Residential Care Homes - am I expecting too much?

[Buttercup16]

Hi, thank you in advance to anyone reading this! Are all (most) care homes in the UK just poorly run profit making businesses or am I being too harsh?
My dad is 85 years old with dementia; the forgetful kind where he can remember his past but not what happened 5 minutes ago. After the loss of my mum, I had been sharing the care of my dad with my sister for over a year, desperate to keep dad out of care. My sister decided it was too much for her, and withdrew her care meaning that unless I gave up my job and cared for dad 24/7, a residential care home was the only viable option. So after looking at 11 care homes, I selected the 'lease worst'. There seemed to be no middle ground. Sorry for being blunt, but they were either absolute hovels or presented like ridiculous cruise ships; I didn't find one that was just homely and comparable to our 'normal'. I ended up choosing one of the new residential care homes (cruise ship style) at £1,275 per week. Dad has been there for 3 months now and has had more falls and illness there than he ever had when being cared for by us. The latest is that dad had a very nasty rash / blisters on his chest 2 weeks ago. 111 was called and the advice was to get him to a GP if it got no better within 2 days. Only yesterday did they take action and contact the GP. Shingles was diagnosed by a nurse who looked at photos (so dad was not seen in person). When I asked the home why the 111 direction wasn't followed, I just get a stream of excuses "I was on holiday"..."I wasn't in that day"..."someone will call you back"... etc etc. And this is just one example of so many errors. But when ever I ask people (district nurses, GPs, care workers) I am categorically told that this home is the best in the region 'by far'???? So I would love to know, are my expectations too high? Is it normal to have to advocate so often for problems? Are residential care homes really just about profit and not care? Is anyone else absolutely flabbergasted and exhausted with similar situations? Any tips? Thanks so much for reading xx

 

[jugglingmum]

Not all care homes are like this. My mum was in a small privately run care home at the lower end of cost in my area, and I couldn't fault the care.

Communication wasn't always perfect, but was adequate, and was good when I visited and they always contacted me when the contacted 111 and advised me of progress.

Mum was loved by her carers.

Falls do happen and can't be prevented even with one to one care.

I don't consider the approach to the shingles to be acceptable, and they should have followed the 111 instructions.

 

[Harky]

Number of years ago, football stars etc were advised by financial people to invest in them as it's a great investment (says it all). Also, visited my friends parent when he was on holiday only to find the staff huddled in a corner on mobile phones eating crisps etc. On the other hand, i visited an elderly relative in a small country home which appeared excellent. Its really difficult for you. My wife has dementia and the last thing I would do was to put her in care.

 

[Calon Lan]

Hi @Buttercup16,

I am sorry your dad has suffered falls and illnesses since moving into residential care. The management of his shingles infection certainly seems to have been poor. I think you are right to expect better care when your dad is unwell with an infection, especially given the advice provided to the care home from 111. You could ask for a meeting with the registered manager of the home to discuss what went wrong and what steps can be taken to avoid a repeat if you haven’t already tried that. You could also ask questions about risk assessment for falls, and whether there is something in your dad’s care plan about reducing risk if he has had frequent falls.

My mum has Alzheimer’s and vascular dementia. She has lived in two care homes.
Her experience in the two homes illustrates how care can be very different in different places.

My mum’s care in the first home was terrible. The staff were disengaged and complacent. I witnessed some serious failures in hygiene procedures. There was dangerous broken furniture in my mum’s room. Managers were not willing to listen to concerns and became verbally aggressive very quickly. My mum lived in this home for two months. Her physical health declined catastrophically. Her mobility was seriously affected after just one week in the home. She had a series of infections, including covid. She became incontinent. During her last week in the home she lay in bed for four days in serious pain and unable to get up. When an ambulance was at last called the crew diagnosed a hip fracture in minutes. My mum had bruising on her body and in my opinion this was consistent with an unreported fall. My mum was taken to A&E and had hip replacement surgery the next day.

My mum was in hospital for three weeks. I made it very clear to social services that I did not want my mum discharged back to the same care home. A safeguarding investigation was started to try and discover what happened at the care home and why. A place was found at a nursing home and my mum was moved there when she left hospital. She has lived there for just over a year.

My mum’s care at the nursing home has been good. Her mobility is good for a 90 year old with dementia. She doesn’t need a walking frame. She has not fallen since she moved into the home. She has occasional toilet accidents, but generally no major problems with incontinence. Her physical health is so much better than when she was living in the first home. She has not had any serious infections. Staff are very caring and engaged, and consider me part of the team looking after my mum. Management tries to communicate well and will listen to concerns and take action to address them. There are problems, the most worrying being high turnover of senior staff and not enough staff at certain times of the day. I suspect these are common problems in care homes.

Looking back, I often question whether I could have discovered the problems at the first care home when I went to see the place and talk to management before my mum moved there. I doubt it. Other reviews of the care home turned out to be completely unreliable. It’s very difficult to know what happens in a care home unless you spend a lot of time there. I think I will always feel responsible for what happened to my mum because I made the decision to move her into that care home.

With respect to advocacy, I would say yes, it’s normal to have to frequently act as an advocate. It’s sometimes frustrating, and often exhausting - but I know that if I don’t act for my mum no one else will.

I hope things improve for you and your dad. Sending thoughts and best wishes.