Patience a virtue?

Patience may well be a virtue but it may also tarnish your spirit.

This blog of mine has been silent for many months now, because I was patiently waiting and hoping that Care UK might just find it possible to be as virtuous as my patience has been since 2007.  Sadly, I now know that is not to be.  I waited and hoped in vain.  Foolishly, I gave the benefit of the doubt to Care UK.  Back in 2007 when I allowed my relative to be placed into one of its care homes, I placed my trust in Care UK.

From when my relative died, then through all the investigations and reports written by the Local Authority – with input from all and sundry –  and right through to the end of the hearings at the NMC in 2013, I continued to trust.  After the conclusion of those NMC hearings, with two nurses being struck off the NMC register, and two more having serious conditions imposed on their ability to continue working in this country as nurses, I asked Care UK to do the decent thing.  We entered into what began as meaningful and purposeful correspondence.

Since then, I have been passed around like the proverbial parcel.  Kicked about like a football.  I lost count of the number of times the goalposts were repositioned again and again. I’ve been bounced from Care UK to solicitors to financial bigheads to insurance policies, then back to bigheads and even bigger heads.

Care UK has shown itself to me to be a business stripped of humanity.

Fortunately, over the last year or so, I’ve been able to put my thoughts and feelings into another blog – far removed from this one, and not on Care UK’s radar, as this one has been.  But over the last few weeks and months, I’ve received so many kind comments about this particular blog, that I have decided to return to it and to resurrect it.

I’ll be back soon.

Care in the UK over two weeks in December 2012

1 December 2012: TENS of thousands of vulnerable people are being physically and mentally abused by the very people meant to be caring for them. Disturbing figures reveal that 130,000 adults were ill treated – usually at the hands of carers or family. Abuse most often took place in their own home or care home.  Read more here.

1 December 2012: Abuse of elderly patients by NHS staff rises by a third in one year with a  shocking 36,000 offences reported last year alone.  Read more here.

1 December 2012: Care home regulation criticised by Norman Lamb.  Regulation of the care sector is not fit for purpose, care minister Norman Lamb has said as he unveiled proposals on English care homes for consultation. He also said there was a “significant lack of corporate accountability for the quality of care”. One suggested measure involves companies having to open up their books to inspectors to ensure they are financially sound. Read more here.

1 December 2012: Care home companies could be forced to open books to prevent another ‘Southern Cross’ collapse.  Read more here.

4 December 2012: Care home job advertisements ‘encouraging’ criminals to apply.  Convicted criminals have been encouraged to apply for jobs in care homes looking after frail, elderly people.  Read more here.

4 December 2012: Ann Clwyd, Labour MP tells of inhumane treatment and says she fears normalisation of cruelty now rife among NHS nurses.  Ann Clwyd has said her biggest regret is that she didn’t “stand in the hospital corridor and scream” in protest at the “almost callous lack of care” with which nurses treated her husband as he lay dying in the University Hospital of Wales in Cardiff.  Read more here.

4 December 2012: Melton Court care home to be closed by Friday. The manager of a South Yorkshire care home, which has been ordered to close by Friday, says she is in talks with two potential new providers. The 21 residents at Melton Court in Maltby have to find new homes, after it emerged the owner is in prison. The Care Quality Commission (CQC) revoked Ishtiaq Zahir’s licence and said the home is operating illegally.  Read more here.

5 December 2012: A PENSIONER with Alzheimer’s died after she plunged down a lift shaft when the door was left unsecured, a court heard yesterday. Annfield Plain company faces health and safety charges after tragedy.   Read more here.

5 December 2012: Wrexham – Concerns over care at mental health hospital.  Read more here.

6 December 2012: Leicester – Dementia sufferer ‘left in agony’ at George Hythe House care home in Beaumont Leys, court hears.  An 89-year-old dementia sufferer was left in agony for four hours with a broken thigh  because a care home supervisor could not be bothered to assess her, a   jury heard. Sarah Bewley was “too busy” doing paperwork to see the woman after she suffered a fall, despite several requests from a care assistant, it was claimed.  Read more here.  See below.

7 December 2012: Regulator moves closer to setting up ‘negative register’ of adult care staff.   If the proposals are approved by government, a national code of conduct would be applied to workforce and the HCPC would consider serious complaints made about individual professionals; any decisions to uphold a complaint would be made public, as would the resulting sanction.

A “negative register” would be maintained of those found unfit to practise.  Read more here.

7 December 2012:  Leicester – Jury clears Leicester care home boss of neglect charge.  After the not guilty verdict was announced, Judge Lynn Tayton QC said: “This case raises very worrying issues, particularly concerning systems that seemed to be in place which created a situation in which no-one took responsibility for the care of this lady.  “She was left in severe and unnecessary pain for a number of hours.”I hope those in charge of the home have looked at the systems and the staff training.” Read more here.

7 December 2012:   Chorley, Lancs – A care-home worker and her husband who subjected  their children to years of horrific abuse were facing jail yesterday after being  convicted of cruelty.  Read more here.

8 December 2012: Wolverhampton – An investigation has been launched into safeguarding at a care home, which helps people with mental health, drugs and alcohol problems.  Read more here.

8 December 2012: Derby – A national health watchdog has issued a damning report on a privately-run Derby care home.  The Care Quality Commission has told the company  that owns Cleeve Villas Nursing Home, in Wilson Street, to do more to protect the safety and welfare of residents – or face legal action.  Among the problems identified were:

• No organised stock control system of medicines
• Failure of staff to update crucial medical documents
• Care plans reviews not completed on time
• Failure to ensure prescribed medicines were always available
• Medicine doses not being documented, meaning it was unclear whether medications had been administered
• No appropriate systems in place for the safe disposal of medicines when they were no longer required.

Read more here.

Read the CQC report on Cleeve Villas here.

That list of failures is just the kind of thing most people don’t know about, so  awareness raised to the top is what we need in the world of care.

When it comes to the comment made by the spokeswoman for Cleeve Villas Care Services : “As a dedicated provider of care services, we at Cleeve Villas have taken on board the suggestions from CQC as to how to enhance our overall performance and have already taken steps working with a specialist healthcare consultancy to address these.”Our aim as always is to ensure the individual and complex needs of our residents are met.”

I don’t believe you.  Yet.  This is not the first CQC detailing same/similar problems.   What has taken you so long to show that you care enough to provide good quality care?

9 December 2012: Vulnerable care home residents are treated like “brutes or malfunctioning machines”, said Hilary Mantel, the author, as she spoke of the “utterly depressing” search to find accommodation for a disabled friend.  Read more here.

10 December 2012:  We haven’t a clue how much a care home will cost us.  The vexed question of how we pay for the care needs of Britain’s ageing population rears its ugly head so often that it is no wonder everyone thinks it is a pain in the neck.  Read more here.

10 December 2012: Star ratings: Families need reliable information on care home performance.  Read more here.

10 December 2012: Preventative care for elderly under threat.  Services have been cut or frozen by two-thirds of local councils since coalition came to power, according to ComRes study.  Read more here.

10 December 2012: A Birmingham care home is being investigated by council and health bosses amid  allegations of neglect.  Bramley Court Care Home, in School Road, Yardley Wood, is facing the probe  after a complaint was made about the standard of care given to elderly  residents. New admissions have been suspended while a joint investigation is carried out  by the city council and NHS Birmingham and Solihull.  It is not the first time the home has been in the spotlight over its  treatment of residents. In August a report by watchdog, the Care Quality Commission, found residents  were being put at risk of not receiving adequate food and drink.  Read more here.

10 December 2012: Winterbourne View scandal prompts new care guidelinesReport warns that care sector risks slipping back into institutional culture typified by Victorian asylum system.

The report warns that, elsewhere, staffing cuts caused by reduced fees paid to care providers are causing residents to be left alone for hours at a time and are fostering excessive reliance on use of drugs and on physical restraint, “often for minor perceived misdemeanours”.

Brendan Sarsfield, Family Mosaic’s chief executive, said: “We would argue that if providers don’t believe this has ever happened in their services, it just may be that they haven’t looked hard enough.  Read more here.

10 December 2012: Care home provider Family Mosaic has warned that the care sector is in danger of slipping back into the institutional ways of the past and is urging care providers “not to be complacent” and be vigilant for danger signs of abuse.  Read more here.

10 December 2012: Winterbourne View scandal: Government rethinks use of hospitals.  Norman Lamb said “”We need to have a situation where people who run care organisations – public or private sector or voluntary – know that they are accountable for the services they provide and there are consequences if they don’t.”  You can’t argue with that so let’s home he brings about accountability.  Read more here.

12 December 2012: Copthorne, Sussex – Care home boss suspended over death of patient.  A care home manager has been suspended by the Nursing and Midwifery Council over allegations she shredded a document to cover up a mistake which led to the death of a resident. The resident of  Orchid View care home in Copthorne was given three times the prescribed dosage of Warfarin, a drug used to prevent blood clots, over 17 days in 2010. Read more here.

12 December 2012: Stockton care home boss denies a catalogue of failures.  Meal times at the home were “appallingly organised” and 15 out of 17 patients  lost weight over a one-month period, the Nursing and Midwifery Council heard.  Read more here.

12 December 2012: York care home warned to make urgent improvements.  The Care Quality Commission has issued a formal warning to Mimosa Healthcare (No 4) Limited, which is the registered provider of Birchlands Care Home, that they are failing to protect the safety and welfare of the people using the service.  Read more here.

12 December 2012: Wall Heath care home told to shape up or face enforcement action.  The Care Quality Commision (CQC) is demanding an improvement in the standards of care at Holbeche House after inspectors found failings during an unannounced visit in October.  The Wolverhampton Road home, which is run by Four Seasons (Bamford) Limited, was found to be below standards for the care and welfare of service users and assessing and monitoring the quality of services.  Andrea Gordon, deputy director of operations (central region) for CQC, said: “The law says these are the standards that everyone should be able to expect. Providers have a duty to ensure they are compliant.  Read more here.

12 December 2012: Nurse at Rodborough care home slept with vulnerable female patient and invited another to swingers’ parties. Trevor Rice, a senior triage mental health nurse at Park House Mental Health Resource Centre, was formally removed from his post by a Nursing and Midwifery Council disciplinary committee on November 23.   Read more here.

12 December 2012: A bungling nurse who was cleared to work in Sussex despite making a number of shocking errors is being investigated for a second time.   Nicanor Sindanum made national headlines after he was allowed to continue to work as a nurse despite being found guilty of 17 serious errors by a nursing panel while working in Scotland.   In June this year a nine-month banning order imposed by the Nursing and Midwifery Council (NMC) in September 2011 was revoked and replaced with conditions of practice order.  This meant that, despite his failings, Sindanum was allowed to start work for an Eastbourne care home so long as he told bosses that he had restrictions placed on him. But now it has emerged that Sindanum faces a second investigation for alleged failings dating from 2009.  Read more here.

13 December 2012: Slyne-with-Hest, Lancashire – Four people have been charged with offences under the Mental Capacity Act 2005 following a police investigation into the mistreatment of residents at a care home in Slyne.  Read more here.

13 December 2012: Wales – More should be done to reduce Wales’ reliance on using care homes as a way to look after older people, says a group of Assembly Members.  The assembly’s health committee has backed moves to help people keep their independence for as long as possible. Families need simple and accessible information about the options available for elderly relatives, it said. It pointed out that many elderly people who pay for their own care were unaware of the help available to them.  Read more here.

13 December 202: Panshanger, Welwyn, Herts -Massive arrogance’ jibe as ‘out of scale’ care home plans thrown out.  Read more here.

13 December 2012: Morpeth, Northumberland – Coroner hits out at care of woman in Morpeth home.  Mr Brown, recording a narrative verdict, yesterday concluded the fall “did  play a part” in Mrs McEwan’s death as the fractured femur caused immobility  which made her more susceptible to the fatal complaint. The coroner also found three serious failures in the care of Mrs McEwan.

He ruled senior carer Stephanie Wilson had left Mrs McEwan’s bed in an  elevated position, moments before she fell while trying to get into it.

Furthermore, Mr Brown said staff had failed by phoning a doctor’s surgery  instead of an ambulance after the fall, even though Mrs McEwan was in obvious  pain and in need of such care immediately.

Finally, the coroner said workers had been wrong to lift Mrs McEwan back on  the bed, saying they should have left her where she was comfortable until the  ambulance arrived.

Mr Brown nevertheless accepted that staff had been misguided and in need of  better training rather than motivated by malice.  Read more here.

13 December 2012: Croydon  – Are Croydon care homes up to the job of looking after borough’s most vulnerable?  Nearly a third of care homes in the south of the borough are failing patients and residents in one or more key standard, an Advertiser investigation has found.

Campaigners for better care say the findings paint a “dire” picture for sick and elderly people at a time when savings in care provision are set to be enforced.

Among those that are failing in one or more key standard are homes which charge elderly people up to £800 a week.

Stuart Routledge, chief executive of Age UK Croydon, said: “It is appalling that any nursing home should fail to protect the dignity and respect of their patients and residents.

“This survey underpins the urgency for social care funding reform so that those older people who struggle daily with chronic ill health, frailty and disability have the peace of mind that they will be well cared for at their time of need.

“In particular, this shows the dire consequences of a social care system that has been under increasing financial pressure over the last eight years and in many areas is now financially stripped to the bone.

“Staff across health and care services have a professional and moral duty to make sure the dignity of their patients and residents is enshrined in every action. This means involving people in decisions about their care, providing care that treats people with respect and helping people to be as independent possible.”

Read more here.

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.

CQC and Castlebeck and whitewash

The Care Quality Commission (CQC) has yet again almost managed to airbrush itself out of existence.  If only it could finish the job properly and be done with the constant whitewashing of the responsibility of the Regulator.  Then the world of care might be a better place.

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.

Panorama – Undercover Care: The Abuse Exposed

It must be impossible to have watched the Panorama programme last evening without feelings of disgust, revulsion, horror and utter disbelief.  The torture inflicted by so-called support workers on adults with learning disabilities was reminiscent of a horror movie.

It’s available here if you missed it, and if you feel strong enough to watch it.  It certainly comes with a warning

Joe Casey, the investigative journalist working undercover as a support worker at Winterbourne View, shot footage on his hidden camera that is almost impossible to describe.  His article in today’s Daily Mail puts into words the scenes transmitted.

Winterbourne View is described as a hospital, run by Castlebeck, a company I’ve never heard of before.   Joe Casey uses the words ‘state-of-the-art’ hospital – I’ve developed an allergy to such descriptions now, because it was a ‘state-of-the-art flagship’ care home that was responsible for the neglect and death of my own relative.

According to Castlebeck’s website, Winterbourne View ‘is a purpose designed acute service, offering assessment and intervention and support for people with learning disabilities, complex needs and challenging behaviour’.

It is the staff at Winterbourne View who are in need of immediate assessment and intervention because of their own acutely challenging behaviour.  Now that some of them have been arrested and placed under police investigation they will hopefully receive a full assessment of their own needs for care, long-term care, with fully trained supervision, support and care.  Their mental health needs should have been addressed beforehand, by Castlebeck who employed them as ‘fit for purpose’.  I hope that not one of them will ever be allowed to work in the world of care again, once they have been dealt with in an appropriate fashion by our system of justice.  They are thugs – not support workers.  They don’t know the meaning of the words ‘support’ or ‘care’.

The management – if there is any – cannot plead innocence and ignorance of the situation.  Local and senior management must have known what was going on, but they ignored the whistle blown by a former senior nurse, Terry Bryan.  He tried to get them all to act – but they all failed to listen to his whistle.

As did the Care Quality Commission.  The horse has always bolted before the CQC gets anywhere near the door.  The CQC does not respond to complaints brought to it by us, mere human beings.  The CQC merely hands those concerns down to the very service that is at the centre of the concerns.   The CQC needs to establish a unit that deals in depth with each and every concern brought to it – and not just as another paper-exercise, which appears to be the only thing that the CQC currently has the ability to handle.  It only takes the CQC to ignore one single concern, like this one highlighted to the CQC long ago by a Senior Nurse, and you can end up with a torture setting being allowed to flourish.  That’s nothing to do with care – it’s all to do with neglect.  I accuse the CQC of neglect in the case of Winterbourne View.  To mention just one establishment that the CQC has neglected.

What is the point of a regulator if a regulator is incapable of regulating?

This was institutional abuse.  Abuse that was seen to be happening and so should have been prevented.

There are other kinds of institutional abuse that can never be seen until it’s too late, but they too can result in the destruction of life.  But the very systems within any care setting – that that the CQC and local authorities are meant to ensure are in place – can be absent and impossible for the person in need of care and/or their relatives to identify as being absent.  That’s what a regulator is supposed to be doing.  Ensuring that every single system is in place to protect those people who are at risk.

The Castlebeck website claims to be proud of its staff training.  Castlebeck has a very strong training and development programme. Staff are encouraged to improve their performance and the performance of others.

The company has appeared in the top half of the Nursing Times Top 100 Employers survey for the last three yeas.

Shame on them all, and heaven help those in the bottom half of the NT’s list.

Unless and until there is widespread recognition that the care system needs a thorough overhaul, nothing will change.  I’m sick and tired of hearing apologies, and “this will never happen again”.  It does.  It continues to happen.  Day by day by day – somewhere in the UK.  Oh yes, I have no doubt that there are good hospitals, good care homes, good care workers out there, but there are also too many shabby, sub-standard operations that are allowed to abuse people.

Alongside a radical shift in attitudes, the language of care also needs to change – I hold the CQC and its predecessor the CSCI responsible for the fact that the language of care is enabling abuse.

CQC statement:  “We apologise to those who have been let down by our failure to act more swiftly to address the distressing treatment that people at this hospital were subjected to.”

CQC has “spoken to the former member of the hospital staff, apologised for not contacting him earlier and offered to discuss his concerns.”

CQC says “We have asked Panorama to provide us with detailed information about the hospital to help us in our continuing regulatory work. We have also suggested that in future we would welcome earlier involvement by the programme in cases such as this so that we can step in to protect people as early as possible.”

Why would the CQC listen to Panorama any more than the CQC listens to people who bring concerns to the CQC?  Panorama is not the regulator.  The CQC doesn’t care enough to listen to those who are in the frontline and that includes staff blowing whistles, residents or patients complaining,  and relatives of those in care who are concerned.  But Panorama has the power to name and shame those who pretend to care.

‘National Minimum Standards’ – ‘Essential Standards’ – ‘Regulatory body’ – all meaningless words.

How about a new standard: Guaranteed Quality Standard without which no care home will be allowed to operate, without which no manager will be allowed to manage, without which no nurse or support worker will be allowed to work.

Where are the Required Standards?  Required standards of training for all support workers before being let loose to work in care?  Required standards of supervision of all staff?  Required standards of regulation?  Required standards of career progression for all care workers?  Required standards of respect for all care workers who provide good standards of care?

One of our esteemed (not always) MPs – was it Iain Duncan Smith? – suggested that  unemployed people in receipt of benefits should be forced to work in the community in places like care homes.  Well, my message back would be that you show no respect for the world of care, no respect for staff who might be good support workers if given support themselves, and no respect for the people in need of care.  Because you could end up with utter chaos – but, I am presuming that all the staff working at Winterbourne View were carefully selected, CRB checked, trained and supervised, especially the most senior thug of them all.

And all this on the day that Southern Cross is in desperate trouble, with the begging bowl out now, all because Southern Cross failed to get its priorities right.  It failed to remember that it’s there to provide care.  If Lansley and Burstow and our Demolition Government don’t care enough to care, they should be ashamed of themslves.

How about begging for guaranteeed standards of decent care for those in need of care?  But we shouldn’t need to beg for that, should we.   It should be a basic provision made available by a civilised country.  If we really care.

Legal nooks of care, whistleblowing, cotton in ears & velvet soles on boots

“Behind the most ancient part of Holborn, London, where certain gabled houses some centuries of age still stand looking on the public way, as if disconsolately looking for the Old Bourne that has long run dry, is a little nook composed of two irregular quadrangles, called Staple Inn. It is one of those nooks, the turning into which out of the clashing street, imparts to the relieved pedestrian the sensation of having put cotton in his ears and velvet soles on his boots.” –  The Mystery of Edwin Drood by Charles Dickens

That was “one of those nooks which are legal nooks”.

I was born and grew up not far away from that ‘legal nook’, long enough ago to have experienced the peace and quiet of the City of London on a Sunday morning (then!).  Little did I realise that I’d be reminded of Dickens’ description when I read the report on whistleblowers from Public Concern at Work – Speaking up for Vulnerable Adults : What the Whistleblowers Say.

There are far too many disturbing quotes from the report – which is very user-friendly so you’ll have to read it yourself – but here’s a few that grabbed me, from the 100 cases looked at:

• Year on year we receive the highest percentage of calls to our helpline from the care sector (15%).
• In care, 55% of all calls were about abuse.
• In 40% of all our care cases, concerns were initially ignored or denied by the organisation.
• Additionally this is a sector with many workers who may be considered vulnerable due to low pay, low awareness of rights and lack of access to or knowledge of support.
• Within the care sector itself, over half of the calls we receive are about abuse. The most common concerns being: physical abuse, lack of dignity, neglect, conduct of staff, verbal abuse and medication administered incorrectly or not at all.
• the vast majority of workers in the care sector (80%) have already raised their concern when they call us and over a third of these concerns are initially ignored, mishandled or denied by organisations
• care workers often do not realise that they are actually “blowing the whistle” until they encounter difficulties when having their concern addressed or are mistreated personally
• whistleblowers struggle with the lack of feedback from organisations regarding how their concern is being handled
• we also receive calls from workers across the adult social care spectrum including: social workers, safeguarding teams, volunteers, students, cleaners, doctors, nurses and other professionals.

And that’s all from the first couple of pages of the report!

The report looks at physical abuse, medication concerns, neglect, financial abuse and so on, and works its way through various case stories, all demonstrating the need for safeguarding vulnerable people in care and also the workforce providing that care.

It has allowed me to understand more of the reasons why I have needed to bang my head against a brick wall in recent years.  It also confirms to me what I sadly had to learn the hard way: that – in my own experience of dementia care – the local authority (all departments from the care commissioning team through to the Safeguarding/Adult Protection unit), the mental health care of older people multi-disciplinary team , the CSCI/CQC regulators and the care providers all colluded to care far more for themselves, to protect their own best interests above all others, than they ever cared for my relative’s best interests, and the best interests of other vulnerable older people in this particular part of the world.

They closed ranks in their own ‘legal nook’ to such an extent that I’m almost in need of care myself, because they have almost managed to transform me into a vulnerable adult, by their own sins of commission and sins of omission.  Almost, but not quite.

Not for the first time, I ask why everything can be hidden behind the word ‘confidentiality’.  We now have the vulnerable being cared for by a vulnerable workforce, according to this report, so it’s hardly surprising that nothing changes for the better.

It’s as if the whole care sector has become anaesthetised, numbed and indifferent to all that is going on under the umbrella of care.  I have been planning to write more about my own experience of dementia care, and this report has sharpened my resolve, so I will go back to the beginning and work my way through it all, chapter by chapter, stage by stage.

“…. the sensation of having put cotton in his ears  and velvet soles on his boots ….”

The cotton may still be in their ears – the velvet soles of my boots will have to be removed.

Whistleblowing in the sphere of Vulnerable Adults

My thanks to Fighting Monsters AMHP for bringing to my attention a Report from Public Concern at Work about whistleblowing in the care sector.

The title of the report – Speaking up for vulnerable adults: What the whistleblowers say – speaks for itself, almost, and is available here for anyone interested.

I’ve read it twice now; it’s only 21-pages long and it’s very well written indeed.  I’m going to read it a third time before I comment any further, but I just wanted to say a quick thank you to Fighting Monsters and to Public Concern at Work for allowing me to see, in part, the reasons why I was beginning to think that the pea had been stolen from my whistle, over the recent years of my own attempts to blow it in the ears of those charged with providing decent standards of care in the UK.

“Public Concern at Work is the leading independent authority on whistleblowing in the UK. We run a free advice line for those who have witnessed crime, danger or wrongdoing at work.”  I wish I’d heard of Public Concern at Work  before now – because I could have pointed a few people in the right direction.

It’s not just my pea that’s been stolen.

If I forget to return to this report, I’ll be surprised – or it may mean that I’ve been abducted.

Care home residents died from ‘severe neglect’

Will it never end? Will lessons never be learned?  Will we never be able to guarantee quality care in care homes?

Please tell me what more we have to do?

Guardian.co.uk carries this horrific story of neglect.

“Five elderly residents of a failing care home who died within two weeks of each other had suffered “severe neglect”, an official inquiry has concluded.

The residents of Parkside House nursing home in Northampton died between 22 July and 6 August, 2009. They were aged between 83 and 100.

A serious case review into the deaths, published today, described standards of care at Parkside as appalling. It said signs of a rapid decline in standards at the home in the weeks before the first resident died had not been picked up.

At a press conference, it was disclosed that there was a lack of basic care, including ensuring residents had enough to eat and drink.

Verdicts of natural causes were recorded in all five deaths, but the review found they died from causes that “were considered to be consistent with the effects of severe neglect”.

Seven members of staff and the owner of the home were referred to the Nursing and Midwifery Council by the Care Quality Commission (CQC).”

The home had been inspected in November 2008.

The review said Parkside House’s CQC registration was for people suffering from dementia and long-standing mental illness. “However by July 2009 it is clear that they were actually looking after people with those needs plus considerable physical and nutritional needs that they simply could not manage.”

What is the point of inspections if they fail to connect?  If only the CQC would talk to and listen to the relatives of people with dementia – many of whom are at the end of their tether trying to achieve an acceptable standard of care for their loved ones with dementia – tragedies of this kind would no longer be happening.  But the CQC, and its predecessor, and local authorities and social services – to name but a few – seem to bend over backwards to ignore the pleas that come from family, but bend over backwards to preserve and protect the inefficient care industry.

BBC News has just picked up the same story.

At the risk of sounding trite, if these atrocities were happening to animals, there would be a public riot.

Mr Cameron, are we all in this together too?  Or is it just vulnerable elderly people with dementia who are in it?

Mr Cameron, you said today at your Conference “Fairness means giving people what they deserve“. 

Mr Cameron, be fair, then, and give elderly people in residential care the good care they deserve.  Otherwise your words are meaningless,.

The systems of protection need to change overnight.

Systems of protection need to be created.

Hospital put dying dementia sufferer in storage cupboard “for being too noisy”

The treatment of Dora Duggan, 81-year old terminally ill dementia sufferer is unforgiveable, despicable, inexcusable abuse  – and criminal.

WHICH MEMBER OF OUR COALITION GOVERNMENT REALLY CARES?

WHICH MEMBER OF  OUR CARE QUALITY COMMISSION REALLY CARES?

Which of them cares enough

…. to make sure we demolish the system of neglect currently masquerading under the umbrella of ‘care’, allowed to  kill and to inflict pain and suffering on vulnerable elderly people in need of  CARE.

If any single one of them really cared, then by now there would be in place a system of genuine care, ensuring quality of care.

Dora Duggan was a mother, grandmother to 15, great-grandmother to 7.  And above all else, a decent elderly person who was vulnerable and who deserved better care.  She was also terminally ill and in need of care and comfort in her dying days.

The full article is here for anyone to read, and it quotes Jenny Leggott, deputy chief executive and director of nursing at Nottingham University Hospitals NHS Trust, which runs the hospital in question, as having said : ‘We are deeply sorry and apologise unreservedly to Mrs Duggan’s family for the shortcomings with the care provided.

‘We have investigated the concerns raised and have assured the family that we will do everything possible to avoid future occurrences of the difficulties they brought to our attention.’

I am prepared to raise my hand – or both hands and both legs if need be – and to say that I am sick and tired of hearing the phrase “lessons will be learned”, or “we will do everything possible to avoid future occurrences of the difficulties they brought to out attention”, or even the one that came my way “we will do everything we can to make sure this never happens again”.

They are meaningless words.  They are just that – words.  The actions required to prevent these crimes happening again and again and again never seem to follow the words.

Without action, the words will forever remain meaningless.

We now need action.

And remember, tomorrow that vulnerable elderly person in need of care may just be you.

Southern Cross under fire over pensioner’s agony

Southern Cross wonders where its profits have gone?  Two days ago I suggested that people are becoming wary – and weary – of the problems surrounding Southern Cross care homes. a reference to the many investigations that have been or are being undertaken in connection with their care homes.

Today, the Manchester Evening News (but be warned before you click on that link – it is not for the timid) carries the horrific story of Betty Delaney, 82, who suffered severe neglect in a Southern Cross care home, where the frail pensioner was left in agony with bedsores during the final months of her life.

The family’s solicitor Sian Thompson said she was pleased the care home’s owners had admitted liability, adding: “Southern Cross could have easily prevented Mrs Delaney’s bedsores by putting her on a pressure mattress, turning her and checking on her regularly and having a risk assessment in place.

“Not only did they fail to do this, they failed to even detect there was a problem.

“This case highlights the way our elderly are so often forgotten about. Betty Delaney should never have been put through this indignity, and we hope the admission of liability has brought some closure for her family.”

“Not only did they fail to do this, they failed to even detect there was a problem.” That is inexcusable, and no amount of post-rationalisation can ever justify such unprofessional low standards of care.

Mrs Delaney, my thoughts will be with you, and with your family.  The likelihood of closure for the family is slim.  They will be only too aware that there was nothing they themselves could have done to prevent the pain Betty Delaney endured.  But they will be left wondering for ever and a day how it came to be that nobody at Southern Cross, nobody at Rochdale Council, nobody at the CQC, and nobody at Oakland Care Home, Rochdale, “detected there was a problem” with the quality of care – or rather the inferiority of care at Southern Cross.

Many people reading this article about Betty Delaney will perhaps be under the impression that neglect in care is a very rare occurrence.  It isn’t, as I know myself.  I believe we need a strong change in the culture of care so that we can work towards a nationwide standard of care that we can be proud of.

At present, we naively rely on the word ‘care’ to mean just that, but we do so at our peril.