/ Health

Why is good care so difficult to find?

Moving someone into a care home can be a difficult decision. That difficulty is only compounded when faced with the struggle of finding good care that suits that person’s needs. Fred Horley joins us to share his difficulties with finding good care for his wife, Joan.

In October 2015, my wife Joan, aged 83, was placed into a care home by a hospital for respite care. This was following treatment for a fractured right leg. Sadly, Joan’s experience in that care home was far from satisfactory.

Care home failings

My wife had specific requirements of no load bearing on the fractured limb. She had a commode in her room and needed assistance with getting out of bed to use it.

Often she was left waiting for more than 30 minutes after activating an emergency alarm before help eventually came for her. On a number of occasions, one at 1.15am, Joan used her mobile phone to call me at home to ask me to ring the home and ask them to respond to her emergency activation of the alarm.

On another occasion after waiting three-quarters of an hour after activating the emergency call button she tried to get out of bed and fell, banging her head on the stone floor. She lay on the floor, in the dark, for about an hour shouting for help and banging on the floor. It was later discovered that the emergency alarm system was not working.

My wife was often woken at around 8am but wasn’t served a hot drink or breakfast until 9.45am. And in the 15 days she was in the home she was assisted with showering only once.

At no point was Joan’s care plan ever discussed with her and she was never given the opportunity to participate in any form of activities.

We decided to remove her from the home as soon as possible and reported Joan’s experience to the relevant authorities. But we felt helpless and concerned for the other residents at the home.

A caring home

The authorities carried out a risk assessment of our home in turning our downstairs dining room into a bedroom. They provided all the necessary equipment for Joan to be cared for at home by carers and family.

With Joan now comfortable at home I was able to look into who was responsible for overseeing care homes provision and discovered the Care Quality Commission (CQC).

I found that in November 2014 the CQC carried out an inspection of the care home and concluded that it required improvement in three out of the five assessment criteria. The overall grading it was given was ‘Requires Improvement’.

The CQC had carried out further inspections and eventually put the home into ‘special measures’. And at its last inspection, in April 2017, the home still required improvement in two out of the five inspection criteria.

In the nearly two years since Joan was at that home it still ‘requires improvement’ and despite this, it’s still able to take on new residents.

Care needs care now

Many elderly patients don’t have friends or relatives who are able to make enquiries or complaints on their behalf. It shouldn’t be a struggle to find good care.

From my own extensive research and Joan’s experience I’m well placed to determine the best home for my own care should I need it.

For me, it will be one that meets the five CQC care criteria and is rated as good or outstanding. But homes in Plymouth that would meet these criteria are difficult to come by, expensive and have few vacancies.

That’s why I’m standing with Which? as they launch their campaign to confront the problems in the care home system.

Join me. Sign Which?’s petition to put care into the care system today.

This is a guest contribution by Fred Horley. All views expressed here are Fred’s own and not necessarily also shared by Which?

Have you had a similar experience to Fred and Joan? Do you worry about finding good care?

Comments

I sympathise and empathise with Mr Horley and his wife. Their experience is just one more to add the multitude that were described in a previous conversation. Mr Horley highlights the problems encountered when thinking about a care home. At this time, emotions are aroused because the need is obvious, the personal ties make it a hard decision to take and the choice of care home, together with the dread of getting it wrong just adds to worry. With an aging population, the need for respite and long term care will increase exponentially. While this is happening the care homes are ( according to the many accounts on these pages) not coping with the current need, let alone anything for the future. Many appear to be finically insecure. One particular one that produces a wonderful printed brochure describing luxury life in their care, has massive debts. Not something that is immediately obvious to those who would like to live there. I think it would be fair to say that there is a huge problem in the making and not much of a lesser one currently, which doesn’t seem to be being addressed. Money, beds and care homes seem to be in short supply. There is no reliable way of knowing whether the home is good or bad. Staff shortages, low pay and homes run on a shoe-string prevent improvements in care and facilities. I also wonder whether companies considering the industry, look at it and decide it isn’t financially viable. Care at home is wonderful, but it relies on family, how ever much external care is brought in. It is easy to say that the government should sort it out, but they do have a responsibility to see that their elderly citizens have a dignified old age, which doesn’t mean waiting to use the toilet, poor hygiene care and inadequate companionship. They have a duty to monitor and assess the standard of care in the industry and ultimately they have the responsibility to see that there is enough provision for those that need it.

Thank you, Fred, for sharing your story with us. It’s an eye-opening read and, as @vynorhill noted, it highlights once again that far too many people struggle to find decent care.

We hope that the competition regulator (the CMA) addresses these shortfalls in its care home market study. We’re calling on the CMA to:
– Press for government action to urgently tackle the challenges people face with care homes today
– Make lasting recommendations to ensure there are good care homes now and into the future across the UK
– Deliver reforms so that people who need care have a real choice, are treated fairly and are protected if things go wrong
You can find out more about our campaign here: https://campaigns.which.co.uk/care-system/

As well as this story from Fred (thank you very much to him for spending the time to share his story and back our new campaign), I also wanted to share a video from another Which? supporter. This is from Eldridge who shares the story of how his mother was let down by the care system…

https://youtu.be/DIifLWbBpK0

my wife has dementia. she is getting worse every day. on sunday 1 October we have been married for 68 years. whilst I am alive she is not going in a home. I made a promise 68 years ago. she stays at home with me.

Trisha says:
4 October 2017

I think that’s great Thomas that you can still care for your wife.

Hello Thomas – I thought you mind find the information on the Elderly Care website about getting a break from care of use if you ever feel the need to refresh your energy. You can find it on the following link: http://www.which.co.uk/elderly-care/for-carers/respite-care

My Wife suffered a brain seizure October 2015 and spent 3 months in St Mary’s hospital Newport Isle of Wight whilst they tried to find a nursing home capable of dealing with her many health issues including type 1 Diabetes.
January 11. 2016 she was moved to Solent Grange nursing home on the Island, where she has remained to date. I visit twice a day, it is only 3 miles away from where I live which obviously is an advantage.
The quality of care has been outstanding throughout and I have regular discussions about her medical care.
Information is always available. Additionally I visit during meal times and asked to comment on the quality of the food which is varied and good.
Every 6 weeks relatives are invited to attend a meeting to discuss the homes plans for their patients.
Activities are available adjusted to the individual patients needs. Regular trips out using a special bus to take wheelchairs.
It would appear that we have experienced a level of care which sadly is not replicated in general.
I would point out that she is under NHS funding and not a private patient.
Yes it is sad that she will not improve, but we have been so lucky to have a caring nursing home.
I give these comments as there are maybe a few very good homes.
Richard Gully
04.10.17

Karen says:
4 October 2017

My lovely dad was in hospital, had dementia, and needed specialist care. We began the quest for a care home that could meet his needs but couldn’t find any that hadn’t failed their last inspection. It took 7 weeks to find a suitable care home that had space… he died due to ‘hospital acquired pneumonia’ a couple of days before he was due to move.

Hi Karen, I’m sorry to hear about your father. It’s stories like yours that have inspired our Care campaign.

Why don’t we push for a National Care Service where young people are drafted for one year to help older people? We managed it with National Service, albeit a long time ago….

I think this would help society hugely, to the benefit of all concerned!

Gill says:
4 October 2017

Tony, I see where you are coming from with this suggestion, but caring needs to be done by people who want to be there doing a good job, not by people who are forced into it. I know some young people would do a wonderful job, but there would also be those who just wouldn’t. Also, I strongly believe that care workers need to be properly trained in dealing with the elderly, frail, and those with dementia. I often see job adverts for carers stating ‘no experience necessary’. Just idiotic.

This is part of the problem – pretty much anyone off the street can walk in and do it. This is part of what leads to all these problems, underqualified and poorly qualified people doing a job they don’t care about.

Quite right. I have been saying this for years. Anyone can get a job in a care home because there is no need fur experience or qualification as training is done on the job. I know there are a many in the job who love their job and are of the right character to be there but equally there are many in care homes who are there purely for the money as they are unable to find work elsewhere and they are definitely not of the right mindset to be carers. I have experience if working as a carer and my own mother latterly being in care. I have horror stories I want to share that are still causing me serious distress almost 3 years after my mother’s death , but on my mobile phone right now and I would rather be say comfortably with my laptop, so later without a doubt. Something needs to be done and soon. I have told my kids that if I need to go into a home, I am checking myself out of life first as there is no way I am going in to experience that.

The profile and recognition of being a Carer ,either for a loved one or in a professional capacity ,does not have the same kudos as many other professions. Recruiting people to work in this profession is extremely difficult . There are many fallacies as to the role of a professional Carer…I have been working in this profession for several years …when telling other professional people that I work as a Carer ,it is met with slight disdain…the pay we receive is just above the minimum wage ..there are no guaranteed hours …zero hours contracts being the main option ..Young people leaving school and going to college or university do not wish to study health and social care as it is deemed a lowly profession.
Perhaps if there was a professional register such as the nursing profession have ,we may stand. a chance of recruiting a new generation to work in this very much maligned industry .

As long as firms WHO own care Home charge a furtune from people WHO are forced I to these homes, and give back VERY LITTLE, ( and before anyone starts SHOUTING, I know what I am talking ABOUT. ).
Yes, I have found ODD staff really go that EXTRA mile, but sorry they are so far far apart it is heart breaking.
Yes, I have seen owners who you can see by actions are only in the action for MONEY could not care less about people.
Yet I also see people in Offices, trying to run places, but knocking heads off brick walls, yes thingsvare in line for reporting things, but come on WAKE Up and stop living in dream land, staff won’t report other staff, they are badly paid now, if they lose a job because they reported something, were are they going to get another job.
These places talk to each other. I have proved it.
The Council need to get moving employ more staff, Check on places with out telling them, not as now PHONING AHEAD they are coming.

This I know happens.

More money into health, Less into Councilors meetings and food at these meetings.
About time ALL Council MEETINGS were WIDE open, and things answer ed at ALL meetings , STRAIGHT OFF, so Lies can’t be sorted.

Anne says:
4 October 2017

My mum was determined not to be “a burden” to her children. She asked me to take her on a tour of all the local ‘care’ ‘homes’: the all-pervasive smell of incontinence, the apparently catatonic slumped in front of the TV, the tatty, gloomy er decor. After four, I said, No Way!
But she was fortunate, after a lifetime of hard work and very economical living, she could afford a live-in carer, in her own home – not perfect, but much much better and half the price. Even the most, supposedly, luxury ‘homes’ were total rubbish
How can it cost £800 for one week, equivalent to a 1 star hotel? And that was 15 years ago. It is a cruelly disgraceful ripoff. No doubt a marvellous investment for investors! Sickening.

But so what about the children and grandchildren? Are so few able to care for their elderly at home? Nan in her rocking chair by the fire? I lived hours’ drive away, in a small house with stairs, was working….it never occurred to me to suggest it and am sure Mum would not have wanted to leave her home, a bungalow, local friends and some degree of independence.

Not everyone has children, let alone grand-children!

Hello Anne – having read about your experience with live-in carers has made me think that maybe others would like to know more about this growing area of caring for older people at home. On the Which? Elderly Care website we have information about what live-in care is, how much it costs, how to organise it, starting on this page: http://www.which.co.uk/elderly-care/housing-options/domiciliary-care/396675-live-in-care. I hope it’s helpful.

My mother died 8 months ago after 9 1/2 years in two Care Homes.

With dementia (Alzheimer’s), she was unsafe to be left alone after my father died so it was the only reasonable option, to be where she could be looked after and monitored 24 hours a day, should that prove necessary.

My brothers and I visited her frequently, despite being at a bit of a distance. I felt that it was important to let the staff know that there was a family behind her, ready to take appropriate action if the care failed. It never did. She could not have been better treated if she had been their own mother. I also witnessed other residents, alone in the world, being treated with kindness and respect (even when the staff did not realise we were there, in the background).

After 8 years, her Home closed but again she was fortunate in being transferred to a sister Home where, if anything, the staff were even more loving. I could not praise them too highly. My family was so gratified that her funeral was attended by some of the staff.

Both of these homes were run by the Salvation Army. I don’t know whether that is relevant but I do know that there were regular religious services (which my mother – and I, if I were there – attended, despite being of a different persuasion, frequent visits from a SA band and that their own chaplain was always on hand with her comforting presence.

At no point did we worry about Mum’s health or safety, her meals were both sufficient and well balanced nutritionally and the staff always tried to involve my her in activities to keep her active and prevent a mental decline for as long as possible.

I feel so strongly that all in need should receive the same level of care, both for the resident’s sake and for that of their family. After a lifetime’s work and contribution to society, this should be a right, not just a privilege.

On the Which? Elderly Care website we also have a directory of care providers that has information about care homes, home care agencies, supporter groups for people living with dementia and the care services that local authorities provide for older people.

For care homes, you can see who the homes are run by (the Salvation Army or a group, such as Barchester Care, for example) and also filter for specialist care needs, such as dementia care. There are also links to inspection reports and if a care home has a website, you can click through to that too.

Visit it on this URL: http://www.which.co.uk/elderly-care/care-services-directory.

Care homes need to be statutory and not brought before the Competition and Markets Authority for it to give its authorization to privatisation and all the problems which come with conflict of interest between profit and care and which is the real underlying problem with care homes.

It seems to me that most of the problems caused in Care Homes and Mental Hospitals is lack of finance . With privately owned homes some of the owners are only interested in profits and the Council Homes have ridiculous amounts of money to exist .
The staff of all homes are paid a pittance for the very difficult work that is needed to give everyone the best care possible.
About time some drastic measures were put in place because so many people are not getting the care they need .

I worked in a care home for 17year myself and the rest of the team treated the people in our care like we would our own family or how we would want to be treated I do know this does not happen in lots of homes but all the residents felt like family to us ,we were a good team and worked well together, although we are retired now we are still friends and even holiday together, we still chat about the people we looked after just like family, we did love our job. But I do understand there is a lot of homes now which are terrible and we retired cares hope we don’t have to finish our lives in a home, yes you do have to be a special person to do this kind of work.

My name is Jim I was caring for my mother Sarah for around 30 years during the last 3 years of her life I brought my mother to my own home. In April 2011 I had a very unexpected visit from the local police they told me that they had a report of physical abuse towards my mother by myself. I was immediately arrested and taken to a police cell.

My mother was 87 years old and extremely frail and in the last stages of Alzheimer’s disease.

I had informed her social worker that I was concerned about her weight loss she had been 11 stone at one stage and over a relativity short period of time had dropped to 7 stone.

My mother Sarah was removed from my care and placed in a care home.
during multi disciplinary meetings it had been reported by care home staff that Sarah was in fact gaining weight implying that I was not feeding her.
Sarah passed away in August 2011 at a weight of approximately 3 or 3.5 stone.
I received a telephone call from Sarah’s social worker one Monday afternoon after my wife visited unexpectedly I was informed that Sarah had deteriorated over the weekend and that I needed to attend but I was told that I would have to be supervised. I refused to attend due to the supervision order.

At that time I was told that Sarah was on “The Liverpool Care Pathway” Which I had never heard off before.

After numerous court cases the case was set for hearing in September. I had been claiming my innocence all the way through.
I paid my solicitor £1,000.00 up front then he rang me unexpectedly one Monday morning and told me the case was going ahead the next day Tuesday and that he needed £2,000.00 cash by Tuesday morning this was duly paid and the case was due to go ahead.
All that day and all the through I clamed my innocence the case was to be heard early that day but my barrister told me it was running late but it would be heard before lunch, then after lunch then mid-afternoon soon my barrister came to my wife and myself and talked me into pleading guilty to a lesser charge which regrettably I done and have done so ever since.

I am led to believe that “The Liverpool Care Pathway” has been abolished.

In closing I hope no one ever puts me into a so called care home because there is very little care involved.

I have much much more I could tell but must finish.

Jenny says:
4 October 2017

I have been working in the care sector for over 28 years, and 10 at my currant job, there has been a lot of changes in that time! More & more pressure is put on the care staff, to meet the expectations of the management, who have totally unrealistic ideas There is never enough staff to cover the needs of the paying residents, The staff often work short staffed on most shifts, are under payed and over worked. They are expected to do more than one job at once, often covering other departments work along side their own care roles, I feel sorry for the residents, is this how it will be when we are there age or will it be worse!

This comment was removed at the request of the user

Jasmine says:
4 October 2017

I’m glad this is coming to people’s attention. My sister had been in care for seven years and the shocking things I have seen and dealt with are unbelievable.
Complaint systems don’t even work, you end up back at the start with only to hear they get a slap on the wrist, people get paid for something that they have not even done and then things affect the person in care. They treat you differently if not worse and don’t even give the cared one the attention and care they need, as they see it as only as Job (not a human being) and pass it on to the next person on shift.
I could go on forever about the system it’s like they are all against you when they should be supporting you as you are dealing with it physically and emotionally as family matter. But once you are not there the horror stories get worse!!

Jean Greer says:
4 October 2017

It is vital that when you have a loved one in a care home, if they are being treated in way way which is unacceptable, that you bring this to the attention of, maybe not to that particular home, but with the head office, so that something can be done to make sure that your loved one and also others who may not have anyone to speak up for them are treated in a correct and proper manner. After all, these souls (or yourselves) are paying a lot of money to ensure their wellbeing. Above all make sure than you pursue this and also keep checking on your loved one to make sure they are finally being treated properly.

Carol T says:
5 October 2017

I hear what you are saying but in reality, this is nearly impossible. Once you or your family leave, the home is in charge again and they can, and will, make your relative’s life hell! I have been in a complaints situation and found it was a total waste of time. Nothing was done to the home or the staff, but my Mum was still dead.

I worked for a Nursing agency for a few years to supplement my pay as a teacher, so I visited many care homes. The opinion of the Nursing staff was ever that they could not live under such conditions and would prefer an injection under a toenal to escape. I gave my best, knowing that one day it could be me. Yes, I was unqualified but I did know how to care for my patients. Yes, some patients were difficult, but I found that staffwere generally caring.

Terry Walker says:
4 October 2017

On the whole I find it such a risk to end up in a care home with the strong possibility of being neglected and/ or being abused. Until such time that the law changes so that one can die with dignity by help from a medical person then I would rather end my life myself. I believe that many older people feel this way. How does one equate the sanctity of life with the quality of life? When this is possible older people will feel more comfortable in their future, and it would relieve pressure on the need for care.

With my limited experience, I found that most patients were angry, Now as I to approah those days when I will be “Put Away”, I must think that it is a realisation of their loss of facilities or abilites. I find it difficult to fill in forms. I can no longer bend down to pick things up. I am angry enough before I enter a Care Home. But I do not inderstand why are homes are so expensive. It must all be to feather the nest of the owners. Money money money rule s our lives these days. Every one is out to make as much profit from the aged and infirm as possible. This is the reson so many facilities are inadequte.

compassionincare.com/breakingthesilence

The charity that has been fighting since 2001 on this subject which could have been flagged up by Which?.

Many harrowing stories – including those members of staff who cared , blew the whistle , and were stitched up by the Care Quality Commission, and lost their jobs. Private Eye has commented several times on the same homes being registered , struck off and re-registered by a “new owner”. The CQC has been a serial paper tiger in keeping a lid on the problems.

Essentially more regulation means more costs and less people willing to run care homes at the rates local authorities can afford. However socially speaking the idea you park the elderly away from families in many cultures is seen as wrong.

The breakdown of the extended family and living away has left us with a major problem . This is compounded by medicine keeping alive beyond what is sensible.
My father dying from prostate cancer at 93 had his life prolonged unnecessarily and messily for 6 months. A total waste of resources of the NHS and the nursing home given there was no possibility he could live long and was suffering in many humiliating and embarrassing ways .

Hi Patrick, I’m sorry to hear about your father. Indeed, there a number campaigning organisations looking at issues in the care sector. We’ve also been investigating care issues for a number years too, looking at the provision and quality of care homes has been a regular focus for us – take a look at our campaign timeline at the bottom of the site – https://campaigns.which.co.uk/care-system/

Our latest research has found that by 2022 we face an estimated 42,000 shortfall in care home spaces, and that’s just in England. It’s not just the data, but the thousands of case studies shared with us have prompted this campaign. We want the CMA to address the problems with provision and quality of care in its care home market study.

Carol T says:
5 October 2017

That is what I fear – being ill and kept alive. I want the option to end my life when I want to do it! Dementia even takes away that choice. We have no Dignitas facility in the UK so it’s stockpile the pills and hope I’ve got enough faculties to let me take them. Growing old in the UK is a fate worse than death!

This comment was removed at the request of the user

I dread the day that I become so dependent on others that I am sent to a care home, an elderly care hospital ward, or have carers coming into my home. What my lovely Mum suffered at the hands of some so-called care staff was unbearable, disgraceful is a word that does not even come close to describing the heinous situation.
To make matters worse the abusers and neglectors had the full support of the agencies and authorities behind them and singing their praises. This included the CQC who gave a 5 star rating to the company who were abusing and neglecting my Mother behind closed doors, despite the evidence given to them.
The good care staff were afraid to speak out, those that did lost their jobs. When I spoke out against bad and illegal practices the abusers made horrific false accusations against me to discredit my claims.
The whole care system needs to be disbanded and restarted with a fresh attitude and better control.
There are many fantastic care staff out there – unfortunately there are many others that should not be allowed anywhere near the care industry.
With the so called ‘care’ system as it is, I hope euthanasia is made legal in this country before I need care. I’ve seen first hand the needless pain and suffering at the hands of so called care (and nursing) staff. I do not want to go through that myself. However I whole-heartedly thank those who really do care and who treat their charges gently, promptly and kindly.

This comment was removed at the request of the user

I agree, why can’t they just give us a needle to finish us off, nobody cares & we live in hell.