/ Health

Care homes are failing – but is it too hard to complain?

Portrait of an old man

Our undercover actors living in four care homes discovered many problems with the quality of care. So how can relatives know what’s going on – and how easy is it to complain when you suspect the worst?

Imagine the scene: you believe that the management in your relative’s care home is sub-standard. You decide to complain, but that complaint has to be made to the management.

As someone who writes about healthcare for a living, I know that it’s important to complain when things aren’t right. But as a relative I can totally understand why people might feel uncomfortable doing it.

I’ve had three grandparents in care homes. I saw my parents struggle over a number of years with trying to get numerous problems sorted.

Don’t get me wrong – most staff were brilliant and did their very best – but it’s very stressful when you feel like you’re the only person sticking up for a vulnerable relative. And you may worry that, if you raise any concerns, it’s your relative who will bear the brunt of any staff disquiet when you’re not there.

Which? investigates care homes

Our recent investigation put actors into four care homes to spend a week living as ‘residents’. They raised lots of worrying concerns in the four homes, as well as some good practice.

These included problems of poor nutrition, lack of activity and poor staff communication and skill, and even potential abuse by a staff member in one home. It made me wonder whether relatives knew about what was going on, and felt too inhibited to speak up, or hadn’t been taken seriously when they did?

Here the actors tell us about their experiences during their week undercover:

Where to go for help

The regulator in England, the Care Quality Commission, doesn’t have a remit to investigate individual complaints although it encourages relatives and residents to feed back direct.

If your relative is funded by the council, or if it’s about an abuse or ‘safeguarding’ issue, you can get the council involved. But if you’re paying for your own placement, your complaint will normally have to go direct to the provider.

The good news is that – since October last year – if you’re not satisfied with the home’s investigation, you can go to the Local Government Ombudsman and they can investigate your complaint. But you can normally only do this once you’ve complained to the home.

I’m concerned that the need to go direct to the home may put many relatives off making their views known, fearful of the consequences. I hope that the opportunity to go to the ombudsman if the complaint isn’t handled properly will make relatives feel more secure raising concerns – but what do you think?

What are your experiences – good and bad – of the quality of care in homes? Have you had difficulties making your complaint heard or have staff been open to discussing your concerns?

s.thomas says:
10 February 2014

We complained to my fathers nursing dementia care in north wales, it was a 77 bed home, We visited everyday having to feed him, and continually keep an eye. There were mice in the kitchen and food served to residents, we had evidence of this, residents left for over an hour not registering their food and it then being taken away, they lied the Tissue Viability nurse had been out when the medical records said she hadn’t, they said the Dietician had been out, all at a chc review and they hadn’t, the list was endless, so many more things, when we complained we were bullied, and then at our wits end with the mice and dads continual pain, complained to cssiw, within days we were served with notice to quit, 28 days, not letting the commissioners know or anything. It was horrendous, it was too late for dad who was now dying from bone cancer, they even ran out of his diamorphine 48 hours before he died, if we had not been staying on the floor of his room, to ensure he was safe and we had asked for the doctor again, we would not have known they had no diamorphine for his syringe driver. He died. Not one of those nurses said sorry. They were a disgrace, and we are still going through the complaints procedure, with all complaints so fare upheld. I saw cruelty and wickedness in that home like I never imagined existed.

Rosa gaziano says:
28 July 2016

I NOT surprising at all nothing better to be with family .they are there not to be loved only to stay under Control food what food .

Gerald says:
11 February 2014

You need to report all this to the NMC NURSING AND MIDWIFERY COUNCIL as I really believe that there has been proffessional misconduct. The Nurses in Charge are responcible for the are of care which you have quoted you need to botain their names and pin numbers.

Gerald says:
9 April 2014

Ny News have you taken my advice, I would really appreciate feed back

Gordon says:
4 June 2014

After the screening of the Panorama programme and other media expose’s it is high time that those who have sat on their hands have their say in what is becoming a national scandal.
Far too many providers of care are too interested in financial and capital gain. It is all very we’ll stating that residents care is the priority this is nothing short of hypocrisy and does not hold water.
My dear mother has vascular dementia and has been in residential care for 4 years. I was chairman of the relatives group at the home until I had to resign because of personal reasons unfortunately at the next meeting it was high jacked by the activities staff, which caused considerable consternation amongst the group to say the least.
It has to go down as one of the most despicable and disgraceful events I have ever witnessed in my lifetime.
My considered opinion of the care company is that they are parsimonious which lends itself by definition to them being very frugal. They do not invest in the area which should be of paramount importance and that is the care of residents and the carers who are employed by them .
It is true that they invest in the training of carers , however that is not what should be their main requirement it is caring staff being allowed quality time being-spent integrating, stimulating and bonding with residents which should be the focus and not bricks and mortar. Building new and extending homes which gives the impression that they care when it is a means of cash flow and income to generate more funds for more building projects.
The image and perception that is in my view being created by the philosophy of the company is such that it is masking the fact that they are unrealistic and unaccountable and a smokescreen for their real purpose which in itself propagates falsehoods that are put forward for example the assertion in the recent questionnaire that the company issued that Care team managers are now based on the units not in the office which is palpably false as far as the unit my dear mother is in are concerned.
Their assertion that they are a not for profit company which reinvest is not quite born out by their lack of purpose.
The “norm” which is acceptable to the company is not as far as I am concerned acceptable to me and I believe that there is an underlying arrogance in the make up of this company and “know your place” mentality.
Various directives are to put it bluntly a means of covering ones back so to give yet another false impression that the company is transparent.
It is of concern to me that in essence they have a misconceived sense of priorities and this has a considerable detrimental impact on the standard of care.
It is a symptom of the whole care sector in this country that the policies of care home owners are allowed to go unchallenged by the state and the regulator does not fulfil its mandate to the extent of questioning the company’s ethos. I do not have any faith whatsoever in the CQC and the reliability of any assessments they make.
It is abundantly clear that low levels of re numeration and status does lead to low moral amongst carers and this has to be addressed it cannot be brushed under the carpet any longer. It also could be said that carers are to a certain degree exploited and cannot because of their terms of employment have any redress.
Personal care is imperative if only to preserve the dignity and respect for the elderly. Unfortunately we have a poor understanding of what this actually means.
In the four years my dear mother has been in the home there has not been one tangible change in staff deployment let alone an increase in staff, they are still expected to carry out domestic and menial duties which I have no doubt are impacting on the standard of overall care.
An example of the lack of attention for individual residents who need personal care is as they tend to wander around because of their dementia sometimes entering other residents rooms and without anyone engaging them and paying any regard for their needs they are left to their own devices due to lack of staff.

Certain staff fall short when using their initiative is required and in some instances this may result in residents of one unit being affected by the activities of another resident. In a recent incident a resident was to all intents and purposes assaulted resulting in hospitalisation and the need for a hip replacement. The resident subsequently died causing great distress to the family .
This event should have been fully investigated and the local authority informed but I doubt whether either has taken place.
This was not the first occasion similar incidents have occurred and it begs the question whether a ” cover up ” had ensued.
It also has to be said that difficult situations occur when some agitated residents try to exit the building thus presenting staff with having to face stressful decisions.
In extreme cases the police are involved this would not happen if there were sufficient staff available.
The home still uses agency staff which I consider to be indefensible as it is uneconomic and the quality is not up to standard.
The present management at the home are in my opinion and other relatives I have spoken to not up to the job and lack organisational, communication skills and also do not have the necessary capabilities when innovation in activities is needed which are a vital ingredient towards residents stimulation and quality of life. It would be better if staff could bend the rules and use common sense in certain situations but in doing so they would be “sticking their neck out”.
All in all I have been disappointed in the way in which this company conducts itself and I have deep misgivings that it is not in the best interests of residents that it is allowed to continue and I sincerely believe that it merits investigation into its policies of construction and other practices which are questionable.
At the end of the day it costs a considerable amount of money to have our loved ones looked after and I for one am not comfortable with the current way this company is carrying out its duty of care. We really do expect our loved ones to have the best care possible given the sacrifices they have made during their lifetime and this is not the case as far as I am concerned.
I would be grateful of your comments on the contents of this letter.

David says:
4 June 2014

My understanding of the Care Home situation is that nursing homes are not set up to provide a good quality of life. This is the conclusion about dementia care homes that Gerry Robinson came to in his Open University/BBC documentary about Dementia care homes in 2009. Even if they were safe and provided reasonable standards of ‘personal care’ – washing, toileting, dressing, etc, the quality of life was usually abysmal. That unsatisfactory quality of life seems to be acceptable to the various bodies involved in allocating people to care homes or inspecting them. Quality of life, community, relationships, etc, need to be given the same importance as nursing, personal and medical care, and the involvement of friends and relatives taken more seriously. Perhaps each home should have the equivalent of a matron or assistant matron who is responsible for creating a home for residents, with a sense of community, relationships and quality of life. It may be that some pilot projects should be set up to try to provide examples of good quality of life where community and relationships are given the importance they deserve.

Gerald says:
4 June 2014

Dear David,
You are completely mixing up two types of Care Homes, the Dementia ones to which you refer are not Nursing Homes, Nursing Homes (which are the Private replacements of the NHS Geriatric wards) are staffed in the manner which you suggests and concentrate mainly with palliative care with all its own restrictions and problems.
Dementia Care Homes ,which are a recent development of the Private Sector Residential Homes specializing obviously with residents with dementia. In my opinion segregating people with dementia has its draw backs and its benefits and at present there has not been sufficient work put into developing Care in this area although I do believe this will be quickly be rectified now that this condition has been highlighted for special attention.

redhurstswallet says:
4 June 2014

There may well be care homes which provide dementia care, and I agree that Gerry Robinson’s programme focused on care homes rather than dealing with nursing homes, but from my experience the issues he raised were also appropriate to nursing homes some of which do deal with residents w3ith varying degrees of dementia.