He said, allegedly: “Good local supervision offers support every day. Distant national regulation can often only react after the event.  Employers must always take responsibility and be accountable for the staff they employ. But, we recognise that more can be done to support employers in this and a code of conduct and clear minimum training standards will provide important clarity in this area.  These measures will help employers to better consider the skills profile of potential employees and ensure that patients and service users get the care and support they need.”

Somewhat late in the day, for some of us, so forgive me for shouting ABOUT TIME TOO!!

But, it’s the response from Care UK and its  Managing Director of Residential Care, Toby Siddall, that has caused me great discomfort :

 “Directors at Care UK see codes of conduct as only part of the solution.   Matters of technical competence and behaviour are already an important part of the employment contract for Care UK employees. Whether or not a member of a care home team treats people with dignity is about the leadership, training and recruitment of people with the right personal values – not about a line in a contract.”

Well, well, well!!!  Perhaps, Mr Siddall, you would care to explain just how long it is that ‘matters of technical competence and behaviour’ have been an important part of the employment contract for Care UK employees.  Since when?  Tell me the date! 

They certainly weren’t in place in Care UK and at Lennox House care home at the end of 2007 and in 2008, when Lennox House was ‘investigated’ twice within 8 months   and not allowed to accept new residents for a year while a whole host of measures enabled Care UK to  drag itself from the gutter to an acceptable standard of care provision. 

As for treating people with dignity – that was absent too when those residents were left dead in their beds for days, as the Islington Tribune reported. 

Of course, the Reports of three (or more?) investigations are all held behind closed doors – far away from daylight, so as to protect the best interests of Care UK.  The best interests of the Leadership of Care UK including Mike Parish, Chief Executive, and the then MD of Residential Care Tony Hosking, and the Managers and Deputy Managers of the whole not-fit-for-purpose care providers, of those in Islington who commissioned and allowed Lennox House to function when it was not fit for purpose, the then CSCI (now CQC) to name but a few.  Their best interests are forever preserved by the hiding of those reports.   

 If leadership can be held responsible, as Care UK now seems to understand, how come heads never roll when people die as a result of sloppy leadership and sub-standard care? 

Unless and until it is a requirement for all those Reports, and others too of similar investigations, to be published and available in the public domain so that everyone can see what went on behind closed doors – nothing will ever change.

Or could it be that too many Directorships spoil the concentration?  9  for Toby Siddall alone.  And for Michael Robert Parish …….

This piece by Kirsty Scott in the Guardian has done just that.  It has rendered me breathless and speechless, almost.  Is this a journalist writing as only a journalist should be required to do – as a free spirit (*ish!!) remembering the need to earn a living and to pay the family bills, yet at the same time not selling her/his soul.  Not governed by anything other than the real free spirit of journalism.

Or is this someone acting as a paid promoter for Care UK?  Promoting private equity to boot!!!

I would dearly love to open the closed eyes of anyone who falls for this kind of promo.

Care UK killed my own relative within 10 days of arrival in a Care UK care home.

How did Care UK manage (for want of a better word) to do that?

Because Care UK had absolutely no systems in place to provide the kind of caring care that one 83 year old required – let alone the other residents, some of whom were younger and in far less need of care, and some were older in greater need of care.

I’m only talking about 3 years ago too, so don’t get the wrong impression of my anger at Kirsty Scott’s article.

Without permission, Kirsty Scott,  I bin your report.  I am not impressed.

As for the Guardian’s Social Care section  …. …. ……. it has been binned also.

Before the kettle had boiled, I came across Outside Left’s cheeky little piece about another bunch of old codgers, this time those on the receiving end of the doubtful wisdom of the Intergenerational Foundation.    (Whoever thought up that name needs help!)  ‘The Intergenerational Foundation (IF) is a newly established non-party-­political charity that seeks to promote the rights of younger and future generations in British policy-making.’ (It’s not often you see the words ‘political’ and ‘charity’ come together in one sentence.  Very strange bedfellows – or perhaps that should be spare-bedroom fellows.)

‘The ability of groups in their late twenties and early thirties to ‘settle down’ and have children is running into the physical obstacle of the lack of housing space.’ according to IF.  ‘There are now over 25 million empty bedrooms in under-occupied homes in England – rooms that are surplus to need based on the English Housing Standard. Very many of these are in the homes of the
retired, and by 2026 empty bedrooms in the homes of the retired will exceed 10 million.’

Well, you could knock me down with a feather!  It’s all the fault of the retired older generation with a spare bedroom or two.  Henceforth should they be known as ‘house hoarders’.

‘The rights of younger and future generations.’  Sod the rights of the current older generation!  That section of the Great British public who will remember WWII, ration books, make-do-and-mend, hand-me-downs, cutting up a cardboard box to make  inner soles to fit in shoes with holes in their soles, the outside toilet, a bath once-a-week, no showers, no central heating, no fridges, corporal punishment, toys and presents at birthdays and the midwinter festival only, life before the washing machine and the supermarket, and life with 15% mortgage interest rates or higher.   ….. …… And yet, they’d never had it so good!

Harold Macmillan, PM:  “What we need is restraint and commonsense – restraint in the demands we make and commonsense on how we spend our income.”  So along came the wage freeze, tower blocks to solve the housing shortage created by that damned war and the increasing population, a man was sent into orbit in space, and later men walked on the moon.  A collection of geeks invented things like video tape recorders and computers. Along came the Beetles, Mods and Rockers, drainpipes, winkle pickers.  More men walked on the moon!

It’s estimated that it took 3 hours of work time in the mid-1950s to pay for a weekly basket of basic food items such as milk, butter and bread.  Fifty years later, when all the emerging house-hoarders were showing signs of clinging onto their spare bedrooms, it took a mere 40 minutes work time to buy a similar weekly basket of food.

(The old codgers in the House of Lords have long since begun their deliberations, and I’m using it as radio. They’re not that photogenic, but they do sound good.  They use a few good words to describe the Bill – ‘unspeakably awful’ and ‘wilful disregard’ might sum it up.  If only they’d thrown it out!!)

Meanwhile, back at the Intergenerational Foundation:  ‘The British ‘family home’ is increasingly not owned by families, but by older, post-reproductive couples and single people.’   The reason given for the lifecycle of housing breakdown is the ‘behaviour of older groups’.

Post-reproductive!!  Just let the IF try to use the word post-productive – they really will meet the full g-force of the ‘behaviour of older groups’.

Tut-tut!  Their behaviour gets worse – it’s even been known for older people to move into larger houses well after their chicks have flown off to their own nests.  They are also to be found guilty of  ‘over-consumption’.

A sideways glance brought my tea-deprived self back to yesterday’s revelation that the people charged following the riots in August in various parts of the country were in fact ‘poorer, younger and of lower educational achievement than average’ rather than the thugs, scum and vermin that Work and Pensions Secretary Iain Duncan Smith, in particular, would have us believe.  IDS and his fellow MPs used many more foul words to describe these ‘poor, young people of lower educational achievement than average’ – and not many of the words used by our Representatives in the House of Commons were acceptable.

Of the young people involved, 42% were in receipt of free school meals compared to an average of 16%, and two-thirds of young people involved in the riots were found to have had a special educational need (SEN), compared to 21% for the national average

£300 daily allowance is paid to each unsalaried Lord who turns up and sits in the House of Lords.  Our Noble Lords  spent nearly two hours discussing the first amendment, before they voted.  A total of 456 Lords voted on that first amendment.

456 x £300 = £136,800.00.

One amendment down – 399 or more to come!!

The IF may soon write the next Ten Commandments.

Thou shalt not misbehave.

Thou shalt not retire.

Thou shalt not want a spare room so that family and friends might visit
you.

Thou shalt not house-hoard.

Thou shalt not over-consume.

Thou shalt not bedroom-block.

Thou shalt not expect governments to provide sufficient
housing for all.

Thou shalt not expect the younger generation to care about
you.

Thou shalt not develop dementia.

Thou shalt not grow old.

The short story is here for all to read.

Apparently, Lukasz Sklepkowski, 28, of no fixed address, has been charged with causing unnecessary suffering under the Animal Welfare Act.

You know what’s coming next …

We’ve had a week of CQC reports on hospital neglect of our mature citizens, followed hotly by another CQC report on the starvation of same mature citizens in our so-called care homes.

Can someone explain to me why one dog should be more precious than thousands of vulnerable people in need of care?

At least the dog had several police officers to protect it during its activities.

There is allegedly the Animal Welfare Act.

Where is the Human Welfare Act?  I’ve searched but haven’t found it so far.

R.I.P.  Democracy in the UK

R.I.P.  Caring about things other than money

The theatre company Spare Tyre is just about to start touring centres for people with dementia, with its interactive show Once upon a Time.

“The new programme takes an innovative and person-centred approach to working with people with dementia. It involves storytelling accompanied by layering touch, sound, taste, light, smell, to create a safe and beautiful environment and a moment of shared joy. Participants take an active part in the sessions, interacting by shining coloured lights, moving to music, and interacting with multimedia projections that respond to clapping and voice.”

“This work has the ability to change the culture of how we work with people with dementia.” 

“The package   Spare Tyre artists will visit your centre 1 day a week for 3 consecutive weeks. Each day we will deliver a Once Upon a Time interactive storytelling session in the morning for 6 clients and in the afternoon for 6 clients. Our artists will fully brief your staff before the first session and provide a de-brief after each session. To find out about costs please contact Vicky on 020 7061 6454 or email vicky@sparetyre.org.”

5 October – 15 November 2011, UK wide 

More info here – Spare Tyre .

What fun!

This particular Horse has no better purpose in their sad little life than to stalk  and to track me.

Morning, noon and night,  The Horse is positioned at the keyboard, trying to focus on the next fence, hoping that it will come towards and within their peripheral vision and then become the centre point of their breathtakingly boring existence.  Panting and puffing, The Horse must know that it’s a waste of their time.

The Horse is an Outsider, all at very long distance, that is, because this particular Horse lives thousands of miles away, but still would profess to know more about life in this once Great Britain of ours than we know ourselves.   The Horse was exported from these shores circa 30 years ago, but still knows more about day-to-day life here than most of us know ourselves!  That takes some doing.  Or it did before the advent of Google.

Now is the time for all good Googles to come to the aid of The Horse.

The Horse’s life is perhaps pointless and empty, so I should be flattered and encourged to know that I am at least giving meaning to a life .

I feel desperately sorry for The Horse -  if only because so desperate is The Horse that others have been enticed to sniff at the nosebag of The Horse, all by virtue of a message sent round from The Horse to the under-horselings.  Or are those others sniffing at The Horse’s droplets in a fashion similar to that of our grandparents as they strove to shovel up and spread  muck around the roses?

The Horse is welcome to any fragrant droplets that fall from my fingertips, here and in all the other places The Horse tracks me to.

Bye bye, Horse.  You have now been put out to grass, out to pasture, out into the wilderness of usefulness.

I hope you will miss me, Horse, as much as I won’t miss you.

All you need to do is to subscribe, Horse, and you will save yourself a huge amount of energy and long-distance broadband usage.  As for all the other places you track and trace, many have already become aware of your interest.  They thank you and your followers for boosting their viewing figures!

I should perhaps add that I am not the only one being stalked by this particular Horse.  For some unfathomable reason, The Horse feeds on dismantling every single word that is written by any one of the apples of this Horse’s eye.  Para by para, line by line, word by word …. that’s what The Horse feeds on.   Straight to The Horse’s mouth!!

I hope you have a good retirement, Horse, and that your under-horselings will soon rid themselves of your uncomfortable influence.

PS added, to comment on recent contacts from The Horse and from The Horse’s underlings who all seem to be jumping to order : 

To answer The Horse’s question, yes, I do think you should be concerned – you should be seriously concerned.   You have compromised your position for years now, much to the amazement and the disgust of others who have no choice but to put up with your astonishing heartlessness – so it is about time you looked long and hard at your motives.  It’s also about time those who pay for your services should also look at their own reasons for keeping you on their pay-roll, even though that pay-roll may be more perks than bucks.  The Horse knows all about bucks, but has forgotten how to care about The Heart.

The NMC (Nursing and Midwifery Council) is to review serious cases before internal investigations are conducted by the employer of the nurse(s) in question.  According to Nursing Times –

Nurses and midwives involved in “very serious cases” that pose a risk to patients should be referred to the Nursing and Midwifery Council prior to an internal investigation, the regulator has stated.

In updated guidance on referrals, the NMC has called on employers to make referrals as quickly as possible in order for it to consider issuing an interim suspension until the case has been fully investigated.

The regulator said it had “clarified its advice as a result of cases in which employers have misunderstood their responsibility to refer quickly if patient safety is at risk”.

It states: “The revised advice specifically encourages employers to refer a nurse or midwife at an early stage in very serious cases, even before they conduct their own internal investigation.”

NMC director of fitness to practise Jackie Smith said: “We would like to remind employers that if they believe the public’s health and wellbeing is at immediate and serious risk, they should contact us straight away.

“This will give us the opportunity to issue an interim suspension or restrict the person’s practice while the case is investigated,” she added.

The revised advice and information also notes that in less serious instances cases may be referred back from the NMC to the employer to be dealt with locally.

The guidance also includes more detailed information about the existing responsibilities of employers to check references, identity and competence.”

This news is of such importance, that I’ve just given you the full content of the Nursing Times article, and I trust that will be acceptable.   It’s not so easy to find the updated guidance on the NMC website, but this is the nearest I’ve found – Urgent referrals and interim orders.

As an employer you have the power to suspend or dismiss a member of staff, but this will not prevent them from working elsewhere. Even suspensions by a local supervising authority midwifery officer (LSAMO), which would prevent a midwife from practising in that region, will not prevent a midwife from practising in other regions, or practising as a nurse if registered accordingly.

We are the only organisation with the powers to prevent nurses and midwives from practising if they present a risk to patient safety. In very serious cases it will therefore be appropriate to refer a nurse or midwife to us at an early stage, even before you conduct your own internal investigation. This allows for the possibility of issuing an interim suspension or restricting the practice of the nurse or midwife concerned until the case has been thoroughly investigated.

I am shocked to discover that this has only just been ‘clarified’ by the NMC, but it goes a long way to explain to me why I’ve had such a fight on my hands for the last 4 years now. 

Perhaps I was naive and took it for granted that the onus was already there on the employer, in my case one of the big care home providers, and that the NMC would be contacted by any employer who has serious concerns about the standards of care being provided by a registered nurse or midwife.  I didn’t know then how easy it was for the employer to allow several registered nurses to resign from their employment. 

Perhaps I was equally naive to expect that the Local Authority would have a duty to follow through with all the sensible procedures, in order to protect other people who could be at risk if those same registered nurses who were allowed to resign were then ‘employed’ elsewhere.  But when a care provider has several 25-year contracts with the same local authority, you begin to learn how to whistle in the wind! 

Perhaps I was even more naive to expect that the local authority’s Safeguarding/Protection of Vulnerable Adults unit would be equally responsible for ….. safeguarding others.

The NMC is a Regulator.  The GMC is a Regulator.  The CQC is a Regulator.

What is being a regulator all about if it fails to regulate in the way that most of us, mere mortals that we be,  would want and expect a regulator to regulate?

A piece from Community Care on Friday 29 July 2011 begins:

Operators taking over Southern Cross homes face a long battle to earn the trust of residents and relatives, ex-Priory Group boss Dr Chai Patel has admitted as he prepares to take over one-third of the homes.

Patel told Community Care the firm he will head up to run the homes faces a “long journey” as “reputations are breached in a second and take years to build up”.

He’s referring to the reputation of Southern Cross there.  Perhaps he should remember his own reputation and the way it was sullied by the experiences of residents of Lynde House care home.

An article in the Express on Sunday 31 July 2011 refers back to the year 2000/1 when residents of Lynde House  care home were neglected and mistreated, when Lynde House was owned by Westminster Healthcare, with ….. Chai Patel as its then Chief Executive.  Patel sold Westminster Healthcare soon after the scandal emerged.  Patel was apparently interviewed on Friday 29 July 2011 and  the former government adviser on elderly care, vowed that he would protect pensioners from the kind of ­maltreatment suffered at Lynde House, in Twickenham, Middlesex.

The Express quotes him as saying “The residents felt they could get recourse only by going public which has tarnished my reputation… I have never tolerated poor care and never would ­tolerate poor care.” 

You can’t get away with that one, Chai Patel - otherwise people may be hoodwinked or even deceived by such protest!

Did Patel never bother to read the Report of the Lynde House investigation, dated May 2002 and published on 2 August 2002 – 9 years ago almost to the day? 

If the Chief Executive shoulders no ultimate responsibility for the standards of care provided – or rather the sub-standard care a.k.a. neglect provided – the Chief Executive should not share excessively in the profits made either. 

Let’s look also at 1 October 2002, when the London Evening Standard printed a neat summary of Patel’s career path.  Including these words from Vince Cable talking about the feisty woman who had the courage to stand up to Chai Patel: 

“Without Gillian Ward and her brave group of relatives, none of this would have come to light,” says MP Vincent Cable. “They have done us a major public service. The climate of denial they faced was ferocious.”  “When I first raised the issue with Chai Patel, he totally poohpoohed it. All he had to do was to care enough to acknowledge their complaints, deal with them and apologise. But he chose to deny it and that led to it becoming a national public campaign.” 

I do hope that the residents and relatives of all current Southern Cross care homes don’t have to face the same kind of ferocious denial. I also hope that in his new role, Chai Patel will accept responsibility for the care provided in his name and under his banner.

Where does the buck stop?  If it doesn’t stop with the Chief Executive of a private care provider, then the buck will be in perpetual motion. 

And here’s Gillian Ward again – also known as Deddie Davies.  Still supporting those in care. 

It took a BBC Panorama programme to open CQC eyes to the abuse that was going on at Winterbourne View hospital in Bristol, and for the CQC then to realise there were ‘serious concerns’ about the quality of care being provided by Castlebeck.   It took an undercover reporter to force the CQC to do the job it should be doing: inspecting thoroughly, reporting efficiently and demanding that action is taken to prevent any care provider from providing neglect rather than care.

When I first contacted the CSCI (as CQC’s predecessor was called then) about my serious concerns about the care my relative received in a care home, CSCI’s Inspector told me that she would contact the manager of the care home.  I heard nothing from the CSCI, so I chased for a progress report.  Much to my surprise, I was told that the manager had informed CSCI that a meeting had been arranged and that “all my concerns had been resolved at the meeting”.  The CSCI believed the manager and closed the book.  There was no ‘meeting’ and my concerns were not resolved.  Far from it.

Then, the mental health care of older people team carried out an investigation into the circumstances surrounding the death of my relative in care.  I was excluded from all meetings, from everything other than an initial ‘interview’ with the investigator.

Then, the Local Authority ‘claimed ownership’ of the report – and continued to exclude me from all meetings.

The CSCI took a back seat, knowing full well that it would bring a cloud over the care provider, the CSCI inspectors, the Local Authority commissioning department etc. if all the details were to be ‘in the public domain’.  It all remains closeted behind closed doors.

How many similarities are there between the report into the circumstances surrounding the death of my own relative and the CQC report on Castlebeck ?

Try these for starters, although I have paraphrased some:

• problems that need to be addressed at a corporate level – the company needs to make root and branch improvements to its services and processes
• we have demanded improvements
• Where there were immediate concerns about people’s safety action was taken.  In the case of Winterbourne View this action led to its closure.  In the case of the care home I was dealing with, it was not allowed to admit new residents for a year, a massive improvement plan came into existence which had to be worked through before any new admissions were allowed.
• lack of staff training,  poor care planning, failure to notify relevant authorities of safeguarding incidents
• The registered provider did not have robust systems to assess and monitor the quality of services provided in the carrying on of the regulated activities.
•  The registered provider did not identify, assess or manage risks relating to the health, welfare and safety for the people who use this service.
• The registered provider did not operate effective recruitment procedures.
•  The registered provider failed in relation to their responsibilities by not providing the appropriate training and supervision to staff, which would be required to enable them to deliver care and treatment to the people who use the service.
• Medication issues
• Communication issues
• There was a lack of leadership and management and ineffective operation of systems for the purposes of monitoring of the quality of service that people receive.

As for staffing issues, there are so many people in the real world aware of the fact that care homes are endangering people’s lives by running their operation with too few staff, poorly trained, badly paid, unsupervised staff.  Families are aware of it – what took the CQC so long?

How many Castlebeck’s are there in the world?  I know of one providing Care in the UK!  An animal that is growing daily, getting bigger and fatter and likely to become even fatter.  As long as everything shabby and shoddy is kept hidden, the world will never know.

It took an undercover reporter to shock the CQC into action!  Disgraceful.  I know I’ve banged on about this one before, but it really does begin to make the CQC look even more ridiculously toothless than some of us know it to be.

Why should the Castlebeck report be in the public domain – yet the damning report into the neglect of my own relative is concealed from view?  I wonder whether Andrew Lansley might like to comment on that one!!

As for Paul Burstow’s statement, “as a Government we intend to ensure that that doesn’t happen again” – I’m sick and tired of hearing that one.  Because it does happen again – and again – and again.

Helga Pile, Unison’s head of social care, said: “Elderly care is a service where mandatory regulation is vital to protect their interests. The privatised model means that the time carers can spend with each person is minimal, forcing corners to be cut, and employers see basic training as an expensive luxury.”

“It is not right to try to get elderly care on the cheap.”

The rich care providers grow richer – the people in need of care are neglected and die as a result.  The CQC is part of the problem.