    gigi Registered User

    Nov 16, 2007
    East Midlands
    Hello Margaret,

    This is a dreadful situation.

    Your mum is being neglected which is the prime I'd be putting that in writing to the CH owners and everyone else previously mentioned without any more ado.(The more the merrier)

    I'd also start looking round for somewhere else for mum..I agree with the sounds as though the home is being run down..for whatever reason..

    As Hazel has pointed out..I cannot see the purpose of meeting with a manager who is about to leave..unless that person can give you some insight into what is going on ..and more importantly..what is about to happen to the home..

    It's rotten when you believe that you are putting your mum into the hands of people who will take care of her..and paying over the odds for it..that she should be so neglected..and you have no peace of mind.

    I do feel for you..and wish you luck in your endeavours.

    Love Gigi x
  8. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Dear everyone,

    So many thanks for your comments and words of wisdom and care.

    I haven't had time to check how many of you have relatives in a care home, obviously opinions from those who do are perhaps more relevant. I don't think the home is as bad as I might have painted, yes the faults are all there, I am perhaps homing in on the bad bits, but the manager is quite professional and appears caring, she has only been in the position for about 18 months having previously worked as deputy manager for about 3 years, and she has tried to achieve a lot. During her 18 months, a number of staff have improved on their NVQs and the majority of the staff have been there for a number of years. A big problem is that care workers are paid peanuts, and unless they love the job it is a fact that they won't be the best. That said, the workers who do the day shift are all really nice and kind, neither mum nor I have a problem with their attitude - it is certainly not the home from hell.

    I have looked around swiftly for alternatives, but there are none that impress me, or if they do they have no vacancies. Mum has a mega problem in that she wanders in the night, so her bedroom needs to be near somewhere she can wander to safely,e.g. the lounge. One home we saw, which we felt was very good, the only room was way out of the way up a flight of stairs, down a flight, up a ramp, mum would have been lost in minutes. I don't want her being locked in her room at night, not able to get out.

    The social worker (the one we are not entitled to) felt that all my queries could be resolved by communication, and I do feel the manager will listen to me, and record my concerns, even though she is leaving the following day.

    A person has been appointed Deputy Manager, I have no idea how good she is at "management" but she is certainly the best of the care workers, I hope she gets sufficient support from Head Office. She is not of the same ilk as the present manager, rather more lively and sociable, which is not always a good thing in a manager, but I am sure she will do her best. She is certainly someone I feel able to talk to.

    I am not yet at the stage of moving mum. I haven't found a better alternative, but I will look. One of the reasons for choosing the home we did was its convenience for me to visit on my way to work. I am now planning on leaving work, so that criterion is no longer so important.

    I will let you know how I go on on Thursday.

    Thanks again everyone. Good to know you all.

  9. TinaT

    TinaT Registered User

    Sep 27, 2006
    Dear Margaret,

    It is so very hard to decide what to do in a situation like this. You know the difficulties you had getting your mum initially settled into the home and how daunting it is to face moving her again. Stick to your guns and as has been previously said, try to keep it on a business level at the meeting. It isn't easy to keep emotions under check when you feel your mother has been shown unacceptable levels of neglect. Perhaps a check list at the back of the door c ould be set up, signed by the staff who have bathed her, etc. In this way you will actually have some signatures to refer to if she isn't regularly bathed, creamed etc.

    As to the lost clothing, glasses, etc., in my view this is another example of neglect. Surely items left in public areas can be identified and returned to their owners? The clothing lost also shows the careless attitude of the staff. I have personally witnessed bad practice when undressing residents for bed. Every resident was taken to the same bathroom and all clothing was just piled high outside the bathroom. No attempt at sorting it into any form of ownership was made! Consequently everything gets 'lost' somehow. Can you suggest that they appoint one person to become the 'housekeeper' and to be in charge of putting the correct clothing back in each bedroom after laundering?

    Good luck and please let us know how you got on. xx TinaT
  10. Skye

    Skye Registered User

    Aug 29, 2006
    SW Scotland
    Hi Margaret

    That sounds much more positive!

    That's very promising. I think it's excellent that she's lively and sociable, and that you can talk to her.

    I rejoice whenever the charge nurse is on duty at John's home. He gets things done, and there is always a pleasant atmosphere, because the carers like and respect him. On a different day, the same carers can seem quite subdued, because they feel the person in charge is putting them down all the time.

    I'm afraid it's a fact of life that care workers are paid peanuts. It shouldn't be so, it's a hard job, and most of them are extremely committed. Perhaps that's better (though not for them!), at least we know they're not in it for the money. I was talking to some of them about it the other day, and although they know they could earn more at Tesco, they wouldn't change for anything.

    Regarding laundry, at John's home all the clothes are piled into the same bin at night, but the laundry staff sort after washing. Anything that just need folding is put into individual baskets marked with the room number. The things that need ironing are afterwards hung on hangers on a rail, each hanger marked with the room number, and wheeled round the rooms.

    I've never lost anything of John's, apart from the odd sock, and that can happen anywhere.

    Hope your meeting goes well,

  11. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Well, folks I had a good conversation with the manager, and the deputy manager was in on it as well, cos the manager leaves tomorrow, and as yet no replacement.

    They were quite shocked at my long list of "minor" complaints and agreed that I was justified in making them. Some, the manager was apologetic about, some she wasn't sure how to resolve but we talked about possible solutions.

    My mum has a Care Plan! Apparently always has had, just not communicated to me, and I am due to be called to review it in the next couple of weeks. My mum now has a new Key Carer. I find this bit quite appalling. Mum's key worker was a member of the laundry staff!!!! Now I know they all muck in, and I like that, but she has had no training whatsoever, and the job of a Key Carer is quite "key"! This particular young girl works two days a week, one in the week, one at weekend, so I never saw her, she never sought me out, it transpires that she didn't fill in the appropriate records, and all because Mum presented to them as a lady needing little supervision and therefore less input. Sorry, but my mum might not be half as bad as most of your parents, but she still needs help. She HAS been diagnosed with Alzheimers, it doesn't go away or get better.

    Anyway, the Key Carer has been replaced with the Deputy Manager which is great, cos mum likes her, and I like her, and she has already done what a Key Carer should do, which is ask mum about her past and her childhood etc., and she has done that, and got to know about mum's past and finds it interesting! And the finger nails have been trimmed I noticed.

    The night problem remains a problem. Apparently mum is going to bed about 10 p.m. and is up again at 11.30 thinking it is daytime, and okay, she can go and sit in the lounge, but she isn't doing so. She is scouring other bedrooms for any residents that might be awake so she can talk to them. Her best friend is just down the corridor, and she likes to have her bedroom door open at night, so mum is in there, waking her up, wanting to know if she is coming for breakfast, telling her she will be late if she doesn't get up. The staff have also noticed that she keeps altering her watch, from whatever time it is, to whatever time she thinks it should be. I noticed today it was forward by two hours. I tried to tell her it is electric, it doesn't need altering, it shows the right time (it has just been serviced). So the night staff are understandably in some difficulty. Fine if she goes to the lounge, but not fine if she is waking other residents. There are two night staff waking, and one sleeping. They cover three floors. There are other residents who are disturbed in the night as well as the usual needing the toilet, and I think mum is a bit of a pest. That wasn't implied to me, I have thought it myself. It seems that the night staff are busiest until about 1 a.m., and then it becomes quieter, so mum is not an issue after that. It is the couple of hours between 11 p.m. and 1 a.m. that are the problem. Most residents will be asleep then, so the night staff sort out washing and linen, but mum doesn't seem to sleep. This is nothing to do with the home, it is exactly as she was before she went in there. Down at the bus stop at 1 a.m. washed and dressed and ready for action.

    I now wonder whether to suggest sleeping tablets? I know we are all against medication for convenience, and especially sedatives, but if mum is only sleeping for an hour or so, I actually think they would benefit her, as well as everyone else. She is exhausted in the day, often asleep in the afternoon. As she was at home. What do people think about sleeping tablets? Maybe a low dose.

    The activities co-ordinator was sacked cos she wasn't up to standard. Pity, she was better than nothing, but no, she wasn't good. The job has been advertised on Jobcentreplus - would anyone like to try to find it? Buxton. Activities Co-ordinator. X CAre Centre, (I daren't give the name) The search criteria didn't let me find it. I set you all a challenge. You are wanting a jo as an Activities Co-ordinator with old people in Buxton. You go to Jobcentreplus. Find the job, and let me know how you found it.

    They are putting a tag on her specs to identify them.

    The new Key Worker has gone through mum's clothes (with mum to assist), and identified what needs washing, and reorganised her drawers. Mum is very impressed. It was admitted that a lot of her clothes were in a dirty condition, apparently the job of the Key Carer.

    Anyway, I was satisfied with the response to my queries, and the proposed improvements to mum's care.

    The manager has also suggested there is a book placed at reception for visitors to report things of concern, e.g. lightbulb gone in ensuite, room 21, which I think is a step forward.

    We shall see. I am much happier today after the chat. But we shall see.

    Oh, Mum's sore bottom and face, the Key Carer wonders if it is mum's over'zealous obsession with washing. Mum likes to wash in private, fine, but she uses the same flannel to wash her bottom as she uses to wash her face. Now mum won't twig that soap and water don't stop the spread of infection, she thinks that soap and water are marvellous things, and are essential for daily life. All credit to her for being keen on personal cleanliness, I know lots of you have a problem with that, but unless she is supervised (and she doesn't want to be supervised), she will use the same flannel for all body parts. The staff, and myself, weren't sure how to solve that. Any ideas? I think the staff will work with me on this, cos they are just as fed up of her sore face and bottom as she is. A red flannel for her bottom, an orange flannel for her torso and a green flannel for her face? Might need some organisation, but might be worth it. I think the staff would help.

    We did also wonder if the washing powder/liquid they use at the home was irritating mum, but I doubt it, she is a lady used to sticking her hands in neat bleach and not suffering.

    Anyway, she is getting a jug of drinking water to her room each day to be use for teeth cleaning and drinking.

    Hopefully things will be better by next week.

    Thanks for listening to me, I know my problems are practical rather than emotional, but it does all contribute to mum's feeling that she is valued.

  12. Taffy

    Taffy Registered User

    Apr 15, 2007
    Dear Margaret,

    It does all sound so positive I do like the idea of a key carer to overseer such things as you mentioned. The GP would be the most appropriate one to discuss sleeping medication with. This up and about at night definitely poses as a problem for staff.

    In the care facility mum is in.... a chappy is just like your mum up the best part of the night....staff give him the Newspaper and ask if he can find suitable Trades Persons for them it takes him hours to scour the paper but he likes doing this, staff also give him a cuppa and biscuits. Maybe your mum could help the staff in some way. Sweeping or dusting....

    I hope that everything is followed through and you see many changes for the better. Love Taffy.
  13. Westie

    Westie Registered User

    Margaret, that sounds like a really productive meeting.

    Well done for highlighting all the things which were worrying you, and well done the home - their responses sound encouraging.

    Afraid I don't have any suggestions about the night time confusion, but I hope your Mum finds some rest somehow.

  14. Skye

    Skye Registered User

    Aug 29, 2006
    SW Scotland
    Hi Margaret, that sounds like a good meeting, well done! It sounds as if they have taken all your niggles onboard, and are acting on them, and you can't ask for more than that.

    As for the sleeping tablets, you'd have to talk to your mum's GP -- or the deputy manager would have to ask for them to be prescribed. I know lots of patients are wakeful during the night, but if your mum is disturbing other residents, I think they'd have to do something.

    Well done!:)
  15. Kate P

    Kate P Registered User

    Jul 6, 2007
    Hi Margaret,

    I'm so pleased your meeting has proved productive and that you have a new key carer who seems on the ball and ready to listen to you.

    As to the night time I wonder if a short course of sleeping tablets (2 weeks or so) would be enough to get mum's body clock into a new routine?

    It's an odd reason I suggest this but we managed to get our baby sleeping through the night at three months old by dream feeding her. This means you feed them through the night while they are still asleep (strangest thing you've ever seen - only works until they're about 6/7 months old). Basically the nurse had told us that this was the most effective way to get babies into good sleep patterns because it puts their body clock into the right pattern.

    Now, although this is a different scenrio I wonder if the same rule could apply?

    Just a thought...
  16. Margarita

    Margarita Registered User

    Feb 17, 2006
    #16 Margarita, Feb 22, 2008
    Last edited: Feb 22, 2008

    Does your mother still go to the toilet herself ?

    Or does she have a room with a toilet section of just for her ?

    As I am wondering if she just getting up to go to the toilet and forgetting how to get back ?

    As my mother wake up in the middle of the night at 2 am go toilet then call out my name .

    Could they not put a mat on your mother floor that when she step on it , it send a message to they office , tell them that your mother getting up ?

    I have seen them in respite home my mother been to .

    You could buy her one if they do not have one .
  17. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Thanks everyone, I know you were all so concerned as to how bad everything seemed to be. The manager left on Friday, the Deputy manager is likely to be doing a 60-hour week this week cos she says she can't stay away! I didn't realise but the local chemist does his drug delivery to them on a Sunday, and it takes about 3 hours to organise, so the Deputy manager came in out of hours, unpaid, to do it.

    She has applied for the post of manager, I am hoping she gets it.

    The head office seem to be worried about her "academic" ability (my word, not theirs), i.e. she might not put apostrophes in the right place. She is up for doing her NVQ4 in Management, she needs to find an assessor. I might actually be qualified as an assessor, need to check it out cos it is a while ago. Would be nice to get involved in improving mum's home if I can.

    Love to all,

  18. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Hi Kate

    I am emailing direct cos I didn't think anyone else would be interested, but I can't quite see the logic of your suggestion. Are you saying mum should eat during the night and that will get her body clock altered? I'd very much like to alter her body clock, but how does feeding in the night do it? Or maybe you don't know, you just tried it with your baby and it worked!

    Trouble with mum is that for about a year (maybe more, we aren't sure) she was actually eating in the night, thinking it was day, so I don't think your idea would work for her.

    But it's interesting isn't it?


  19. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    Margaret - I think Kate's point was to try sleeping pills to keep your mother asleep for several nights to see if that would reset her clock, not that you should feed her. The feeding was just an example of how she dealt with keeping her baby asleep - obviously a baby can't have sleeping pills, but by feeding her before she woke up, she managed to keep her asleep. If your mother could be effectively knocked out for a few nights, then possibly that would become a habit and not something that needed to be chemically induced.
  20. Margaret W

    Margaret W Registered User

    Apr 28, 2007
    North Derbyshire
    Margerita, bless you, you are still trying to help us all.

    Mum has an ensuite toilet and washbasin, so no problem in finding her way back. I am afraid she is just a night wanderer, that is the main reason she is in the home, was found to be wandering on the street at night - the social worker described it as "purposeful wandering", it is a new term they use. It is not that mum doesn't know where she is, she knows exactly where she is, but more to the point knows exactly where she is going. the problem is she doesn't realise what time it is. So she would arrive at the post office a 6 a.m. thinking they were shut cos it was lunchtime, the old ladies club at 8 p.m instead of 1.30 p.m., and Sunday mass 11.00 a.m., she would turn up at 3 in the afternoon and wonder why there was a christening going on instead of Sunday Mass.

    That wasn't so bad, till she started trying to get a bus to the library at 2 a.m. It isn't her getting lost, she is definitely going somewhere.

    I am now a bit concerned that she has been in the care home for 6 months and thinks "it is time I got out a bit". She stil has her free bus pass, wouldn't let me remove it (no, I might need it!), will have to try secretly. Problem is her care home is in in a strange town, so she would definitely be lost, though some resident has told her the bus stops outside, which it does.

    The home is now more secure than it used to be when she arrived. They do have residents who are able to come and go to sit outside for a fag, so when the staff are around downstairs, the front door is unlocked. I don't think mum knows her way to get downstairs. But when they are serving afternoon tea or whatever, the door is securely locked. And it is locked after 6 p.m. at night.

    Yes, I have heard of the mats outside the door. But mum is up so often, they would be going off all the time, and in fact I now learn that she isn't in her room much in the night at all, she is in the lounge or other people's bedrooms, and the manager and I have agreed that she should be allowed to come out of her room. However, she is now disturbing other residents and making it difficult for night staff to deal with her, so I really think I should suggest sleeping tablets for a short while, for my mum's benefit as well as the staff who are doing their best to look after her.

    Thanks for your support.


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