Why I despise the so-called system of care for vulnerable people

I’ve been fairly controlled over recent weeks, months or even years.  I suppose I’ve been waiting and hoping for a chink of light to emerge, for a culture change to emerge, for a way forward to emerge in the so-called system of care that we have allowed to be in place.

However, I am reaching screaming point.  Hardly surprising.  When someone is destroyed because of absent systems of protection, and when it then takes almost 5 years to work your way through to a full understanding of why the so-callled system of care for vulnerable people fails to provide decent care so very often – that’s when you reach screaming point.

Time and time again, the CQC comes up with yet another report as it did today, with a report into the ‘care’ afforded to people with learning disabilities.  Or rather the lack of  care.  I’ve read it all, but there’s not much hope for real change.

Week and month after week and month, our government comes up with …… not one single plan to improve things.

Year after year, the same old same old same old gets published in the press, reported on radio, featured on TV.

Still nothing changes, so I need to scream now.  It won’t change anything – but it may just help me to scream.

[Next section of this particular blog post: Deleted temporarily pending the return of sense to the world of care.]

Therewith, I will leave this one for today.  But not for long.

To care or not to care?

Imagine the 83-year old person in the following story was your own relative.

The article is here : Islington Gazette – dated 10 February 2012 – a few extracts below:

‘The Nursing and Midwifery Council’s (NMC) Conduct and Competence Panel is investigating five nurses’ care and treatment of an 83-year-old woman who died after spending around 10 days 
at Lennox House Nursing Home in Durham Road, Islington.

The panel heard this week that the elderly woman was taken to Accident and Emergency at Whittington Hospital in a diabetic coma on December 8, 2007. She died on December 27.

It is alleged that several serious signs of deterioration in the two days leading up to her hospital admission weren’t acted on.

These included agitation and a tendency to lay on the floor – symptoms which retired nurse Sue Bradell-Smith, who carried out the investigation of Lennox House in 2008, said were abnormal and would have made her “very worried”.

Other allegations include a failure to monitor the patient’s condition and diabetes, failing to create a pain management plan and feeding the patient fluids orally although her swallowing difficulties were known.

According to the home’s records, by the evening of December 8 she was suffering with continuous muscle spasms and had dysphasia, an inability to speak – yet it is claimed that the emergency services weren’t called straight away.

NMC’s solicitor John Lucarotti said the treatment provided fell far below what is expected of a nurse.’

How would you feel if you are now being required to understand alleged facts that are totally new to you – almost four-and-a-half years after the death of your relative?

You are now being given to understand that the care home manager was in the building all day long, right through from 8.30 am to 8 pm in the evening – but couldn’t be bothered to get off her backside to attend to one 83- year old in desperate need of care and attention.

You are now being given to understand that a nurse came to see the manager and told her that the 83-year old was not well.  Still the manager did nothing.

You are now being given to understand that nobody involved considers that the care they provided was poor.

You are now being given to understand that the manager didn’t react or even care much when the nurse told her the 83-year old was in spasm, unable to speak, unable to swallow.

Can you imagine how you would be feeling now?

 

NMC hearings schedules – aka close to Care in the UK

I omitted to post this :  NMC Hearings Schedule – 6th to 17th February 2012 – at Euston House, London.

All in the best interests of Care in the UK.

More later, but click here for the charges.  Same as above link – but I wouldn’t want anyone to miss it.

Shabby journalism masquerading as caring care in the Daily Mail?

This piece by Sophie Borland in the Daily Mail, bearing the title Tied to chairs, sedated or locked up, the ordeal faced by thousands with dementia is one of the most irresponsible articles I’ve read for a long while.  I’m not a natural Daily Mail reader, so it’s an occasional visit only that ever  I make.  I understand now more of the reasons behind my allergy to the Daily Mail.

It’s scaremongering sensationalism gone beyond acceptable limits, preying upon the expectation that the majority of readers may not have read the Deprivation of Liberty Safeguards in full or in part, let alone having tracked down the NHS statistics quoted and then taking the time to read each and every connected download.  Sophie Borland may not have researched, either, the way that DoLS are not all about being ‘tied to a chair’ or ‘being locked up’, with or without dementia.  I’m well aware of the fact that the DoLS procedures are not well understood by some  Local Authorities, by some care providers, and even by some Social Workers.  But the use of restraint is not, I think, the main focus of the majority of DoLS applications (granted or refused) where dementia is concerned.  Or am I being naive here?  I’m not normally that gullible, but perhaps the DM knows different.

Shame on you, Daily Mail, for your careless and carefree journalism, as I view it in my perhaps simplicity.

We’re all in this together ….

It’s beginning to unravel itself, day by day.  At long last!!

When our ConDemOlition first tried to persuade us all that we are all in this together, it sound somewhat oddly reminiscent of the Orwellian phrase.  The spin made it resemble a positive way forward – for some.

But it’s all falling into place now – for those who never realised the underlying significance of the ConDem ‘modern and convenient’ understanding of ‘in-it-togetherness’.

Hook, line and sinker – they’ve all been in the trough together – so it’s time to haul them in, and to make them accept responsibility.  Supporting each other, concealing their indiscretions, providing the props of survival  is where they’ve all been for years now.  Now it’s our turn.

There’s more in this, altogether, than we have yet been allowed to see.

I’m beginning to see the light – as a few people once sang albeit with a different intent, perhaps.  It just takes a spark.

 

 

Care home secrecy slammed

It is with some considerable personal pleasure that I have just read  in the East Anglian Daily Times that POLITICIANS have hit out over secrecy surrounding an Essex care home which was shut down amid abuse allegations.

If any politicians would like to ‘hit out’ over the secrecy surrounding Lennox House care home in Islington, they only have to ask me, and I will provide as much detail as has so far been available in the public domain – and I can provide far far more than has ever been made available in the public domain, if that’s what would help you, Politicians, to achieve honest, decent, caring systems of care for our honest, decent, caring vulnerable elderly citizens.  The rest is still shrouded in secrecy.

They have slammed a decision to bar the public from a meeting next week where lessons learned from the saga at Greenways Care Home, Colchester, will be discussed.

Well, in Islington family were barred from meetings too – let alone the public.

Why does this all interest me enormously?  Because my own relative was the person who suffered neglect, which is a form of abuse, in that Islington care home, Lennox House.  Nobody from our family was allowed to attend any one of the ‘meetings’ held.  We have never been allowed to see the full report either.

But the care home management, the care home provider, the healthcare professionals, the social care professionals were all invited to attend those meetings.  The care home management, the care home provider, the healthcare professionals and the social care professionals were all provided with a copy of the full report of the investigation carried out into the neglect of my relative.  So that they could all comment on  it and have any ‘amendments/alterations’ made before it was finalised.  That is one aspect of the whole mess that I will never understand.

The family of the person who was the vicitim of abuse in care, neglect in care,  was not allowed that same privilege.  No ability to attend meetings; no ability to contribute significantly to the final report; no ability to inisist on changes to that final report – other than simple factual inaccuracies, that is.

Our family member was no longer in a position to ask to attend meetings, to see the report before it was finalised – she died within 3 weeks of suffering that abuse/neglect in care.

The Safeguarding Adults team ‘chose not to inform the police’; they chose not to inform the Coroner either; they chose not to inform family that they had the right to ask the Coroner to conduct an inquest.

And yet, the whole situation was considered sufficiently serious for the then CSCI  to impose ‘enforcement action’ and to refuse new admissions for a year to Lennox House.  The CSCI inspection reports are all still available on the CQC website.

The perpetrators  are the ones to have been protected.  The care home provider that couldn’t provide care has been protected.

What was that policy called?  I remember –

NO SECRETS

No secrets: guidance on developing and implementing multi-agency policies and procedures to protect vulnerable adults from abuse

Our relative wasn’t protected.  She was dead before anybody thought about massive ‘action plans’ and ‘enforcement action’, all of which the Care Provider willingly complied with of course, and all of which will have been of benefit to the other residents and future residents.  Too late for our relative.

My thanks to Vern Pitt at  Community Care for bringing to my attention the fact that politicians seem to have opened their eyes.  Long may they stay open.

Open up please also the hearings/meetings/serious  case reviews/adult protection procedures to public scrutiny.  Otherwise we will never believe that you really care.  And then we too can see whether lessons have been learned.

Intermittent connections in the world of dementia and care

There is what is known as a ‘major Service Outage’ in my part of the UK, and many of us are struggling with creepingly slow broadband connections – all are up the creek without a paddle for the foreseeable future, and no amount of troubleshooting has so far been able to sort us all out.  I’m told I have an intermittent connection, but no boffin has so far been able to create the constant connection that I need.  And as those strangely disconnected moments turned into hours, then days and now weeks, we have all been driven to distraction.  So, many micro filters have been changed, routers powered down and powered up, settings have all been checked, lines tested … and so on.  The systems have all had a thorough MOT.

But the brain behind the broadband can’t send the right signals to the right place at the right time for a meaningful, reliable and constant connection to be established.

Just like dementia.

When the brain’s working properly all those little electrical impulses work their way along the nerves to and from parts of your body and parts of your brain.  The neurotransmitters help those signals to jump across the gaps between the nerve cells.  And language, movement, problem solving and memory all work according to plan, according to the blueprint.  The connections remain constant.

But, with Alzheimer’s disease, the brain shrinks as the number of nerve cells in the brain reduces.  You can’t grow new nerve cells, so as more and more cells die away, the problems of dementia increase.  The neurotransmitters are reduced too so they can’t send the same signals.  The intermittent connections begin to surface.

The brain needs a good supply of blood – via blood vessels – for it to function, but if the vascular system in the brain becomes damaged, because of diabetes, high blood pressure or heart problems perhaps, or a stroke, the blood can’t reach the brain cells, so they eventually die.  And then along comes Vascular Dementia to wreak havoc.  More intermittent connections surface.

It’s 100 years since Alois Alzheimer first described Alzheimer’s.  Very little of Alzheimer’s teachings had to be revised and, though 100 years older today, they have not been corrected or amended but only confirmed.  Alois Alzheimer was apparently an optimist.

Dementia is the word we use to describe the symptoms that occur when the brain is damaged by disease, the most common being Alzheimer’s Disease.  Vascular Dementia is the second most common form of dementia.

Dementia is degenerative, and the speed of decline varies. A person will become repetitive both in speech and movement, will look in a mirror and fail to recognise their own image, will also fail to recognise their own family and friends, will lose the ability to carry out everyday tasks (the so-called activities of daily living or ADLs), will often become verbally and/or physically aggressive, will become agitated, may suffer hallucinations and delusions, will gradually suffer severe memory loss, will often lose their speech entirely and in the latter stages they will lose the ability to swallow, the ability to move, the ability to breathe.

Dementia leads to death.  There is no cure.

For some unexplained reason, Dementia is  seen at present as a problem requiring social care rather than health care.  And that is where the intermittent connections in the world of dementia and care really begin to show themselves.

Paul Burstow, Care Services Minister and Liberal Democrat MP, had a crack at local authorities for jumping the gun and making cuts in care support ahead of next month’s public spending review.  He also told Community Care that “Every local authority has a responsibility to do its best to make efficiencies and protect the frontline – there are better ways they can do this than salami-slicing and slash and burn.”    I can only agree with him when it comes to salami-slicing – if only because I can think of a few salamis that I’d like to slice, all currently involved in the care industry and in the dementia care industry.

Mr Burstow is also upset by the low uptake of personal budgets.

The Princess Royal Trust for Carers published the results of its survey of 800 carers, who care unpaid for a sick and disabled family member, and found that over half (53%) of all carers who work earn less than £10,000 a year, with three-fifths (60%) having to spend all of their savings to support the person they care for. 89% say that they are financially worse off as a result of caring and, consequently, almost two-fifths (39%) fear they will lose their home.  Broke and broken: Carers battle poverty and depression.

Read these Quotes from Carers – the intermittent connections in the world of care are clear to see.

Today, Stephen Dorrell – the new Chairman of the House of Commons health committee – has urged politicians to face up to the way in which vulnerable elderly people are being forced to pay for medical care, health care, all because of the redrawing of the boundaries between health care and social care, without proper debate or scrutiny.

The debate surrounding NHS Continuing Healthcare – which is healthcare fully funded by the NHS, in any ‘setting’ so in hospital, in a care home, in one’s own home, in a caravan or even on a double-decker bus (privately owned, of course!) – is something that most people never need to come into close contact with, unless and until they or their relatives are old, and/or with health needs.  And especially, unless and until they develop dementia.  Then, for some strange reason, the connections of the professionals suddenly resemble our broadband problems: fully funded, but fully intermittent.

Many people are denied the human right to return from hospital to their home, by healthcare professionals and by social services.  They’re told they need ‘nursing care’ 24/7 in a care home.  They are then offered by the NHS £100 towards the cost of that nursing care, the Nursing Care Contribution.  But they are then also forced to pay £3500 per month or more for residential care, often shabby and sordid residential care.

All because they have health needs that are such that they can no longer live an independent life.  Residential care is the choice of last resort for so many people, because they can no longer be cared for at home.  And that applies especially to those with dementia.

They are often forced to sell their own homes – or rather their family is forced to sell the home, because by this time, the person needing 24/7 care is in no position to do so themselves – to pay the extraordinary costs of residential care.  Extraordinary costs, because nobody is ever given a breakdown of that cost, but it’s not normally a fair charge.  The quality of care provided is rubbish in many care homes, with enormously inflated charges, enormously inflated pre-admission promises of care, enormously low-paid workers, mostly immigrant workers, enormously low standards of training, especially dementia training.  But enormous profits for the care home industry.  (see the CQC announcement today today about some of the sordid care homes and agencies it has forced to close.  Many  other sordid care homes and agencies have survived the CQC axe – but only just, and only thanks to some very closely woven and constant connections.  There’s little chance of their connections becoming intermittent.)

The hoops and hurdles that have to be faced by those who challenge the decision-making process (also known as the National Framework for NHS Continuing Healthcare) are so complex and complicated that the so-called professionals can’t even work their way through them all.  And then the family members who find the inner strength to challenge it all are forced to spend years, and years and years being humiliated by the Primary Care Trust (PCT) and Social Services (SS).  It comes to resemble a game without rules, like Snakes & Ladders with venom-filled snakes hissing and spitting at the poor souls who try to climb the rungless ladders.

Except that there are rules.  There are legally binding rules that should not be broken.  But they are being wilfully broken, by the NHS, the PCTs, and the SS.  Aided and abetted by governments, one after the other.  They are all in it together, to paraphrase David Cameron.

“We are clear about what we must do … in a way that protects the poorest and the most vulnerable in our society, in a way that unites our country rather than divides it, and in a way that demonstrates that we are all in this together. Prime Minister David Cameron’s speech on the economy, Milton Keynes, 7 June 2010,

Dementia is an extraordinary disorder of the brain, a disease of the brain, a most devastating illness, for which there is no cure.  People die of and with dementia.  But dementia is not being acknowledged as a disease, an illness, a destructive force, removing from a previously capable and competent human being each and every single quality that defines a human being.

We as a civilised country ought by now to have found a way to create the constant, reliable connection between needs and service provision.  Dementia care still suffers from a ‘major service outage’ of a kind that paralyses those with dementia and their family members caring for and about them.

I am sick and tired of reading, hearing and watching our government, our ministers, our politicians, our healthcare professionals, our social care professionals and so on, all cry out in shock horror about the problems of caring for the elderly that we are facing, but they continue to do nothing to correct the ills of their ill-defined system.  Actions speak louder than words.  If we really are all in this together, then we should not be so lily-livered about sharing the responsibility for it together, via taxation.   All that is required is for the connection to be made, between health needs and care.  Between dementia and care.

After all, tomorrow it could be any one of us – even you – with dementia and needing care.

From grey power to Care UK via Briars care home and via Southern Cross

My time is heavily ‘restricted’ at present, but I don’t want to lose sight of a few things that have come my way recently, so a miscellany of care in the UK today.

From 26 February 2004: If … the Generations Fall Out :

“It is 2024 and the baby boomer generation, currently in their forties and fifties, are starting to retire. The number of people over 65 has increased by nearly 50% since 2004. And this is just the beginning.”  The start of things to come?

From 23 March 2004: The Rise of grey power:

” With a falling birth-rate, increased life expectancy and a shrinking number of working-age people to pay for the welfare state, there are set to be pressure points ahead.“

From December 2007:  Prospect of moving to a care home frightens two thirds of Britons:

“Britons are living in fear of growing old in a society that fails to respect the over-65s or provide adequate support for those in need, a Guardian poll reveals today.

It found a country struggling to come to terms with demographic pressures that are set to see an increase in the number of older people by more than 60% over the next 25 years, putting a huge strain on the resources of the welfare state.”

From 6 August 2010:  Southampton Briars care home bosses sentenced:

“A care home owner has avoided jail after she was convicted of ill-treating and neglecting residents.

Annette Hopkins, 65, who owned Briars Retirement Home, Southampton, was order to pay a total of £52,000 and given a 30-week suspended prison sentence.

Care home manager Margaret Priest, 56, was ordered to carry out 200 hours community service after also being found guilty of wilful neglect.”

That particular result bothers me – and especially “Judge Derwin Hope said both were unqualified to do their job and they had not kept up with legislation to protect vulnerable people.  But he decided not to jail them because they were “obviously caring people” based on the references from their supporters”  I have problems with that decision of yours, Judge Hope, and I hope you will consider things differently in future.  Anyone running and managing a care home should be qualified to do the job and must keep up with legislation to protect vulnerable people – no matter whether their ‘supporters’ can provide good references!  Where are the references for the vulnerable people?  Did you have an equal number submitted to you?

From 9 August 2010: Profits plunge at care firm Southern Cross :

“The UK’s biggest care home operator today revealed earnings have plummeted by £7m in the last three months.  Bosses at Darlington-based Southern Cross Healthcare announced they expect total earnings to have dived by £20m by the end of the financial year.”   I’m not sure such a plummet could be all down to the fact that local authorities are placing fewer people in your care homes, Southern Cross.  Could it be down to the fact that many people are becoming very wary – and weary – of the problems that surround Southern Cross care homes?

And finally, also from today 9 August 2010:  Brighton and Hove private care provider nets £767,000 for work it didn’t do :

“One of Brighton and Hove’s leading private health providers has made an extra £767,000 for work that it didn’t do.

Care UK, which runs several NHS services in Brighton & Hove, pocketed the money for the 2009-10 financial year.

The sum relates to work scheduled at the Sussex Orthopaedic Treatment Centre in Haywards Heath.

Sven Rufus, the Brighton and Hove Green Party health spokesman, said: “This is another example of how difficult it is to manage and ensure value for money from outsourcing public services to private contractors.

“It’s clearly inappropriate for Care UK to be taking home an extra three quarters of a million pounds of taxpayer money for failing to do much as work as was predicted.”

More another day.

Baby Peter doctor ‘missed unique opportunity’

The GP who saw Baby Peter missed a “unique opportunity” to send him to hospital just eight days before his death, a hearing has been told.

Peter’s mother, her boyfriend, Steven Barker, and his brother, Jason Owen, were jailed in May last year for causing or allowing his death.

Dr Ikwueke is the second doctor to face GMC allegations over Peter’s care.

Consultant paediatrician Sabah Al-Zayyat is accused of failing to spot that he was suffering abuse two days before his death.

She was due to face a GMC disciplinary panel in February but did not turn up.

The hearing was adjourned until a later date after she was said to be “suicidal”.

The above is reported via BBC News.

…… …. ….. …..

I’ve mentioned little Baby P, Baby Peter before, and I’ve also mentioned GPs and the GMC.  But what I may not have mentioned is the almost-equivalent situation of a GP missing a ‘unique’ opportunity.  My 83-year old was unable to breathe, unable to swallow, unable to move, unable to call for help.  Eventually, but about 3 days too late, the care home was asked to call a doctor immediately, when another relative visited, by pure chance, at the care home.

Two hours later, the staff managed to call a GP, who arrived another hour later, and diagnosed a suspected UTI (urinary tract infection).  The GP issued a prescription for Trimethoprim.  The GP departed, having spent a grand total of approximately 12 minutes in the building, from signing in to signing out.

The GP failed to ask the care home nurses about the past medical history of a patient she had never met before, never seen before.  As a result the GP failed to discover that the person she was now visiting was a Diabetic.  If that GP had bothered to ask questions about the medications being given to a patient they had never met before, then that GP would have realised that the patient was on the brink of a diabetic coma.

My relative may have lived.

But she was admitted to hospital less than 24 hours later, in a diabetic coma.  And she died there, 3 weeks later.

The GMC?  I have complained, and I am still considering my options.  But it strikes me that the GMC is protecting the GP.  I am not allowed to view the ‘supporting evidence’ submitted to the GMC as a result of my complaint.  And yet, the documentation that the GMC has already allowed me to see indicates the extent to which the GMC has been misled, hoodwinked.  Call it whatever you will.

Justice will never be justice-seen-to-be-done as long as systems of protection are in place to protect the guilty.  Or at least, those who are prepared to ‘bend the truth’.  In their own ‘best interests’, of course, rather than in the best interests of their patients and their family.

Alan Simper ‘died for want of care by those charged with it’

I’ve mentioned Southern Cross Healthcare several times recently.  Today, a Coroner had fairly meaningful words to say about a Southern Cross care home, Swiss Cottage nursing home, Leighton Buzzard, Bedfordshire, after a man died as a result of ‘inexcusable failures’ by care home staff. Britain’s largest care home provider was criticised after a pensioner died as a direct result of ‘inexcusable failures’ at the hands of Southern Cross Healthcare’s staff.

Bedfordshire and Luton Coroner David Morris’ words:  ‘There was a failure of professional responsibility at all levels.  Mr Simper, whilst incapacitated by rapidly deteriorating physical and mental health, died on this date for want of care by those charged with it.’

Another report of the same story, this time via BBC News.   I’m not a natural reader of the Daily Mail, so I always try to match the content elsewhere, and the BBC is normally reliable.

There’s one mutually shared aspect of every single sad story of neglect that I come across – along the lines of ‘lessons will be learned’ :

Sarah O’Mara, Area Manager for Southern Cross Healthcare, said that a full investigation had been carried out following the death of Mr Simper.

She said: ‘Following Mr Simper’s death, Southern Cross co-operated with the Police and other authorities in their investigations.

‘We also undertook a comprehensive internal review in consultation with social services and the Care Quality Commission.

‘As a result, significant steps have been taken to improve the quality of care provided at Swiss Cottage.

‘The health and well being of residents is our priority. Under the new leadership, staff are focused on providing the very best and most professional care.’

These words become meaningless after a while, and the story of Mr Simper echoes the experience of my own relative, and also the same questions I have been asking for more than a couple of years now:

1. How can a care home, provided by one of the biggest, richest, fattest care home providers in the UK, be allowed to open and operate, if it then takes the death of a vulnerable resident for an “Action Plan” to be put in place to achieve the very standards of care we all expect to find in any care home?  And all that, in our case, within 6 months of the care home opening and receiving residents.
2. Why does it take an investigation by the Local Authority, Social Services, CQC (CSCI as was), the local commissioning team, the police, the coroner for ‘significant steps’ to be taken to provide the quality of care that a big care provider should know all about?  And the home is then not allowed to accept new residents for a full year, in order for ‘acceptable standards of care’ to be seen to be present – in our case, again.
3. Why is it necessary for someone to die, before quality care is provided’?
4. Why are so many of these investigations conducted ‘behind closed doors’ unless a coroner is involved, so that the general public knows nothing about it all, knows nothing of the ‘clean up’ that is conducted, knows nothing of the pain it causes?  That is the burning question for me.  Although there are other questions simmering away at present.