/ 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?

Gail Sims says:
29 November 2017

I don’t have any experience of elderly care homes other than visiting various relatives, nor experience of the “system” which is very big in the news now and quite rightly so; I’m 57, I’ve given my instructions to my family and am quite clear about quality of my life rather than quantity to take precedence in decisions when I start to go downhill, lets hope the law also changes in that regard before then. What I am certain of is that this and future governments MUST cut the UK Overseas Aid Budget- the NHS must come first and needs every penny; this aid is a grotesque and obscene waste of hard working UK taxpayers money; last F/Y we squandered 13.5 BILLION throwing cash at despotic and extremely wealthy governments-then what happens? I get pestered in the street and on my own doorstep from Charities this time, ASKING ME FOR EVEN MORE MONEY!! Cut this budget, join the Daily Express Campaign.

I feel sorry for the uncivilised treatment that some old people have suffered especially as we in Shetland have a number of Council owned and run, all nearly brand new and well staffed by truly compassionate and caring people many from a nursing background. We are very, very fortunate

Marion says:
29 November 2017

I have visited people in care homes. I have also worked in care homes and what troubles me most is that there is never enough carers for the needs of the residents. This is difficult for both the people needing care and the carers. Many are leaving care work because they know they don’t have time to give the residents the care they deserve. The pay is low and they can earn more stacking shelves in a supermarket. Carers should be given the value they deserve and so give them the incentive to remain in care work. Also more staff on each shift. Things won’t change for the better unless this is allowed to happen.

I agree totally..Not enough careres on shift… Carers getting overwhelmed with the impossible demands on time allocated, and poor pay.
Also another problem can be from management how they treat the staff and patients. bullying may also be present. The care guidances are certainly not met. and rightly as others have commented the homes continue to operate.
I suppose there is no where else to house the residents so what do they do.
I feel if relatives of inmates spoke up more and if there was a reporting body for employees who work in the homes too. however this is not the best way, as they fear for their jobs.
I worked in a care home and thought I was greiving, and suffering from depression, the environment and the care I witnessed at sporadic times was also a contributory factor to my mental and emotional health. When you are not strong enough to stand up to fight for what is right and correct behaviour.
I pray that a new policy and legislation is passed and funded to support the care system and aid it development of better caring standards for the service user and the employee.

My experience of working in a care home for LD is that it’s very much down to the manager. WIth so much legislation and checks you’d think nothing could slip through the net. Sadly, Care, does attract unscrupulous individuals. However, the less obvious abuse, tones of voice, misuse of power and control is so damaging; insidious and much harder to prove, yet cause untold misery for those who cannot voice their disapproval. Woe betide if they or staff bring it up. Mostly, workers leave rather than whistle blow and so the ongoing cycle of endless new faces continues. Getting to know individuals and their likes and dislikes, takes time and patience. When I mentioned the importance of consistency regarding staff, my manager did not agree.

I agree with this outright. I have experienced the same… its impossible to get the abuse that goes on documented . maybe there should be cameras put in place for a monitoring period of say 2 months. so it makes everyone up there game.
I was abused from management and did not feel strong enough to fight it so I left.

Murray says:
29 November 2017

My mother – now no longer with me – went into care Home – but only lived 12 months afte died at 85, with a chest infection she caught in the Home – by the time ‘they’ had realised she wasn’t well it was toate @ the doctor gave her 2 days – Christmas 2012.
I went every day – sometimes all day – doing the laundry cos no staff. Doing the Garden – I even cleared the garage of ‘stuff’ some I sold – it wd have cost the home £500 tontidy it (although I believe someone was taking them for fools). I actually raised £200 from the ‘stuff’ in the garage.
The staff were happy to spend 10 mins every half an hour having a cigarette & leaving the tips in the garden !
I should have had my Mother at home – lazy – uninterested & with no common sense or ‘actual care’
He pulls wrre given to patient but no body watched that they’d actually been taken.
Absolutely shameful – I’ll nevee forgive myself.

I have visited an aunt and a friend in care homes. My friend has been in two care homes, one a modern, purpose- built building which is bright and airy inside. Corridors are wide, with plenty of light. There is a large room, where residents can watch TV, and a large conservatory where comfortable chairs are arranged in groups, and quiet conversation and reading can take place.
Staff are helpful and cheerful.
The other two care homes in which my friend, and my aunt resided, were Victorian family homes. They were built for large families, but not wheelchairs being moved through the narrow corridors. They both had a ‘run down’ air about them, and were quite dismal inside. Having a conversation was difficult as both sitting rooms had a TV.
I am sure that both homes would fetch a good price on the market, becoming offices or flats. Homes for the elderly need to be purpose- built for the benefit of both residents and staff.
In the US, some care homes have plants in the residents rooms; staff encourage them to care for the plant. Residents are also encouraged to take turns at walking the ‘home dog.’
A new vision is needed.

June Sims says:
29 November 2017

I think it is awful that we are not looking after our elderly properly. Most have worked all their lives and paid into the NHS that does not want to give them anything back. Whilst a lot of money can be found to look after children sent here alone from foreign places, money cannot be found for our old folks and they are expected to live in horrible, smelly conditions. Wake up this county and look after our elderly because they deserve it.

I have a 98 year old Aunty, who at the beging of this year 2017 had to go into care, we as her family found what we believe was a high standard care home, how wrong we were, after 10 days in the home an ambulance had to be called for my Aunty as she had become unwell, during the journey and her admittance to our local hospital, she was found to have a broken hip and numerous bruises over her body, she was moved to another care home on her discharge from hospital, there was an investigation into all the bruising and her broken hip, CQC was involved, Elder care was also involved and also social worker, it was deemed because my Aunty had lack of capacity, there was no one who could explain how she came to have all these bruises and a broken hip, the home was told to improve it recording of body mapping and also improve on certain care procedures, to say we were devastated was an understatement, I feel really strongly that care facilities for our elderly is way below what it should be, and also the people who should over see that these care home run correctly, definilty do NOT keep our elderly people safe, and CQC is just so out of touch it’s unreal, a real frighting insight into how bad our care system for our elderly is today

Maggie says:
29 November 2017

My dad was in a really nice place with wonderful staff and a wonderful atmosphere. He was happy there but it was only a temporary place as they needed his bed, so he was moved to the only place available at the time. I read the most recent inspection report and it had a pretty glowing report (recently done) . So although it was a 75 minute drive each way we felt go they could getod about the report. Sadly, as time passed, my dad started to look unkempt. His clothes were stained, and sometimes not his, he had not been shaved for a few days and sometimes had an unpleasant odor. We tried to tactfully raise concerns but the staff reacted badly, so we were worried if we continued to raise concerns they would treat my dad worse. Most of the staff did not seem happy doing the job of caring and I wondered why they chose that career. Perhaps it was the only job they could get? It makes me feel that there needs to be better screening – not just exams – but also values. Luckily we have now found a place in the south closer to where we live.

My mother was put in a care home to give me a break for what was supposed to be a week,my mum suffered with dementia Whilst in the care home she had a fall which left her with a broken hip she had been left unattended she was in hospital for weeks,she was then transferred to a special care home that deals with people with dementia bearing in mind she could now no longer walk or stand I visited her every day her Clothes were dirty and hadn’t been changed from when I lasted visited, her dentures would absolutely disgusting her hair had not been done she smelt,I asked them to give her a bath and they informed me the bath was broken. The last straw was when I revived a phone call in the early hours of the morning informing me my mother had had fallen out of bed cutting the head wide open her face was black and blue,there was a cover up on how this had been allowed to happen I was told by the nurse on duty at the time what really happened,I completed to the home also social services and was told the home had been cleared of neglect Even though I had photographic evidence

My mother was living at home, with help from carers twice daily, aged 99. She fell & broke her hip and as part of her recovery was put into a care home just before Christmas. She was fully compos mentis but contracted a nasty flu type virus soon after admission. The radiator in her room was broken so they gave her an electric fire propped up on a house brick as it had a broken castor. They didn’t bother to encourage her to eat or drink, didn’t help her to the toilet. They catheterised her and put her in nappies for their convenience. I visited twice a day to help her eat etc. One morning I arrived early to find her completely naked on top of the bed, on a freezing cold day in early March with the windows WIDE open and a nurse who said she was washing her! It wasn’t long after that she died of pneumonia. I believe that they hastened her death…..

Graham says:
29 November 2017

Like Marion above I have worked in a care home,I know it was just for a couple of months on college work experience scheme but it was long enough to see that the whole system is in real trouble.my co workers at the home were wonderful and did their very best ,but the managers were always looking to refil vacancies as the job turn over of staff was and as far as I understand it ,still is frightening The staff,managers,and care users deserve better.

My mother was in a very fine retirement home in the South but she was becoming a little confused. The Home suggested they moved her to another of their homes, meaning my journey to visit her would be 8 instead of 7 hours. So I decided to move her North where I could visit more often. The only home which had a room was adequate, and all was well for a year when I visited once a week and she came to us for Sundays every week. Gradually I found the staff very young and frankly unsuitable and eventually I “heard” she had been taken to hospital. Apparently her bra had a rough place which caused a bed sore. No one told me anything about it. I was appalled when I saw it in the hospital and she died three weeks later, she was 89. When I was nursing, we CAUGHT the bed sores before they became bad.
Some years later my husband had dementia & Parkinsons, and after being hospitalized for pneumonia (it was high summer) I was advised to put him in a home so the hunt was on again. I did find one, a nice room with TV, en suit and I visited him daily. Sometimes I took him to the pub next door for a shandy and crisps or a walk in a wheelchair in the park near by. The mostly Philipino staff were charming and the food was good.
I am over 80 now and hope that second home will be still going strong when I can’t cope any more.

I have worked in care for nearly 5 years and in that time I have experienced and seen some things I wish I hadn’t. My first and worst care job was in a home where I started as a cleaner and then moved towards being a carer when I was of age. In my time there I can only imagine how many times I was made to run a floor of 25 residents, some nursing some residential, from basically 8 in the morning till late afternoon sometimes 8am till 8pm I was on my own with just one nurse on the floor with me. Me being the kind of carer I am i wasn’t going to let the fact that the staff were leaving on nearly a daily basis stop me from helping my residents, getting them up and ready for the day, having there hot meals and participating in the activities that were on that day if that’s what they wanted to do. What I never understood was with this manager who was 90% of this places problem, CQC would give her a warning about the inspection and basically prepare her so then when they came we had full staff all over, live entertainment, everyone (even people who don’t usually) were up out of bed basically being made to pretend they were having a great time when every single person apart from the inspectors knew it was total s**t. The training I received was minimal. There was one more thing before I finally left that place that I couldn’t quite believe, for the whole 3 years I was there the only thing I really felt was actually okay was the look of the home itself as it was very warm and homely. A few months before I left they began doing loads of work on the home, this included changing carpets and painting gradually which seemed like it would be a nice idea. They then decided ‘due to what I can only assume is called BUDGET’ they changed ALL lighting in hallways, bedrooms, bathrooms to bright white energy saving STRIP LIGHTS down the hallways and in every bathroom and then in the bedrooms put dimming lights that’s were also bright white energy saving. Now this may not seem like a big deal to others but the way I saw it was it was no longer warm and cosy and homely it was bright, cold and looked like an institution especially at night. And then you put someone to bed and try and leave them in a nice warm room but now instead it’s cold and dark unless they had a lamp which everyone did not! That happened just to save money, the whole tone of the home changed and felt even less of a HOME than it did before. Now if that don’t show you that even the big companies are lying and more worried about there pockets than the residents I don’t know what will. My manager came up to me once and asked ME to introduce HER to a new resident we had as she didn’t even know she was there?! I once did 75 hours in a week 6 days in a row just to help out and make sure my residents were okay as we didn’t have the staff and for a long while we weren’t allowed to use agency so what choice do people like me have when we really do care about these people. Carers get slagged off and under paid and i think enough is enough now, how can we be more interested in putting 5 million quid into a painting or something totally irrelevant when we’ve got carers and nurse all over the UK working there absolute a***s to the ground for one of the worst incomes anyone can get! If things don’t change soon even people like me will give up despite it being the job they love and are passionate about unfortunately the hours you have to put in just in order to make ends meat is too much for anyone especially considering the physical and emotional work we do, it’s draining and tiring! This is my story and I want nothing more than health CARE treated with exactly that, care, respect and dignity the three words you learn before doing any care job and yet the carers and nurses are given if anything the total opposite. Help change this, spread the word

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My parents actively engaged in what they believed was a Social Contract between The People and The State. Many promises from successive Governments confirmed that the sacrifice of National Insurance payments on top of the myriad other Taxes levied was for the common good and would ensure a civilized First World treatment and care during and especially in later life. The reality is that there is now insufficient funding for the elderly and elderly mentally impaired. How can this be after 3 to 4 generations of contributing to this funding? Nobody in Government is accountable, nobody in Government has the courage to address the problem and the system of care assessment is designed to create an adversarial battle between minor State officials and the relatives of those in need of care, it is more than time that this issue was brought to the fore and I wish you well in your campaign. The State has broken The Social Contract and needs to be brought to book for its offences, party politics does not represent the people and divides their collective power in a wasteful and (based on the televised standard of debate in Parliament) a childish and simplistic way but while we have it the search for funding to deal with elderly care is a definite vote loser, so who will take it up under this current political format???

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My 93 year old mother fell down the stairs earlier this year and was hospitalised for several weeks with a smashed knee and subsequent infections. She was totally bed bound and when they deemed she was fit for discharge they informed the family that they had arranged for a temporary nursing home. We objected to this as the home in question was poor on CQC ratings. They found another which was worse, and has since gone into special measures. They threatened my mother with eviction from the hospital if she did not agree to any home which they designated, even if deemed unsatisfactory on safety grounds by CQC. This was very distressing for her and us. It was obvious that finance (lack of)was the motivating factor in the choices on offer. We were made to feel troublemakers and told to ignore CQC ratings, but we held out and she was eventually moved to a nursing home which was adequate for her care. When funding ran out she was sent home, still immobile, with an inadequate care package. She is often left distressed because of late medication (a controlled, strong opioid), in wet inco pads (she isn’t incontinent if she is lifted onto commode) and there is often no time to wash her. Sad way for her to end her days. I do not blame individual care companies, or nursing/care homes. The problem is that the care industry is privatised and I do not see how profit can be made from the sick, elderly and vulnerable. There is a huge lack of funding primarily to pay for sufficiently trained staff, and in our rich country many people are ending their days with a dreadful lack of care and dignity.
I have no doubt there are good care homes and companies out there, but in my experience they are few and far between.

P Lawson says:
30 November 2017

My grandfather was put into a care home on discharge from hospital.
The window was propped open with a toilet roll. He was left with no covers on him, I had to cover him and wrap him up when I went. Every time I went he was half way down the bed with bent knees and no-one pulled him up during the day. I had to do it myself.
Because he couldn’t go down for meals, he was left until the end to be given his food. It was always cold.
Then, the worst thing of all, a paper notice was stuck onto the bathroom door saying ‘do not use’. I asked him if anyone had told him why and he said no, he didn’t even know it was there. The bathroom was full of bees, dead and alive. I was later told that the problem had been sorted…but it was still full of bees!!
Despite bringing several issues up with the person in charge while he was there, nothing was ever done. He was basically just left. It was an awful, awful place.

My wife is now resident in a local care home . I must stress staff are excellent . .As husband I am consulted at every stage of Catherine’s care including being telephoned if an out of hours doctor has been called . Where Catherine is in her bed staff check frequently on her and if required turn her i her bed . The home also arrange activities to stimulate residents .

Hi my brother in law was recently in a care home until the day he died. The care home was in Swindon and although he was well looked after and it was very nice it was also stupidly expensive over £1000 a week which is probably the going rate. But we have paid our taxes and national insurance all our lives then at the end you have to pay extortionate amounts when you most need help. This used to be Great Britain not so sure now.