/ Health

Medication left out of reach – home care must change

Our undercover investigation into home care unearthed shocking examples of poor care. Missed visits, forgotten medication and food left out of reach – why aren’t older people being treated with respect?

We asked older people and their families to record their care in a diary for a week. From a woman left alone in the dark for hours unable to find food or drink, to a diabetic man’s vital medication being repeatedly forgotten – carers were often found neglecting the needs of their elderly patients.

But there were some examples of good care, where our diarists reported carers going the extra mile to give excellent service, especially those with regular careworkers. However, a good service was often only provided after complaining, with some family members forced to make continuous phone calls in a battle with agencies.

Is poor communication the cause?

So what’s at the heart of the poor care we’ve uncovered? Can it be blamed on the agencies or the system itself?

The House of Commons Health Committee recently concluded that ‘the current social care system is inadequately funded. People are not receiving the care and support that they need’.

But some of the problems people are experiencing are more basic. In a separate Which? survey, poor communication came out as a big issue, such as agencies failing to let people know that their careworker couldn’t make a visit.

Nearly half of those asked said that at least one visit had been missed in the past six months. Worse still, six in ten had’t been warned in advance.

And poor communication can have a big impact on family carers too. One daughter told us:

‘[The agency] missed a day after Christmas. They incorrectly entered into their database the days we didn’t need care. I covered, but mum didn’t contact me until early evening by which time she needed a lot of clearing up.’

Are care agencies stretched to their limits?

Would it be letting home care agencies off the hook if we said that the system itself is broken, and that they are – as one manager put it – victims caught in a ‘conspiracy of silence’ and unable to challenge the council that pays them? Is the poor care we hear about simply down to these agencies being genuinely stretched to their limits?

Whatever the case, it’s important that the government tackles this issue before missed visits cause serious safety issues and vulnerable people become the next big headline.

Comments
Ken Maddison says:
26 April 2012

My wife passed away in March this year having suffered MS for 40 years during which time I was her main carer. We had tried local Authority care workers and agency care workers and were never able to find any that were any use at caring for someone who could do nothing for themselves.
The only time my wife was in a care home was for 9 days when I was hospitalised, and she was so bad when she came out I took legal action and the home settled out of court. It took me and a team of nurses 6 months to heal the damage done by the home’s neglect. The dog received better care in kennels.
The last time this home was inspected was in 2008, the year my wife was in there, and even though I sent all details to the CQC no further inspection has taken place.
I put a report on the new site-good care guide- to warn people how bad it was, but the owners of the site removed it as ” the home has disputed your report”?? Obviously they only accept good reports.
In all the years I have been a carer I have never found a home I would risk putting a dog in, and things will never improve while councils expect to be able to farm out social care to private-for profit- agencies at less cost than providing it themselves.

Gerald says:
30 July 2014

Dear Ken,

Why do you politicies the issue? in the light of the Mid Staffs Hospital you shouldrealise that that are Rogues in both the Public and Private Sectors.
Surely, having the years of experiance you have you could have done your homework better and choses a more appropriate Care Home, one which had a good track record and one which was properly staffed. Bye the way I have worked in the Private Sector for many years and had to sort out many legacies given to us by the Public Sector .
Why did you put your Mum into a Home which in your own words “you would no put a dog in” I wonder?

My wife worked as a visiting domiciliary nurse for old people for ten years, until she was diagnosed with Alzheimers disease. We managed with some outside help for five years, and she has been in a care home for the past year and a half, now bedbound and spoonfed. The home and the carers are wonderfully loving and professional, after a couple of early blips when her specs and teeth went missing.

Gerald says:
31 July 2014

Dear Zanwed,

Knowing the system you obviously chose well (and related to the levels of care needed) and had the sense to go to a Care Home which could deliver the service required.
Prehaps you could give others the benefit of your knowledge and detail a few Guidance Notes to help them acheive a satisfactory result.
Care at Home is NOT a replacement or substitute for 24 hr & 7day 365 days a year care in a Care Home , it is ,however considerably cheaper, people have to make their own decisions of what they really need or want to pay for.

Huw Jones says:
14 May 2012

My elderly mother has been received daily care visits in her own home by a local care company (One 2 One Private Care Services, Ashford, Kent), which she funded herself. Although most individual carers were good in looking after my mother well, they invariably stayed less than the time contracted for. When I installed a security camers that recorded arrival and departure times, and sent the results to the company requesting a meeting to discuss this, they immediately – with no notice – cancelled all further visits. I did not pick-up this email for several days, leaving my 94 year old mother bereft of care for those days. All registered care agencies have an obligation to investigate and try to resolve all complaints, but this company clearly have failed in their duty, as the Care Quality Commission inspector appointed to look into this matter pointed out to me. Oh, and the agency have failed to return my mother’s house keys.

shelokay says:
27 March 2013

You say the care workers didnt stay the whole allocated time.. but was everything done that needed doing at the visit? i wander if the call time was too long?

brian linegar says:
29 July 2014

I fully agree with the original quote from huw jones in this matter and I do not find it very fair that a woman of 94 should be left alone.

Brian Tout says:
2 June 2012

Recently, an elderly woman friend, who is badly crippled with arthritis, contracted pneumonia and spent a few days in hospital recovering. She decide to coplete her convalescence at the BUPA hospital at Little Aston, Walsall, having stayed there many times before and always been well looked-after. This time, however, it was dreadful. The room was COLD and the food was poor, with no choice!
When she protested she was first offered an extra blanket, and later a nurse found a portable heater..
Next morning, when she complained again the maintenance man came to see her to say that the central heating switched off because it was too warm outside (not true!) and she shouldnt have the heater because of safety rules. The charge for this”service” was £200 per day, reduced later to £160 as a gesture of “goodwill”. She discharged herself immediately, preferring to struggle on her own at home – with support from friends.
No member of management came to see her, and she was reluctant to say more at the time because she was unwell and also she was aware that many residents have dementia and might suffer if she made a fuss. Compare this account with the tone of BUPA’s Tv adverts.

To mark Carers Week, Joanna has provided a round up of some of the experiences you’ve shared here. It’s available at https://conversation.which.co.uk/consumer-rights/carers-week-poor-care-home-care/ if you’d like to continue this discussion.

Mary Evans says:
29 July 2012

Some private Care Agencies are not bothered about good client care, as long as they get the contracts that’s all that matters to them. Care workers who cover 24hrs shifts are underpaid by their agency,hours spent at the client’s house should not be classed as unmeasured work. Depending on the clients needs after assessment from Social services for a 24hrs care the agency can be paid between £1500-£2500 per client, per week from the Council then the agency will pay the care worker £50-£70 for a 24hrs shift, divided by 24hrs it is definitely below the NATIONAL PAY RATE which everyone is entitle too. where is the rest of the 14hrs money going? this should be classed as fraud. Surly the amount the amount the agency receives from the council is sufficient to pay the carer a decent wage also make a good profit for themselves, they don’t need to be so greedy.

Gerald says:
31 July 2014

Dear Mary,

The Council is responsible for the Contracts iwhich they enter into for quality and value for money and if you have evidence to support your statements I strongly suhhest you go to the Local Authority Ombudsman or even you local Councillor .If you really think it is FRAUD then you should got to the police. I am amazed that which? have allowed you to make this sort type of statement as they are normally against such blanket derogatory rants

RICHARD RADFORD says:
27 October 2012

Have you published any reports on the best firms to use who provide personal alarms? We are looking for the cheapest but good and reliable ones. Age U.K. ones are regarded as disappointingly expensive. I am enquiring on behalf of an elderly lady who may need to call for help at any time of the day or night.

ANN O'CONNOR says:
31 October 2012

I am currently with the third ‘care agency’ since April 2011. I am so disappointed with the quality of service. I do not know what to do next. Nobody is interested in helping to improve, not even MP… I will now pursue CQC but am concerned that current agency has not been inspected and judgements about one of the others.
I have kept a detailed log of good & so many poor events, some devastating. Who would be interesting in using this information?

Juliet Cottle says:
28 November 2012

I have contacted the CQC but not received a response; they only seem interested in the Ts being crossed and the Is being dotted! And, of course, it is all about the service the clients receive, not about how the care workers are treated.

Gerald says:
31 July 2014

Dear Ann,
You fail to say in what role you approached the three agency (worker or client) perhaps you could clarity and then maybe I could help to direct you.

Gerald says:
31 July 2014

Dear Juliet,

The CQC have enough work on their plate dealing with the NHS failings and complaints about the mistreatment of people (Seniors and Juniors) in Care .In spite if recent revelations with regards to Actions of Senior Staff cover ups of reports of serious incidents related to elderly patients of Mid Staffs Hospital I genuinely now that the inspectorate is becoming independant of councils and polititions etc we might get what we all want which unbiased, honest and fair reports .

The working conditions, pay rates and other employment issue are not within the mandate of CQC you need to got to ACAS or your Union (UNISON if you are a public servant) if you are in need of help in these matters

Juliet Cottle says:
28 November 2012

I have recently worked for a care agency attached to a local church; I was seriously disappointed in the larger care agencies as I could see that everyone would be stretched to the limit with little time to do anything of any import for each client, so specifically chose what I saw as a genuinely caring agency.

Unfortunately, the agency does not care about its employees, though they, naturally, think they do. Like so many others, I was expected to be available from, for example, 7 am through to 10.30 pm. I may only have about 6 hours’ worth of work during this time. All the running around was at my expense (this was not mentioned at interview) and I could be doing a 14 mile return journey from home 3, even 4 times a day; some days I was paying them to work! When I complained I was effectively constructively dismissed: Either you work the 3 shifts or we call it a day.

My last few days this agency broke several employment laws: I was expected to work until 10.30pm and be back at work 7.15am (both jobs were a good half hour drive from home), I was then expected to work from 7.17am through to 4pm without a break! My pay was paid almost 2 months in arrears – I would work, say all of September and this would be paid into my bank at the end of October. None of my pack packets ever equated to what I considered I had worked in that time.

When I left my employer thought she was being generous by paying me some extra days, when I became unable to work due to a back injury, compounded by their expecting me to hoover through someone’s house a short while later, after having enquired as to how my back was! I have no idea whether any holiday pay has been paid, it doesn’t state anything on the payslip.

All in all if the CQC were actually genuinely interested in the service these are issues they would be addressing, since, in my opinion, if you do not treat the workers with respect and dignity then there is every likelihood that it will impact on the service being provided. This does not seem to interest anyone and I am convinced that this is the road to success.

shelokay says:
27 March 2013

im curious at to what employment laws the agency broke?

With driving there is strict laws about end and start times, but this is professional drivers like bus and coach drivers..

i would like to see the exact laws you are refering to

Gerald says:
31 July 2014

Julliet,

You need to go to ACASS please read the opening conversation, I do not believe workers employment issues is mentioned ,The inadequacies of the Care at Home System is complex enough without getting sidetracked into employment problems.
Maybe your local Council might assist by making your employer price for giving Care workers a better deal and then ensure that they pay for it

shelokay says:
27 March 2013

Which talk about a woman left in the dark.. Is the family aware of timer switches? have a lamp or 2 put onto the timer switch and they will turn themselves on and off..
you can buy them in most hardware stores

brian linegar says:
29 July 2014

I fully agree with what has been said. In fact I have just sent in a complaint because it seems to me that as you past 70 yrs of age they seem to care even less. My gran has breast cancer and has been told that she needs a nurse to go in twice a day. The only problem seems to be that the night nurses don’t always turn up and because she takes “Warfarin” she bleeds from the area affected. Without the night nurse going in she gets soaked in blood. She will be 92yrs old in October. It is a disgrace that she paid in all her working life and is treated worse than an animal.

joyce hunter says:
3 April 2016

My father is in a nursing home in Penn Wolverhampton, he’s had so many un explain injuries, I have taken pictures, report it to wolverhampton Safe Guarding, Walsall social services that pay towards his care,CQC, Health watch, no one appears to care. the CQC will pass it on to Safe guarding, safe guarding ignored me for months,
His last injury was on the 11th march 2016, I was informed by the nurse that same day that 2 carers was cleaning him in the toilet and he slip off the toilet, new cross hospital stated that the wound was too deep for stitches it had to be glued,
I was so upset and angry that I put some of his injuries on face book to get some help, only to be banned by the home , on the 14th March, other family and friends try to visit and the home told them they cant see him, I went to the home on the 25th only to be told no you cant see your dad, I am worried sick for my fathers life in this home

Hello Joyce, my apologies for the delay in replying to you. I’m sorry to hear about your father, it sounds like a very frustrating and stressful situation for you.

We have an advice guide on how to deal with unsatisfactory care on our Which? Elderly Care website here: http://www.which.co.uk/elderly-care/your-relatives-needs/dealing-with-unsatisfactory-care

To escalate complaints and raise your concerns about a care home it’s best to fist speak with the care home, as you’ve done, then with the local authority. In this case, I understand that it would be Wolverhampton City Council’s Adult Social Care unit (telephone 01902 551199). You may also want to speak to the Relatives and Residents Association, it’s a charity that supports older people in residential care and their families, their contact details are here: http://www.relres.org/contact-us.html

I hope that helps.