/ 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 complained about a member of staff being very rude and aggressive to me, after twice finding my friend neglected, and had no response from the care home. The next day at 9pm at night the police visited me to tell me I am now banned from seeing my friend, whom I have known for 30 years. I am his only regular visitor, In my opinion this Man is being denied his human rights, and I believe he is being mentally abused.

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I doubt it. And I’m curious: as far as I know the Police can’t ‘ban’ anyone from visiting a friend, and they certainly wouldn’t call round to tell you unless they had extremely good cause.

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I believe there are only two PsOA:

Ordinary Power of Attorney (OPA)

This covers decisions about your financial affairs and is valid while you have mental capacity. It is suitable if you need cover for a temporary period (hospital stay or holiday) or if you find it hard to get out, or you want someone to act for you.

and

Lasting Power of Attorney (LPA)

An LPA covers decisions about your financial affairs, or your health and care. It comes into effect if you lose mental capacity, or if you no longer want to make decisions for yourself. You would set up an LPA if you want to make sure you’re covered in the future.

However,there are two types of LPA:

– an LPA for financial decisions
– and an LPA for health and care decisions

That last – the LPA for health and care decisions – covers health and care decisions and can only be used once you have lost mental capacity. An attorney can generally make decisions about things such as:

where you should live
your medical care
what you should eat
who you should have contact with
what kind of social activities you should take part in.

You can also give special permission for your attorney to make decisions about life-saving treatment.

The crucial aspect is that this has to be done while you’re still cognisant. But it’s simple enough to do and, once done, the holder can permit visitors almost at their discretion, unless they threat the safety of the resident.

So I’d argue that very close relatives need to think ahead for what might be.

Under the CQC’s “Information on visiting rights in care homes” care homes are not allowed to ban visitors without good cause. The causes listed are where the visitor or visitors may pose “a risk to a resident’s safety”. It’s how that is defined that may well be an issue.

Visitors who scream and shout, for example, could well be considered as frightening and thus a danger to the health of elderly residents.

This is far from easy as a topic, and it seems very clear that it’s certainly not all one sided.

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As explained above, Duncan, not having the right LPA can be an issue, but it’s easy to do, providing people think about things in advance. The case you mention might never have happened had the complainant thought about things in advance and prepared.

And you’re making an allegation there that can open you and Which to legal action, and which I doubt you can defend.

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I don’t know why you have quoted me in your comment above, Duncan. I am not an expert on powers of attorney but do believe Ian is right and that this is not legal chicanery [or deviousness as you have subsequently suggested].

You are commenting on a story that has been reported in Which?. Are you able to give the reference so that we can look it up? If not you might be relying on your memory of the article or report and that could be selective. For instance, I am surprised that you said that the care home held the lasting power of attorney. That would be extremely unusual unless there were no living relatives. A lawyer drawing up the LPoA would probably question such an instruction.

I notice you have quoted me again, Duncan. The dialogue you have been having about LPoA’s was with Ian, not me – check the time stamps!

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And the Which? guide to choosing care references LPsA in detail, pointing out what I’ve said above: think ahead and get an LPA in place before you need it. Easy to do, no cost and anticipates all the hassles. If you don’t do it, then it can be very expensive, as you’d have to go to court.

I am not complaining that you have misquoted me, Duncan. You have been addressing me over things I have not said as I was not party to the dialogue you were having with Ian.

I certainly do not want to see the comments posted by residents’ relatives banned by Which?. But it is fair to point out that that out of context of date and place, and with little verifiable evidence, they can only be taken as background information. That does not diminish their importance but it does mean we can’t draw conclusions.

I compiled a report and submitted it to the CQC. Their response was that they couldn’t ‘take up individual cases’! So who do we turn to? My old Mum is now in another care home that is superb.

This type of disgusting behavior happened to a friend of mine a couple of years ago. Her dad suffering extreme Parkinsons disease had pneumonia and the staff at this foul but now closed down home were asked to sit him up in bed as he couldn’t breathe. I was on the other end of the mobile phone being a retired registered nurse and could hear everything being said. I even spoke to the so called nurse in charge trying to convince her to sit him up. I was told to ‘f*ck off you c*nt’ by that nurse and my friend was then threatened with physical violence and thrown out for supposedly causing trouble . Upon getting back home and very upset, the police arrived and cautioned my friend as the home called the police to say she was causing trouble. I spoke to the police officer on the phone as I live miles away and told her what had happened as I witnessed auditorily. I was told by the police woman that I was a liar as nursing homes are places of safety and cautioned me also…………… I worked for the NHS for over 30 years and I am totally dismayed by what is happening in these private homes and parts of the NHS.

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Sue says:
22 April 2018

The Relatives and Residents Assciation has a Help line, it is a Fantastic national charity that helps to advise and listen to distressing situations like this.i do not have the number to hand it is on their website. Manned from 9-5 Mo day-Friday
They provide written booklets too. Do contact them

So many people are met with this response, including myself, and even my two teenage children. Their Mother had been on respite in Whittington House, Cheltenham, for 3 days and resulted in literally bleeding sores resulting from failing to change her pads. She is 48, has MSW, dementia and unrelated advanced cognitive impairment. Cheltenham social services, safeguarding and CQC failed to follow-up on these concerns. This was not the 1st instance of poor care, we have been subjected to consistent poor care from four separate domiciliary care providers in this area. Eventually, I created a FB page, hoping to ‘persuade’ care providers into communicating and engaging when people share concerns.. After 9 months, there is a clear improvement, still slow going, but nevertheless, improvement.

Good morning
I am so sorry to hear you have been banned from seeing your friend. I am so worried about this factor as I have made numerous complaints regarding my mothers care in a Care Home in Yate, South Glos. The staff (senior and manager) tell the most dreadful lies and make up stories that South Glos Safeguarding have believed. Even though my mum was admitted to hospital. Care plans are not adhered to. But it February 2018 mum fell yet again and broke her leg (she has dementia and hardly any mobility) But this time I took photographs of where she was laying on the floor and took photo’s of the whole room and interviewed the staff. The Manager and RGN’s said she had walked herself. I managed to prove this was not the case. So I was at least taken seriously. Another thing I would really recommend, is the implementation of a communication book. You write your concerns and complaints in the book as well as making verbal complaints and then photograph the entry and make a note of the date and time and who you have spoken to. This has been invaluable as it is proof and has been proof of poor and inadequate care and has been taken up by the CQC as the poor care has not been rectified. Its a battle every day. These poor souls cannot speak up for themselves, as they have no memory of what is happening or what has happened. They and we are taken advantage of in every way. I am disgusted and deeply hurt. My poor mother who has given us every bit of her life and love should end up like this. You must get on to the local authority Safe Guarding and find out who is the Social worker. If you feel that there is abuse, contact the Police.

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Its time to think outside of the BOX in relating in how and what is needed, People have the need to know that they still can contribute to their Community and those around them, not discarded, They have so much knowledge,wisdom stored away to share with those around them,grant them a listeners ear, and see what joy you will give and receive.

Hi. My mother in law had to go into a care home we were told by doctors they she only had a couple of weeks to live. She was 100 years old. The care home were fantastic. I cannot praise them enough. She saw her 101st birthday. They laid on a party and arranged for her brother and his carer to come from Edinburgh. I know this is rare but true. This is how they all should be.

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It’s nice to hear a positive for once. Usually positives are a minority,, Decent care homes do exist, as do professional carers.. “Individuals” cause problems, sorry to say, but usually it’s poor management. Of 15000 followers on my FB page, I think the majority would agree.

Care Home critically understaffed. My mother was kept waiting one hour for the toilet while 30 other wheelchair residents were taken upstairs from the lounge, undressed and put to bed by 4 staff, working in pairs. Daytime, the lounge- c*m- dining room was silent as 30 residents stared unsupervised into empty space. There were no activities, just one TV, left on one channel all day.

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I agree that this represents a complete failure of care.

It would be interesting to know in cases like this how long ago it happened, whether the local authority or the Care Quality Commission investigated it [and with what results], and what reports or action have been undertaken.

It seems to me that the fundamental deficiency here was the understaffing. If staff are under acute pressure then the quality of care will be seriously affected and it will become highly detrimental to residents’ welfare. These are important points that CQC inspections are supposed to assess. It would be useful to have the name of the establishment so that we could check on any inspections and outcomes.

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People might not be happy to do this, Duncan, especially if posting under their real name.

Here is a link anyone who would like to look at CQC reports for care homes: http://www.cqc.org.uk/what-we-do/how-we-do-our-job/inspection-reports

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Agreed. I don’t think people should identify the care home if they report adversely under their own names, but if their report is complimentary then I can see no harm.

Bad memories last a long time and my concern is that some of the reports that come in are for situations that occurred some years ago. The establishment might have since closed, or now be under different management, or have been corrected as a result of CQC or local authority intervention, so an old report might create a false impression of the particular place or give a distorted picture of care homes generally. On the other hand, unless we know the relative timespan for these references it is difficult to make a responsible judgment and all too easy to condemn the whole private care homes sector without justification.

I think it is because of the experiences described in comments here that the CQC has become more penetrating and more open in its inspection results so that the public can see what they have found and compare it with their own experiences. Longer and more competent inspections have made it harder for care home managements to “deceive” the regulator. Nevertheless, even a three-day inspection by five inspectors will only ever be a snapshot. Personnel and practices can change for the worse as much as for the better so the frequency of inspections is critical. Repeat attention, rightly, focuses on those that have performed badly but others with good reports might start to fall back. Understandably, many with family members in a care home will be reluctant to complain to the CQC or the placing authority for fear of reprisals [even though there seems to be little evidence of such action, but then there wouldn’t be if few complaints are made; it’s a circular dilemma].

Hopefully, the higher profile of the CQC will give more people the confidence to report problems and prompt official investigation.

I am not sure if Which? is the right place, but there does seem to be a need for a support organisation for the funding relatives and next of kin of care homes residents, many of whom are becoming elderly themselves or might not have the confidence or experience required to take on a care home management. Two conditions make this difficult: one is that private care home managements seem to be a tough, case-hardened breed who keep their compassion well concealed; and two, it can probably be very stressful to pursue a complaint. The care home management’s mentality might be that if they can stonewall long enough the problem will go away due to natural circumstances or the wearing down of the complainant. Generalisations are dangerous and there is probably a good side to the sector so that overall it is more than satisfactory with a small percentage of rotten apples in the barrel. We don’t hear much about the good places, unfortunately.

Duncan – We would not be having this Conversation if there were no problems. I do not have much experience but I don’t believe that CQC reports are a waste of time. Inevitably, staff may perform better when they know they are being watched, so unless the person in the care home has their wits around them then we are dependent on family and friends reporting problems. Other than having CCTV in every room I’m not sure how identify poor practice, but maybe that should be done where there have been allegations.

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Duncan, I am not joking. Almost everyone has some compassion – for their own loved ones, their pets, and so on – but I think there are care home managements that, possibly due to circumstances in a difficult working environment, do demonstrate a compassion deficit. They might not be pathologically bad people, or evil people, and as employed managers they might not be particularly well-paid themselves. But they are struggling to make ends meet for their establishments because local authority funding has been cut back and all they can see is an oppressive inspection regime that they perceive as making their life even more difficult instead of raising standards. Some school teachers have a similar mindset.

There are hundreds of thousands of residential care homes and we have seen reports about a tiny number, unknown and undated. It is irresponsible, in my view, to come to a conclusion about care quality and standards on the basis of such a small sample – especially when we cannot put the information into its historical context: it might be last week or a decade ago, we just don’t know.

We have to rely on the CQC to examine and report on care homes and their assessments are our only competent guide. They say that the overwhelming majority of homes are satisfactory; this means that only a tiny percentage are not and those are being dealt with. The CQC make it perfectly clear that their inspections are unnanounced so why you contradict them I do not know. You need to explain the basis of your rejection of that statement in terms of today’s experience, not that of some unknown past period. As I have tried to emphasise previously, we owe it to those who have family members in care homes or are trying to find a suitable placement to establish the unemotional truth and help them to find the right place for their relatives, not paint the whole sector as a bunch of wicked vagabonds and thieves. I know from personal experiences that that is not the case by a long chalk.

I am sorry you take no notice of official reports, Duncan. I am afraid that discredits your ability to comment responsibly on this important issue and does not help those in care or going into care.

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Why is the US being brought in, yet again? It has no relevance to this topic. And you aren’t reading what John is posting. He didn’t say what you alleged he did.

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Duncan – I can sympathise with your reactions to things said in this Conversation and can understand how your real life experiences have affected your attitude. It must make it very difficult to be objective. Objectivity does not imply a lack of compassion, however, or unjustified support for one side of the argument against the other.

We are where we are with care homes. We cannot rewind to some notional time when things were different. The population has changed, the financial and physical resources have changed, and the regime has changed out of all recognition. My view is that things are getting better as a direct result of the greater empowerment of the CQC and its actions against inadequate care homes.

I was in my forties when my parents were needing care; today many sons and daughters are in their sixties or older. I think that does make a difference in how they perceive things, especially when care home managers and staff are one or two generations younger. It might be interesting to explore and develop this dimension.

You have said previously that you “stand toe to toe – arm to arm – with ALL the British public suffering under this for-profit ‘care’ home business”, and I applaud your efforts. I hope you are satisfied with the results of your endeavours since all this pressure is certainly making a difference, although there is always room for further improvement.

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Care homes now are big business and what does business always put first ? Not those who supply the means to give them profits they come last WHO every time ? Small concerns look after those who provide them with money because without income the small business would be no more as many now are because of business taken away by large businesses who offer cheap deals to persuade people to buy or use them

back in the day when i needed to approach a car home, i had dune my home work, made a care plan of what was most important to the member of my family, i was shacked to be told by the care home, the plan was not sustainable as, it was fare to person centred .??
hence ,, i approached my local authority and requested an assessment of personal care this resulted in a personal budget where the family employed carers the member of our family lived in her own home haply for the rest of her life .

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There is something very frightening about having to go to a care home or seeking a care home for a relative. From my experience which is too much to go into detail right now so I will make it brief. For me its about the people who run care homes. The question is are they only in this business to make money? The costs involved are extortionate in exchange for very poor value for money and a point I would like to make here is don’t be impressed by a posh outfit with a good décor!! That could be a front for inadequate care. Its the people who run and work in the care home that can or cannot make the difference to proper care being delivered. I always feel that the staff and managers don’t really care and lack the true empathy required to care for people. Obviously everything costs money and you don’t get anything for nothing. But surely if you have worked hard and paid your taxes all your life then surely you deserve to live your final years in an environment surrounded by people with real compassion and understanding of sometimes complex issues in caring for people. There seems to be a complete lack of knowledge particularly with mental health issues such as Alzheimer’s and vascular dementia. I’m not saying all the staff are incompetent but the majority are!!! There are some really good carers and I wish I could say that about all of them. It appears that because the wages for carers is poor then it attracts unskilled people who perhaps cannot get a job elsewhere. In other words it attracts the wrong people. That needs to change and quickly. The industry needs to be more transparent and scrutinised. Staffing levels need to increase and it needs to recruit people with empathy. A more thorough recruiting process. Perhaps exams and practical ability assessments before being offered employment. Basically the industry needs a complete overhaul. Its scary…I hope I never need to go into a care home because they are not care homes they are prisons. Anyone knows that when you are ill the worst time of the day is night time. This is when you can feel alone and vulnerable and frightened. Yet patients are left for the longest period over night without seeing a sole. Why????? This is when they might need more care.

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The question seems to be whether residential care homes should be operated by business types with career ambitions, accountancy and management skills, and one eye continuously focused on the bottom line, or by more empathetic people from a caring background who are entirely resident-focused, or whether it is possible to have the best of both worlds.

In previous Conversations on this subject I have proposed the establishment of a national college of social care to provide a hierarchy of training and qualifications, a set of national professional standards, and a standardised disciplinary and regulatory framework for all workers in the sector. One objective of such an institution could be the development of a management pool that did indeed offer the best of both the managerial skills required to operate a care home to meet its commercial requirements and the sensitive and resident-focused attributes necessary to ensure a safe and life-enhancing quality of care. It would take time before the results of such investment bore fruit but it could be a good way forward,

I have found in any industry people who started at the bottom level and worked their way up to the top know how to run their business ,they have seen all the problems and know what to when one arises .When accountants run the business all thy see is money and profit for the shareholders Many businesses have failed because the people running them have very little idea of how things work so do the wrong things Many a nurse could run the NHS better than it is run now because they know the problems faced by those actually working in it not someone who all he or her knows is what they were taught at where? “university “The university of life is the best place to learn most things Big is not beautiful it can also be the worst thing Big concerns think the can do not wrong and just what they like without question

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Well, a residential care home that failed to make a profit would be heading for closure with untold problems for the residents. There has to be a balance, so financial and managerial skills are needed alongside compassion and domestic management skills.

This Conversation is not about nursing homes or NHS establishments where the balance might be slightly different. The NHS is so massive and complex that it has to run in accordance with many layers and divisions of budgets. Clinical professionals and nursing staff frequently complain about budgetary control but it is absolutely essential and, actually, strongly in the interests of patients.

The allocation of resources is possibly the most critical [and most criticised] function within the NHS and, so far as I am aware, involves clinical specialists and health care professionals at every level alongside the management and financial personnel. This is what distinguishes it from strictly private hospital services which, as one would expect, go for the most remunerative procedures irrespective of their overall priority and contribution to public health, and seek to attract only wealthy patients who might be susceptible to up-selling techniques in terms of the accommodation and comforts provided. Whatever this country does I hope it never lets the NHS go down that road.

A business has to make a profit to survive, and to do so requires considerable financial knowledge, provided by specialists – just like specialists deal with other aspects of the business, such as design, manufacture, sales…. Part of a team. Financial discipline is crucial, and our public services would benefit if it were observed more widely perhaps but, of course, they cannot go bust so the pressures to survive are not present.

It is the finances above the care homes that are extremely questionable.

https://www.theguardian.com/news/2017/nov/08/private-equity-terra-firma-care-home-four-seasons-loan
It appears that Four Seasons was made to borrow £220m from its owner Terra Firma at 15% a year interest and in November had a debt of £540m.

In December Four Seasons had to find £26m interest repayment on the debt.

https://www.theguardian.com/business/2017/nov/15/debt-laden-four-seasons-health-care-suffers-275m-loss
Four Seasons suffers £27.5m loss but blames local authority funding cuts and Brexit-related nursing shortage. yeah right

These financial engineering vultures are guaranteed a permanent supply of the product (i.e. our old folks) that brings in a guaranteed income. Until our care homes are removed from their greedy clutches, they are not going to improve.

You are right, Alfa, and because public money is heavily involved, even in these private businesses, there ought to be much greater financial scrutiny by the placing authorities or the government auditor. I suspect that one of the problems is that the normal rules of public sector procurement do not apply and getting a place in a care home is a question of a council officer telephoning round the local establishments until a place is found. Maximum relief is then experienced and the question of undertaking due diligence on the company running it fades into the background. I could be wrong of course.

It would be interesting to know why the company’s auditors allowed deficits to develop in the Four Seasons case, and why the directors were not warned about trading insolvently. The controls on big businesses are clearly deficient. These situations did not occur overnight and must have been building over a number of financial years. Did anyone or any organisation responsible for overseeing the sector actually read the financial reports and notice the warning signals? It is no part of the CQC’s remit so where does it belong? I think the answer is the shareholders, but they are an incohesive group of investors who are more concerned about damage limitation for their share values than the interests of their customers. Have the directors suffered any adverse consequences arising out of this collapse?

Did you read my previous post John?
https://conversation.which.co.uk/health/care-home-contracts/#comment-1523716

Googling:
who owns…(a care home group)
group debt
owners of the private equity companies
who benefits from the debts

turns up a whole web of financial trickery with layers of multiple companies formed to hide their finances.

We keep hearing how care homes are run on a shoestring, when most of their money could be paying off massive debts loaded on them by the greedy vultures at the top with auditors and accountants compliant in letting/making it happen.

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Duncan: the “Institute of Government” was set up by a Labour Peer – Lord Sainsbury, and is independent or slightly Left of centre.

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Business want profit nothing else Profit always is the first priority

Yes, Alfa, I did read your previous post in the parallel Conversation and I entirely agree with you. When private equity funds take over companies the only motivation is profit pure and simple, and they will do anything to maximise the profits, including loading the companies with debt, withholding tax, decimating the pension fund, paying the directors golden bonuses, and awarding themselves eye-watering dividends. Unfortunately, because they employ top lawyers and accountants, they have found ways of doing this legitimately, or at least not illegitimately. Their intention is to find the right moment and circumstances in which to beat a hasty exit with all the ill-gotten gains totally irrecoverable.

It has frequently been the case that small residential care homes have struggled to survive and eventually go under because their turnover is not sufficient to generate the money needed to pay for good management, well-trained staff, investment in the fabric and facilities, and full compliance with the regulatory regime. There has been a lot of consolidation in the sector and I think some operators [for that is what they have become] have grown far too big too fast and as an entity they are nothing more than an investment vehicle and this status infects the management and personnel. However, they don’t necessarily fail their CQC inspections, or have a bad care or safety record, or come before the courts for maltreatment or neglect. There are some very good providers in the mid-range of care home establishments, as well as some in the smaller range of just two or three homes.

Where the big companies, with several thousand beds, can make money is through the economies of scale in supplies and services, the sharing of resources across the group, and the ability to employ higher grade advisory and consultancy experts to steer them through the shoals and rapids. Unfortunately, if on top of all that there is a vulture culture feeding off the operation, and reducing its resilience, then the risk of a catastrophic disaster increases. And that is where we are in certain cases. But with no overall economic regulator I cannot see how this can be controlled; it means that the interests of residents and their families, as well as of the local authorities who are paying with our money to place them there, are of little concern to the investors.

This particular Conversation is called “Why is good care so difficult to find?” but I think the corporate arrangements, until collapse occurs, are not the only or chief reason for the difficulty in finding good care home provision. We might not like these convoluted financial mechanisms but is there much evidence that they are prejudicing residents safety and welfare? It is impossible to generalise and say that all big care home providers are providing bad care.

I think, Duncan, points to the major problem: the lack of funding for adult social care in its many forms and the adverse effect of that on profitability that induces the managements of homes at every level to take short cuts, employ fewer staff if they can get away with it, and reduce the overall quality of the services, unless they can force up the fees and charges and eventually control the market. That remains a risk to finding good care.

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The sad thing about this is the people who need care homes hospital treatment etc will have worked the best part of tthere lives and paid national insurence tax etc so should be able to have the care/ treatment thats needed. Im one of these persons thats worked over 45 yrs and pay in continuously you should be treated with respect and allowed the treatment you need without losing everything you have worked hard for i dread the day coming when i may need help myself and my loved ones. My mother in law needed a care home in her final days it was an horrid place she didn’t get the care she needed. Which is why i dread the day i may need one myself. Its time these so called governments started realising how much workers pay into there coffers and realised we are getting nothing we haven’t already paid for including our pensions that we have to work longer for these days.

Clive Harrold says:
20 April 2018

I have a friend who is in a care home. A very good one but it comes at a cost of £3500 per month. She can just about afford it using her pensions and savings and state benefits. She is fortunate but will face a problem when her savings run out. I am also a trustee of a local day centre that provides first class daily care for elderly people who are more able. All at a cost of only £30 per day. The local authority make very little use of use of us, and despite our best efforts to demonstrate how much better value for money our service is, and prevents hospital bed blocking,they still prefer to pay considerably more for home visits under their contracts, or for residential care when it would be better for the person to have some independence in their own home. There really is a lack of joined up thinking and it still seems to me to be a misuse of public funds where private contractors can make profits out of public funds.

Hello everyone, I wanted to share with those of you who have commented here that we’ve published a new discussion about our care funding investigation. Join the debate and share your stories here: https://conversation.which.co.uk/health/nhs-postcode-lottery-have-you-been-affected/

Whilst we have Governments, who, in the main, disregard, or give minimal thought to the poor, ill, the unemployed, then this situation will continue, if the have-nots, stay that way, then in time it becomes the norm, other Countries, have the will, and the know-how, to not let this happen, in some, the taxes are greater, but the care is fairer, and better,how do they do it,lets copy them, it is,nt magic, it,s more thoughtful, it,s called caring for your fellow man, or woman, I wish.

We seem to have a Trust Health Service rather than a National Heath Service. Care should not be a postal
lottery. The NHS CHC should be dealt with as laid out and help should not be withheld because the assessors are inexperienced or they want to save money so refuse help. I have MND and live in fear of needing financial assistance. I do not want to end my days in an inadequate Care Home that cannot provide for my complex needs. This Government must decide to either support those who require Care properly or agree to legal assisted suicide. The present situation is cruel.

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The NHS, we are told, should provide free health care regardless of who you are. Those working on the front line are incredible people who soldier on, working a system that is, frankly, doomed.

If the government ran the supermarkets providing free food for all then it’s easy to see that that would be unsustainable. It’s surprising the NHS has lasted the decades it has.

If we are to have a world-class health service then we have to pay for it from our nett income.

I witnessed terrible treatment in one of the care homes money can buy my friends brother was a millionaire and was financing her stay – she was coming to the end of her life with lung cancer but actually was bedridden with multiple sclerosis – the care home did not take any special care of her even though they knew it was her last few weeks – she was still mentally very alert and knew what was going on – her meals were out of reach for her to eat and she was not helped with meals, I fed her on many occasions, she had a broken window pain in her room and she was positioned underneath, when patient buzzer/alarm was pressed by other patients they were left ignored – even when one was on the floor – as they were doing the meals at the time. One of the carers argued across my friend in bed when I asked her about something – the majority of the carers seemed very hardnosed – they were all white British incase you are wondering which you wouldn’t expect as a previous post on here said we are a nation of dog lovers – so why can’t we find the same compassion for our fellow man. It seems to be a case of the biggest bully wins within the staffing team very concerning considering that this care home was owned by two consultants whom you would of thought would have more integrity. I would of liked to have considered being a Carer myself but could not be part of this sham. I am now a Carer for a family member in their own home and nothing is too much trouble – as I myself may be in their position one day but as long as I have my faculties I would fight tooth and nail not to go in a home – I have even made a lasting power of attorney already which did cost a considerable amount at a solicitors to ensure that I have made everything as straightforward as possible for myself and family should it be needed. Let’s stick togeather on this and make sure that all our experiences are heard.

Rita Potter says:
22 April 2018

A lot of care homes in Stockport are owned by the same company who treat their staff badly, change working contracts without discussion and refuse to allow unions to represent their staff. How can residents get good care when staff are leaving and the remaining staff feel disgruntled and victimised?

The problem is we no longer have a NATIONAL health service, just a local one run by grossly overpaid CEO’s, matrons were very good and a lot cheaper. Until we get rid of the expensive bureaucarcy and return those funds back to where it is needed and get local councils to fulfil their care roles then we will never solve this problem, regretably.

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As we all pay the same amount of tax ( short of being rich enough to to fiddle it, obviously), how come we keep letting our glorious “leaders” get away with this farce without giving them a serious kicking (looking at them funny being against the law now notwithstanding, obviously!)?

Petra says:
18 July 2018

My husband has recently had respite care in Shaw Home. Came home with clothes missing although clearly tagged + with other residents clothes! Why were they in his room?

Most concerning is that both legs/ankles blotchy scarred and bleeding with a form of infected eczema. GP said he has not had his legs kept moist with a skin moisturiser and were now infected. Also questioned why a gp had
Not been called been called previously and prescribed antibiotics. He is in a lot of pain from his legs and swollen feet.

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I wrote to my MP with a formula to make it fair, in the big picture of things, on everybody.I did this because the system at the moment is totally unfair.I will share the response with everyone shortly.
To start with, care homes need to be taken away from greedy for profit private enterprises and put into the NHS hands. By doing this, as anyone who is part of this forum will know, these nursing homes can just ‘Jack up” your loved ones care costs, not even in the parameters of C.P.I or R.P.I. I.E. my mum was paying £3,200 per month, the excuse for putting it up another £600 was, “Because we now have to pay the living wage “. What do you think of that?
I complained to my MP. I got a response from the House of commons, basically laying “it” at the door step of the local authority and the care homes to “charge” whatever.
Under the present system any money over £23,500 (approximately) goes to your care cost. Some councils can “whittle that down” to £14,000.
The majority of people will in “The big picture” pay a disproportionate amount.So, the answer is
fairness for all. 1) Put taxes up, or 2) up to 20% of your loved ones worth.I think either of these solutions would be proportionately “fair”.

Following the General Election in 2017 – where the Tory manifesto caused pandemonium on this issue because it was half-baked and upset many of the party’s own members – I believe the Prime Minister promised a Green Paper in the Summer of 2018 on the whole question of paying for adult social care. I realise the PM has been somewhat preoccupied of late, and I did not want to see another rushed job because it is an incredibly complex and controversial issue, but I think it is now about time the government set its stall out and explained what it has in mind before we go over the cliff, the race for which has now started. That, as Sir Humphrey was wont to say, was a courageous pledge.

Early this year I visited a dear friend of mine who had recently been admitted to a care home. I had looked after him at home as a neighbour for 8 months.
17th Feb, I visited with my partner to find my friend sat in faeces; trousers round his ankles, and wet up to his waist. Complaining of being sore. I reported it to a carer, who totally blanked me. On the following Tuesday we visited again to find him slouched in a chair with a pressure relief cushion half way up his back. He was wet, and his room had the most awful smell of stale urine. The various items we had taken in for him from his home were stacked round the room, had been left there some weeks. A telephone wire was stretched across the room causing an even more dangerous situation.
I tried to help my friend, when two carers marched into the room aggressively threatening me. Her words to me were.” If you touch ______ we will sue you for every penny you have. I was quite taken aback that one of the carers could speak to a member of the public in such a way. (I thought she must have been the home owner, she was only a carer) When I returned home, I made an official complaint to the home. On the Wednesday night following at 9pm, Police arrived at my home informing me I was banned from visiting.
At the time I had been working for a volunteer agency as an old persons visitor for 13 years. I am also a retired SRN.
I reported this to my manager. who informed Social services, they did an investigation.
It wasn’t until much later that I discovered by accident they were actually investigating me, and the home had accused me of Physically abusing my friend (whom I had known 30 years).
The home claims they reported me on the Monday. Yet did not prevent me and my Partner visiting on the Tuesday. I reckon if that is what they claimed they would not have allowed my visit on the Tuesday.
I also believe the staff at the home were writing false reports, by falsely accusing people of abuse, when in fact it was the staff who were the abusers, and covering up their own abuse.
Social services did their obligatory investigation, (not very well either) but found there was nothing for me to answer. Yet all my correspondence with the home and social services, has failed to give me any kind of apology. What concerns me is, If these staff wrote false reports and false accusations, they are breaking the law simply by making false reports on residents.
Apparently, no one is interested in investigating this home. I contacted Quality care commission, my MP. I contacted local ITV. The local paper, none of whom were in the least interested.
I am still in correspondence with this company, who have over the past 8 weeks ignored my letters to them.

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I agree with Duncan. I am surprised the CQC have not taken any action in response to your report. That is disturbing.

Is your friend still in the care home? I think the local social services authority should review his situation as a matter of urgency. He might need to go into a nursing home instead of a residential care home.

Try contacting the Chair of the Social Services Committee of the relevant local authority to bring this case to their attention.