/ Health

Forced to settle for an inadequate or poor care home? Too many are…

elderly woman

Our latest research reveals that some areas have more than half of care home beds in homes rated as ‘poor’ or ‘inadequate’. As Ann’s story shows, action is needed to confront the creaking care system now…

Ann, a supporter of our Care Needs Care Now campaign, told us about her challenging experience with her mother’s care home.

Ann’s mother was in a care home in Wiltshire for six years before she died. She was bedridden and had dementia. She needed help with eating and drinking and couldn’t ring the bell to call staff because of her condition.

Care homes don’t always care

What Ann’s mother really needed was a care home that cared. But Ann had numerous problems and concerns about her mother’s care – here she tells us about just a few of them:

‘When we had to choose a home for Mum, we visited three homes. One was like a dark warren and the room wasn’t very nice. We wouldn’t have wanted her to go there, or to the other one. Both stank to high heaven of urine. The one we chose was brighter with less of a smell, but being at the end of a corridor, she was reliant on staff who never came.

‘I worked as an auxiliary care assistant in the local hospital at the time. Luckily, my employer let me take long lunch breaks to visit Mum every lunchtime to check she was given her lunch. My sisters and I felt the need to visit daily because on two separate occasions, the staff simply forgot to give her any lunch.

‘Mum needed help with eating and drinking. She couldn’t ring the call bell because of her condition; she was reliant on the staff to ensure her needs were met without her having to ask. Her room was at the end of the corridor, so there never seemed to be any passing staff.

‘One November, when it gets dark at around 4pm, Mum was left without a working light in her room over a whole weekend, because the bulb had gone and the maintenance person was off! Staff didn’t even bring in a bedside light for her – they used the light from the en suite with the door open to change and clean her.

‘Soon after Mum moved in we noticed on several occasions an odd tablet on bedside table or the floor. Staff didn’t seem too concerned when asked about it, but they didn’t recognise the tablet either. Eventually one of the care assistants discovered that Mum had sucked the coating off the tablet and then spat it out.

‘Over the years, my family was concerned about the state of her room. There were some worrying cracks in the walls, yet nothing was done until we pointed out to one of the senior nurses that we could feel a draught through the crack. The nurse then checked to feel the draught herself – only then was the problem tackled.

‘My family felt trapped and tied to this nursing home because it was allegedly one of the best in town. We didn’t want to move Mum far away because then we wouldn’t have been able to visit so often or keep an eye on things.

‘Since Mum died, it makes me fear for my own future should I ever need a nursing home.’

Care Needs Care Now

Ann’s experience with her mother’s care will be a familiar story to many care arrangers across the country. Our latest research has found that nearly a third of local authority areas in England have one in three beds or more in poor care homes – find out what the situation looks like in your area here.

Thankfully, there are some areas where at least nine in ten care home beds are in homes rated as good or outstanding. Yet, as the demand for beds is set to outstrip the provision for care home spaces, it’s clear that more needs to be done to confront the creaking care system now.

We want the Competition and Market Authority’s care home market study to make strong recommendations to the Government to address both the current crisis and future stability of the provision of care in its upcoming Green Paper.

What’s your experience of care homes?

Does Ann’s story ring true with you? Have you found a relative’s care to be much lower in quality than you would expect – or have you been pleased with care homes you’ve encountered?

Tell us your experience below to help us build up an accurate picture of care home quality – and don’t forget to sign our campaign calling on the CMA to confront the creaking care system.

Comments
Liz H says:
30 November 2017

In my opinion the CQC rating for care homes and care agencies is only valid on the day of the inspection. After that it is possible for a service, which has been rated as “good”, to deteriorate but for the rating to still be seen by prospective purchasers, such as myself. I employed a local care agency which had a CQC rating of “good”. Initially they appeared to be attaining that standard but it became clear, after a short time, that the service was deteriorating. I feel that this also probably applies to care homes. I am currently trying to source a local care home for my mother and am trying not to be swayed by CQC ratings.
I agree with a lot of the comments on this page,particularly that pay and training need to be improved for staff . Also, management systems need to be improved to include regular supervision sessions for care staff; equipment should be installed to allow “distant monitoring” of clients e.g CCTV, smart technology such as bed,chair,floor and falls alarms; CQC inspections should be done on an annual basis.

Julie says:
30 November 2017

My father was in a care home in Glasgow, which was nearly closed by the care inspectorate in 2012 before he was admitted, but was ‘saved’ by the new owners/ management. My mother was happy for him to go into this home because my sister worked in it. I never liked it. The floor my father was on was basically a long internal corridor with bedrooms off it and a lounge/ dining room at the end. The windows were too high to see out. There never seemed to be enough staff on.
My father had vascular dementia and sadly passed away in this home. Seven weeks prior to his death he was assaulted by a staff member. The worker was dismissed and struck off, we were told. Police were involved but nothing came of it.
This weighs heavily on me.
My sister continued to work in this home until recently. She constantly told us of chronic staff shortages and care staff unwilling to do anything they did not consider to be their job, even when kitchen and cleaning staff were absent. She told us that laundry did not get done, cleaning did not get done and menus were not adhered to. She also talked about staff not turning up for shifts, calling in sick, leaving early and generally not doing their jobs without any form of commitment or genuine interest.

Christopher Taylor says:
30 November 2017

The Pensioners of NatWest formed a charity with donations and opened 3 brilliant care homes 36 years ago but sadly the Charity Commission allowed them to close in circumstances that were not transparent and still our 6 year campaign is yet to see them replaced. No lack of funds. So sad that those with the power do not always understand the bigger picture or take national needs into account.

Cardi says:
1 December 2017

The problem in this area is lack of facilities. The local council is currently running down [it will close by 31 March 2018] their only 1960s-built care home in a town of 20,000, as it does not conform to present day standards (e.g. size of rooms, en suite facilities, &c). There is no provision for dementia patients in this county and patients are sent to neighbouring counties up to 60 miles away, which makes visiting difficult for relatives.
I know of a husband and wife currently housed in two private homes 12 miles apart who are vexing for each other.
Another problem is the lack of staff who speak Welsh in some of the private homes. Many of the elderly residents are Welsh-speaking and tend to revert to their first language as senility sets in.

Anne says:
2 December 2017

As the daughter of an Alzheimers patient in Wolverhampton, the quality of good care homes for these patients when they are at risk of wandering is abysmal. We paid over £850 per week for the only physically suitable place, only for the number of patients to increase and staff numbers remain unchanged with the effect of my dad, and other patients falling. He spent his last month of life in a charity run home with 4 staff to 10 patients where the care was superb and about £200 a week cheaper. It is possible to run safe, effective care homes when the motive isn’t profit. That’s the fundamental issue

The UK care home sector is being propped up by self-funding residents and needs “significant reforms” to survive and grow, a study by a government watchdog has warned.

The report, published yesterday by the Competition and Markets Authority (CMA), pointed to a national funding gap of at least £1bn by 2025 and said many homes faced closure in the medium term.

Fees paid by councils to care providers are already on average 10% below costs, the CMA said. To plug the resulting £2-300m shortfall, self-funders were typically being charged on average weekly fees of £846 in 2016, compared to the average £621 per week paid by local authorities.

Hi Lauren,

Sorry, I hadn’t realized that Which were campaigning to get Care Homes Higher payments from the NHS and Local Authorities , I will pass om this info to my colleagues, it is really great to have your backing, this might explain why the CMA have, at last . endorsed our claim, that we are being underfunded by at least 10%.
All we have to do know is to canvass the NHS and the L/As to implement these recommendations.
Bye the way could you check out the legality of the NHS introducing “means testing” into the system

It is quite wrong that residents who must personally pay for their care home fees are subsidising those who do not, unless their care is inherently more expensive. Subsidy in this field is a job for the general taxpayer, either through national or local taxes, and not for a selected group of individuals.

Totally agree Malcolm,we have been saying this to the Local Authorities and the Health Authorities for years and have always been ignored, lets see what they will now do to respond to the new report .

veronica capaldi says:
5 December 2017

uOh I could write a book. The first home we chose for my husbands half sister, who is now nearly 90, didn’t tell us about a fall on a Tuesday, rang us on the Friday asking us to take her to A&E as she was “refusing to weight bear” – couldn’t get her in the car, & had to push her over a mile in a wheel chair in the dead of night on December the 16th (2016). She was rushed into ED, put on sepsis care, x-rayed & discovered to have two breaks in her ankle, which had probably been hair-line ones if they hadn’t made her walk on it for 3 days. Result was 15 weeks in hospital, (the hospital placed a Safe Guarding order on the home she was in) discharged eventually to another Care home as immobile for respite, and in just 2 weeks, ended up with 4 bed sores. We went around all the local nursing homes (by now it was a nursing home needed, not a Care Home) – only one had a vacancy, it was basic, but the 2 who came out to do the assessment seemed caring & because of the bed sores wanted to take her the next day – so off she went (in March 2017). After she was in, we noticed a distinct change in their attitude to us, no longer friendly & informative, but “they knew best”. We kept asking them to let her join others in the lounge, have meals at a table, but no, we kept being told she didn’t want to (not true). Eventually, she was never even dressed. For over 12 weeks, she lay in bed, asking us if it was morning, afternoon or night, in a nightdress, & had all her meals laid back in this same bed, causing a lot of sickness due to her hiatus hernia. I resorted to leaving notes out in the hope the carers would dress her. How can someone be so isolated in a nursing home with other people living there? It needed urgent action, so we started searching again & two local Nursing Homes had rooms vacant. The first Nursing home we asked to take her went to do the assessment & said their room wasn’t big enough for all the equipment (I wasn’t at the assessment, but apart for the occasional day when a hoist was in it, it was empty of equipment) – she had also been told our sister would go downhill fast if moved. The 2nd home, who I am so grateful to, listened to me, I went with her to the assessment. Our sister told her she was so unhappy, always in bed, never seeing anybody – she was very coherent and answered all the questions herself with no prompting from me. She is self-funding, so was paying all her hard earned money to slowly die of boredom. We moved her the next day. The change is unbelievable. She has bubble baths now (new to her). her hair is washed twice a week as well as the hairdresser every 2 weeks. She is up & dressed every morning, has her breakfast & tea in her room, in her electrically operated recliner chair, BUT – goes into the lounge in the morning with others every single day, has every 2 course meal with others in the dining room with her cuppa afterwards nattering with others. A few afternoons a week there is entertainment in the lounge & she is wheeled into the room for that. She has loads to tell us about when we visit – & we have so far (it’s only been 4 weeks) have asked them to get her ready & we’ve taken her out for a coffee morning where she nattered away to old friends, and 2 days ago, Christmas shopping with hot chocolate in a cafe. What I am trying to say – is the elderly NEED a life that goes on. It may be slower, less hours of being awake, but it needs to be a life. I’m so grateful I had the guts to cause a fuss, & move her. But there are so many Care & Nursing homes that fall into the category of the 1st two she lived in. It needs the biggest shake-up ever.

Dear Veronica,
Care Homes are not allowed to prescribe treatment, this is restricted to the GPs etc. , you have not mentioned this VIP surely they were involved.?

Shirley McGowan says:
6 December 2017

I am 74 years old and in good health. However, I have no money, live alone in a council flat, have no relatives, and no friends who live nearby. Thus, if my mental/physical health deteriorated where would I end up? It seems I would be one of the many festering away completely neglected and uncared for in a dark hole such as those described above. How could someone like myself avoid such a fate without the massive family and financial support some of your lucky readers’ relatives receive(d)?

Yes Shirley I understand and sympathise as my wife +myself would be in the same position. Maybe if she can get away from the stack of Brexit problems just now TM might post an answer to that , as this is caused by government dogma ? But until she does I would suggest help from the Salvation Army , one of the few decent charities left on this earth . Meanwhile , if it helps — a Merry Christmas from me and best wishes for the future. I know what loneliness feels like .

Dear Shirley,
Please do not fret, things are not all gloom and doom as some people would likes us to believe, there are many Organisations you could join such as the WI , etc. .Might I suggest that you phone a couple of Care Homes and check if they have any Residents who have no Visitors and offer your service as a visitor, this would offer you the opportunity of helping someone and at the same time getting the full picture of the Care available in your area.
Check with Social Services as well they sometimes organise groups , maybe some form of Daycare could be arranged for you with transport, the object is to get out there and see what is available.

Dear Duncan,
For once I agree with you when you praise the Salvation Army, I have many friends who are involved. Did you know that the SA actually runs Care Homes themselves and were kind enough to mentor me when I started 30 years ago.
Perhaps you would have a word with someone you know there as I believe they are suffering from the same under funding by the Local Authorities which applies to the Private Sector ( they also charge more to self funding clients)
I hope that you obtain a more balance view point from the above.

Hello Gerald I don’t “hate ” anyone its not in me but I will fight for the oppressed/ poor/sick + old until my death. While I think it is magnanimous of you to actually say something positive about me I am sorry I cant have more pf a “balanced ” viewpoint on this subject as I have read every single post on the many convo,s on this subject that Which have put forward for public discussion . many are heart rendering , I am not a cold /dry person I am, passionate and a person of action when it comes to righting wrongs and when it is Io defend old/ill people that I will do . If you could reply to those who post those horrendous stories instead of me and make them “see sense ” or tell them to be calm or say to them in the American idiom -**** happens ” I would think more of you . I reply to those people as I am deeply touched by their plight. don’t think for a minute that makes me “irrational ” I am not it just makes me more determined to right the wrongs happening to them . Nobody is perfect in this life including myself but I always lay my cards on the table there is nothing hidden about me.

It appears that no matter what anyone says, good or bad, you twist it.
There is nothing wrong with criticizing any system , I for one can give many bad examples of of treatment in the NHS and Public Sectors (eg. Mids Staffs Hospital Elderly wards) but I also reconise the good work that they do. I have been waiting for you to come up with a more balanced view,but it appears that you are unable to do so.
Your OTT approach is way over the top and I personally believe that you are doing far more harm than good.
Bye the way did you know that one of the biggest operator of Care Homes in the Marvellous German system is actually British ??

When you purport to represent a system/cause/business and project its positive points, in your view , while completely ignoring the devastating , painful, hurtful and human life diminishing of the very many posters relatives on this subject that have posted on Which you do with your arrogance diminish the power of suffering of those relatives in a seemingly damage limitation effect. Even one life lost through neglect, maximisation of profit , and treating human beings worse than family pets or animals in a zoo is to me outrageous and looks like a slap in the dace to those suffering relatives but you refuse to confront them , console them , give them sustenance at this supposed charitable time of the year but can only attack me for defending them says it all for your dogma/moral standards . To those suffering in tears over their relatives dying in this way I say may God be with you and may my Love go with you . If I could visit each one and comfort them I would , that is the difference between yiou and me Gerald .

As it is Christmas, could personal criticism cease and goodwill ensue?

When Gerald stops personally attacking me I also will desist from posting criticism of him- cause -effect/ action-reaction.he has a political policy to follow, I have a humanitarian one- never the twain shall meet

I hope Boris and Sergei are resolving some problems. It seems childish to have disputes with foreigners. Too much at stake.

I watched the conference on Ian,s favorite “hate ” news channel on satellite — they agreed to disagree blaming Russia for Brexit / TM bad election results / the German elections ( even though the German secret service absolved Russia – nobody told Boris ) the state of the country /bad weather / the price of Big Macs and fries/ TM,s bad election results even though when asked for proof ? – he changed the subject and said ah ! but we foiled them -yes sure . , but they did do it diplomatically -well they are diplomats -aren,t they ? America blames Russia for existing .

Well, as Malcolm has started an extremely OT thread, I’ll pick it up. I don’t have any ‘favourite hate news channels’; I do, however, have a list of sources that have been and continue to be utterly unreliable. They include (but are not limited to) RT, DFM, Fox, most tabloids and N Korea state news.

Even PEYE gets it wrong sometimes, but I prefer it to the rest. Do other countries have similar organs?

Sometimes I wonder whether they and Which? might collaborate on certain topics; they seem to have the means to drill down into interesting topics. Purple Bricks, Post Office, diet pills, Age UK insurance, and, on topic, Care homes and the CQC all featured recently.

Indeed, I wonder why Which? do not regularly do collaborative work with other organisations where they have common interests. Perhaps they do…?

I had to look up OT. I don’t really see the point of many acronyms. But I’ll interpret this perversley as on topic. it was an oblique comment to try to divert the Convo away from a personal dispute and back to – OT.

OT was OK for me, but not PEYE. Google then let me down, but I managed to think it out anyway.

Touche DerekP 🙂 Okay.

I realised what you were doing, but it was possibly a little too oblique for the intended recipients.

GeraldHudson says:
31 January 2018

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Peter says:
10 December 2017

please note that I am slightly dyslectic i can the spell checker not very good i am single my Father went to a home and lasted 7years we should able to choose if we to sleep because we get find we pet alive where they life I hope bye i may need help I will be able to end it.

Don’t apologise for being dyslectic Peter .

Gillian Simpson says:
13 December 2017

If you have no family then it is doubly difficult. My immediate family live in Canada and I am not married and do not have any children. We need more care homes which do not force you to sell your property to pay for the care but provide care in the home if at all possible.

Absolutely agree Gillian as provided for by the German social services and other countries under taxation..

These services should be available from your social services authority Gillian. My mother-in-law had daily visits from carers who got her up, bathed and dressed her, organised her laundry, did basic housekeeping, made sure she took her medication, etc. She had visits from her doctor to check on her condition, and the social, services department arranged chiropody, hairdressing, meals, and other personal services. We looked after the personal admin and payments and so on, and made regular visits, but she was reasonably well looked after all things considered. She died after a fall in her own home aged 89 – she didn’t want to go into a care home or an old people’s apartment as she enjoyed having all her things around her.

Patrick Taylor says:
22 December 2017

Just out of interest you may like to see how this matter of care homes in France was reported in 2014.

“There is also a law in France (in the Sud Ouest last week it was detailed in full .. following a TGI ‘trial’ of family members who had not paid for their elderly dependants’ care….apparently there are three levels of ‘crime’ (?) … one being refusal to pay, even if they have the means. 2 being the ability to pay something towards the care when the elderly person’s money has run out, and 3 having no income or assets of their own. It is a law in France that children must, if they can do so, pay the fees (after all, I suppose the law also says that children inherit the house, so that seems fair !) – I am wondering if one is an ex pat living here, if, when the time comes for the care home, the law applies to any children living in the UK or elsewhere ! An elderly man living in our village has just gone into the EHPAD (more of acare home than just a home for elderly – run by the state) and the Mairie have taken possession of his house, as he had no one willing or able to pay the costs, and the commune is now decorating it and doing the garden – not sure if they will sell it or let it out to a person with no home.

As Tricia I think it was, said, there was a case last year whereby the French authorities put out an appeal on the English speaking forums (fora ?) for an elderly man in a care home to find his long lost son in the UK. It looked as if this was for sentimental reasons, but in fact after the grand reunion the authorities slapped a bill of about 10,000 on him for the care of his father !”

Patrick Taylor says:
22 December 2017

” Germany has a rapidly aging population, and the cost of caring for the elderly is growing. A court has confirmed that there is a legal obligation in Germany for people to contribute to the cost of their parents’ care. Germans have a legal duty to contribute to the cost of their parents’ care once the individual’s own funds are exhausted.

The Federal Court of Justice in Karlsruhe upheld this law on Wednesday and ordered a man to pay 40,000 euros ($52,000) to his local authority for his deceased mother’s care home fees. The woman, who had been living in a care home in Gelsenkirchen for five years, had had no contact with her son for over 30 years. ”

Seems to me that there is a problem. ANd a partial answer:
dailymail.co.uk/news/article-2423559/Grandma-export-Germans-sending-parents-nursing-homes-Poland-cheaper.html

And I am aware that Thailand is also cheap.

These posts are for information. I am not proposing a solution.

The NHS also has a responsibility for fund the full cost of Care in a Nursing Home, due to changes engineered by the NHS and the Local Authorities many people are now having to pay under the means testing system .Which really need to look into this in depth because I really think that the public need their protection.

If by care in a nursing home we mean short term recuperation then I think the NHS should see it as an extension of a hospital stay. Ideally long-term care, where health presumably needs continual attention, should be regarded in the same way but surely the problem is one of finances – can the NHS afford it at the present time? My pragmatic view would be to ask those who can afford to contribute towards their care should do so and reserve scarce funds for those without the means.

One day, when we reduce spending on defence, overseas aid, for example we might improve the health care. Or we might cut management and transfer the savings to the front line workers.

Dear Malcolm,
The NHS Act does not differentiate with regards to funding the different terms or conditions which you refer to.
For at least 10 years my career the NHS paid for Nursing Home Care direct to the clients Clients needing this treatment and the clients then decided where they wanted to go. The referral to Nursing Home care was done by the clients GP or Doctors within the Hospital where the client was staying. In 1993 everything changed when the Conservative Party at the time gave the assessment process and subsequently payments etc over to the Local Authorities whereupon the Eligibility Criteria were introduced As far as I am aware Doctors and GPs were not consulted and these trumped up “Eligibility Criteria ” been adjusted many times with the sole purpose of making ordinary people pay for care which they should be entitled to free of charge.
The whole of this system is now run by Occupational Therapists with minimum input allowed by either Nurses or Doctors.
As I see it the system is being abused , but not by Care Homes, but by politically motivated Politicians (Left and Right) the Care Homes are just the little piggies in the middle as Duncan would say.
The real travesty is that all the conscientious taxpayers who have actually funded the NHS system for all their working lives, of which I am one, will now have difficulty in access the funding they have paid for. Can you imagine what an outcry there would there have been if this “National Health Insurance” Company was private?

Gerald, thanks for your response. Both national and local government have limited resources that they must decide how best to spend.

Stigma undermining care homes’ potential to improve lives, finds study
Culture of negativity isolates care homes from their communities and saps confidence of staff and managers, preventing good practice from being realised for residents, finds My Home Life programme.
by Mithran Samuel on October 25, 2012 in Adults, Care Work, Inspection and regulation, Residential care

The study stressed the importance of relationships (Credit: Monkey Business Images/Rex Features)
Care homes’ potential to deliver a positive experience for residents is being undermined by stigma and mistrust surrounding staff and residents, a three-year study has warned.

The My Home Life programme found a culture of negativity – fuelled by media reports of abuse – devalued the complex work that care home staff did and made some embarrassed to tell their friends what they did.

My Home Life good practice examples

Geoff recognised that he needed to come into a care home, but was grieving for the loss of his ‘book collection’. The manager decided they should endeavour to accommodate this, so 25 feet of bookcases were installed in one of the lounges. Geoff has catalogued the collection
and now acts as the librarian, supporting others in the home to enjoy it.

A care home is encouraging its older people to participate in writing
their own daily life notes, rather than this being carried out by staff. They have noticed how those older people who never complained about anything are now using this opportunity to communicate some of the things that are important to them and issues that have affected them during the day. These points are then responded to by the staff in a positive manner.

Source: My Home Life: promoting quality of life in care homes

Mistrust and isolation

“While we know there is lots of good practice out there, too many care homes experience mistrust from the community and statutory services which only serves to increase their feeling of isolation and reduce their capacity to deliver a positive experience for older people,” said My Home Life director Tom Owen. “Quality in care homes has to be the responsibility of the whole community, not just the staff.”

My Home Life, which seeks to identify and spread good practice in residential care, said it had gathered case studies that demonstrated how care homes could help older people regain a sense of identity, involve them in decision-making and provide them with choice over their support (see right).

Success was based on “relationship-centred practice”, in which staff and residents forged strong relationships with each other and with local communities.

Negative media portrayal

However, the report said the negative portrayal of care homes in the media and elsewhere isolated them from their communities and sapped the confidence of staff and managers to work positively with older people. This, along with the significant demands for information from regulators, commissioners and safeguarding teams, bred risk-averse practice.

“Constant bombardment from external bodies, lack of trust and support from both within and outside of the care home, and the fear that they might make a mistake, can all result in managers leading care homes from a position of defensiveness, stress and anxiety,” said the report. “Trying to control everything that is going on in a care home goes against the evidence of what constitutes good leadership, often resulting in staff simply taking orders from managers and a focus on getting tasks done.”

Recommendations

The report said changing the negative perception of care homes would involve strengthening the leadership role of managers, empowering staff and residents, and reducing unnecessary paperwork and bureaucracy.

Specific recommendations included:-

For care providers to allocate specific time and budgets for the continuing professional development of managers, and reflect on how their actions affect managers’ ability to deliver improvements in the home;
For managers to take responsibility for their own professional development and pilot more creative ways of engaging with older people;
For staff to have protected time to foster relationships with residents and their families;
For commissioners and regulators to assess the resource implications of new requirements for care homes in terms of paperwork;
For government to consider how duplication of monitoring of care homes can be reduced and commission schemes to improve residents’ access to advocacy.
My Home Life is funded by Age UK, the Joseph Rowntree Foundation, City University and Dementia UK. The report, which was released at the National Children and Adult Services Conference, was based on analysis of case studies, a review of relevant literature, and interviews with care home leaders.

Interesting comments Gerald. If we bash anything enough – energy companies, rail services, banks, campylobacter, diesel cars, state pension……….business generally…….we’ll successfully generate negative attitudes among the many who look no further than that type of reporting. I prefer to look at ways things might be improved, rather than moan about how bad things are (well, except on bad days perhaps).

Campylobacter is a very poor example, Malcolm. Our supermarkets are still selling chicken that is so contaminated that it makes many people sick and is responsible for some deaths.

The point I was making was we could recognise the positive ways we can, and do, deal with problems rather than just moaning about them. In the case of campylobacter, the food producers and the FSA were tackling the difficult problem of a natural bacterium. It is very difficult, if not impossible, to eradicate, but by researching and testing different techniques they have made great improvements but, instead of recognising that some still keep up their condemnation of the chicken industry. If they have a “magic cure” then put that forward.

It was taking up Gerald’s point (valid in my view) that continually running down an activity, such as care homes, creates in some minds an image of the whole industry that may be distorted and is counterproductive.

As a retired microbiologist I think I can claim a better understanding of the subject, in the same way that you know more than me about standards. Further discussion here would be off-topic.

Totalmoney.com- Annual amount spent in the UK on PETS £ 17.6 BILLION and zoos have better protection against cruelty than ” care” homes inc. How much would it cost to nationalize “care homes ” ? What makes anybody think the NHS ISNT being slowly privatised in England by starving it of funds even though HMG says they give “more ” when inflation etc is added its LESS ask the doctors at the sharp end . Want hospital treatment – asks receptionist to bleeding man -yes – then show me your medical insurance – sorry I dont have one- phone call- take this bleeding man in an ambulance to the low facility , overcrowded , living on a shoestring hospital downtown. Think that hasn’t happened in America ??? think on. Biggest US debt – Medical charges NOT mortgage – check it out. Coming here soon.

I respect your credentials, wavechange, but most people will be able to see the reduction as substantial without having to understand the microbiology.

To take a balanced view, there is still significant risk to the public from current levels of contamination of chicken by campylobacter. I don’t think it’s a good idea to be complacent.

Very little if it is properly cooked as instructed. The FSA report “New figures from UK surveillance bodies show a 17% decline in the number of laboratory reports of human cases of campylobacter in 2016.”. Hopefully another improvement in 2017.

If this discussion is worth continuing we should perhaps move it to https://conversation.which.co.uk/food-drink/campylobacter-food-poisoning-chicken-supermarket-tests-food-safety-week/

The FSA also notes:”Campylobacter is considered to be responsible for more than 280,000 cases of food poisoning each year. There are more than 72,000 laboratory confirmed cases of campylobacter poisoning (also known as campylobacteriosis) and a high proportion of these will be due to food.

We are continuing to analyse the full impact that campylobacter has, but previous estimates have indicated that campylobacter causes more than 100 deaths a year, and costs the UK economy about £900 million. About four in five cases of campylobacter poisoning in the UK come from contaminated poultry”.

Yes, saw that, but note figures “show a 17% decline in the number of laboratory reports” That doesn’t mean a drop in the number of cases, does it? It could, for example. mean the government has reduced the number of laboratories, or raised the bar for samples submitted, or any one of a number of other tactics.

https://www.food.gov.uk/science/microbiology/campylobacterevidenceprogramme

I have read this information, Malcolm. One of the points made is: “Overall, 7% of chickens tested positive for campylobacter within the highest band of contamination” A significant risk remains.

Ian – Thanks. The government is putting more responsibility in the hands of large businesses for ensuring our food is safe. Last June, I met two staff working in different roles in food hygiene and they warned me that this could be a bad move, though I have no way of knowing if this is justified. When the FSA started to publish campylobacter figures for supermarket chicken it attracted a great deal of media attention, but there is little mention of test results these days. It may be that the government is not keen to embarrass the companies further.

Since we have Conversations about campylobacter, there is no reason to continue discussion here.

Patrick Taylor says:
1 February 2018

myhomelife.org.uk/about-us/activities/

Seems quite a few charities and organisations are working positively – and jointly – with the issues.

The point about media focussing on the downsides is generally bad news provides more sensationalist headlines. From a papers point of view on the back of that you sell financial advice service adverts, home care services, and stairlifts. Not all bad but is there anyone looking to the future?

Seems to me that it is going to require a major shift in thinking away from the Welfare State provides everything to that of the Welfare State provides for you is you have no cash/assets and no family to support you in care.

Effectively what Germany and France see as the sensible method.of paying for care in old age. It would be interesting if Which? summarised where the research and options for further reading are located for its members. However it may be that this is actually a matter of political will or preparedness to face the long-term future of care.

As you say, Patrick, good news rarely attracts headlines.

I hope that the UK will one day be able to fund proper care for all with relatively modest means. Some of that money could be diverted from less worthwhile causes. Until then I would have thought an insurance scheme taken out while working could provide the money needed in the event anyone had to go into a home.

Someone can please check my numbers but it seems revealing. According to a 2011 report, the average length of stay in a care home for the over 65s was 909 days. 2.5 years. At, say, £1000 a week that costs £130 000. Government statistics show 3.2% of the population over 65 are in care homes, and the figure is fairly stable. So if all the population over 65 had saved £4160, that would have paid for the care of those 3.2% (actually, less because around a third are self payers, many of whom may have the requisite means to self fund). So if we all save £2 a week during our working life we could fund our possible need for care in old age. Is that too big a price to pay?

It is indeed true that running down the whole care homes sector is irresponsible, especially when it is ‘supported’ on the slenderest of evidence from a limited number of personal reports that might not be entirely without bias. I have been highly critical of the care homes sector in the past, and there remain a small number of substandard establishments, but there is no doubt that the CQC has made a considerable difference over the last two or three years and raised the overall standard.

A specialist care home for blind people in Norwich, run by the Norfolk & Norwich Association for the Blind, has recently received extensive media attention since it was graded inadequate in three out of five categories in a CQC inspection. It is now in special measures and is making many changes and improvements and hopefully it will be transformed into a safe and satisfactory caring environment. One would think that a specialist charity looking after its own ‘clients’ would be an example to the whole sector but dependency on limited funding, the special needs and particular problems of the residents, and complacency, can seriously affect the care outcomes. I would say that, in some respects, residential care is more difficult to deliver than post-operative nursing and requires a different range of personal attributes among the staff and management which are not sufficiently recognised and rewarded.

Dear John
Many thanks for sharing this enlightened view point , you are quite correct the CQC are making a difference , but I would point out that no results can be obtained by the CQC alone and that in all cases the results are achieved by the actions of the Care Home Provider with the help of their staff.
As your example clearly shows a non responsive provider makes it difficult for the CQC to instigate any improvements and often results in the Homes closure quite often this inaction is due to lack of funding and is relevant to Charities, Religious, 3rd Sector and Private Sector Homes .This lack of funding has been clearly outlined recently by the Campaign initiated by Which? Why this lack of funding has evolved baffles me as I strongly believe that Care Homes provide the best answer to this increasing problem , not as cost effective as the” Keep them at there own Home ” model which is being implemented I admit , there again how can we possibly give 168 Hr care for the pittance they pay for Home Care (7 hrs a week). What really worries me is what will be left if all Care Homes are made bankrupt by these short term inhuman policies ?
As I have always said ,any system can be faulted and criticized, but critics should come up with viable , acceptable alternatives.

Best wishes
Gerald

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.

Hi Trevor,
I have been rather poorly myself over the few months and only just discovered your comment, could you be so kind as to bring me up to date as I am interested in helping you obtain a more acceptable resolution to this problem .

Have you tried the safegaurding team at the Local Authority ? They are duty bound to investigate.

My predictions of bankruptcies are coming to the forefront now with the recent news about Four Seasons, I personally rang them to enlist their help over 20years ago when the Local Authorities started their offensive, but no help was forthcoming, maybe someone could explain to me how they (four seasons) supposedly making millions in profits could get into this mess.