Tag Archives: Care Quality Commission

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.


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Who guards the guardians? Oh yes! Good question.

So, Lord Justice Leveson has one simple question at the heart of the public inquiry he is to oversee.

Who guards the guardians?

If only that same question could be asked about those who are charged with guarding our mature relatives in need of care at the most vulnerable stage of their lives.

It would require Lord Justice Leveson to ensure that his inquiry would encompass not only the toothless Care Quality Commission, but also the care providers, the local authority commissioning departments,  local authority facilitators (for want of a better word), the whole network of careless care that so often destroys the lives of those who deserve better care.

The ethics and culture of the care system need a thorough examination also.

“The terms of reference raise complex and wide-ranging legal and ethical issues  of enormous public concern,” said Justice Leveson in a statement released this afternoon.”

The same should be said about the way in which we have allowed a care system to develop that raises equally complex and wide-ranging legal and ethical issues of enormous public concern.

I’m not talking about phone-hacking.  I’m talking about the preservation of life.

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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 trainingCastlebeck 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.


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Is this a care home?

I was hunting around the CQC website for some info and, as always, finding it increasingly difficult to locate exactly the information required.  (Is it just me, or does anyone else find the CQC website one of the most user-unfriendly places?)

Anyway, I came across this Press Release dated 6 April 2011 about St George’s Park Care Centre in Telford. I’ve never heard of it, but I have a friend who lives in Telford, so I read further.

Care Quality Commission (CQC) inspectors who visited St George’s Park Centre in Telford, Shropshire, found that it was failing to meet 15 out of 16 essential standards.

Providers have a legal responsibility to make sure they are meeting all the essential standards of quality and safety.

Inspectors visited the home three times from December 2010 to January 2011 after concerns about the safety of people in the home triggered an unannounced review.

The compliance review outlines thirteen areas where inspectors had major concerns.

I read the full Review of Compliance report dated 24 January 2011.   It is a disgrace that this so-called care home is allowed to call itself a care home. 

The home is made up of two units, Rydal on the ground floor, which can accommodate a maximum of 31 older people who have dementia and nursing needs. Derwent unit is on the first floor and can accommodate a maximum of 40 older people requiring general nursing care.

It’s apparently owned and operated by a company called Modelfuture Limited – I’ve never heard of them either.  So a bit of trawling about reveals that it’s one of ailing Southern Cross Healthcare’s long list of subsidiaries mentioned here.

The Shropshire Star finds it shocking too.

I urge you to read the full Review of Compliance report – if you’ve got the stomach to do so – and decide whether 71 vulnerable older people should be subjected to such neglect, with some of them being charged upwards of £700 per week for that kind of abuse.

Is this the best we can do in this caring country?


Filed under abuse, care homes, neglect

Statement from the Care Quality Commission (CQC)

A statement has been issued today by the CQC insisting that all potential care home residents must be screened, before admission, for any identifiable condition that might contribute adversely to the current spending cuts and financial deficit.  The statement, warns leadenly, reminds us and cites the reason for the statement: aching cells go, from bad to worse, so the cost of care will increase dramatically, while the standard of care required will in fact continue along a downward path.  This new screening (the screening ‘tool’ has yet to be published, but it is likely to require a full multi-disciplinary (MDT) assessment of eligibility for care home admission, plus the associated financial assessments, which may from tomorrow be even more stringent than have been applied thus far )  is to form part of the legally required pre-admission assessment from now on, so that both potential resident and care provider can be sure of providing the appropriate care, as outlined in the contract-to-care that each and every potential care home resident must receive.

Although the CQC doesn’t usually enter into direct comment on medical matters, it has also demanded that all care home residents must be enabled and supported to exercise extreme caution with certain herbal remedies that have been offered in recent months.  The experience of a diverse group of vulnerable older people across the country, with adrenals newly, flushed by a previously untried and untested formulation, was cited as the main reason for these latest warnings from the CQC.

The remedy on offer has not been approved by NICE, nor by any one of the bodies normally charged with supervision of health and/or social care, so it is important to read the instructions that should have been contained within the herbal packaging.  A further warning is that not all people have, in fact, received the full statement of purpose for this widely available concoction.  The instructions should give full indications of the likely contra-indications of this potion which may appear to be a balm, but may not be all that it claims to be.

The final advice from the CQC statement today is to notify that a  Safeguarding Alert has been issued to the residents of all care homes registered with the CQC to be cautious and extremely wary of random advice.  There is no time limit on this Safeguarding Alert from the Care Quality Commission, so it is for the future rather than just for a defined period.


Filed under care, care homes

CQC Report on Deprivation of Liberty Safeguards in England

A Report just published by the CQC The operation of the Deprivation of Liberty Safeguards in England, 2009/10 will be of great interest to everyone who has ever had cause for concern about the way in which these DoLS have been applied in their own particular circumstances.

“A number of cases concerning deprivation of liberty have come before the European Court of Human Rights and the UK courts.  The following list is based on the judgements of several of these cases and indicates the circumstances that have led to courts deciding that patients have been deprived of their liberty:

• Restraint was used to admit a person to a hospital or care home when they were resisting admission.
• Medication was given forcibly, against a patient’s will.
• Staff exercised complete control over a person’s care and movements.
• Staff made all decisions on a person’s behalf, including choices relating to assessments, treatment, visitors and where they could live.
• Hospital or care home staff took responsibility for deciding if a person could be released into the care of others or allowed to live elsewhere.
• When carers requested that a person be discharged into their care, hospital, or care home staff refused.
• A person was prevented from seeing friends or family because the hospital or care home restricted access to them.
• A person was unable to make choices about what they wanted to do and how they wanted to live, because hospital or care home staff exercised continuous supervision and control over them.”

I don’t know anyone who has brought their case the the European Court of Human Rights or the UK courts.  But I do know people who have had to fight hard to challenge decisions made by staff in hospitals, care homes and social services, as per each of the judgements listed above.

The relatives in question may have known little – or a lot – about the Deprivation of Liberty Safeguards.

Some of the relatives who were  challenging these decisions had Lasting Power of Attorney (LPA) for Health and Welfare on behalf of their relatives, but still they were dismissed by the decision-makers as if they were just a thorn in the side of the authorities.

I do wish the supreme arrogance of those with the power to destroy lives could be trained out of existence.

The Report is not comfortable reading, especially for anyone who has encountered sub-standard care and neglect of their own relative in a care home.  The examples given of the inappropriate deprivation of liberty that people with dementia have suffered are particularly gruesome.

“For example, during an inspection following a safeguarding alert, we found that a person in the care home who often suffered from confusion as a result of dementia was being locked in a room alone overnight and not checked by staff for periods of up to 10 hours. This person’s notes described their usual routine as being up at night and up early in the morning. However, because of their confusion and lack of mental capacity, they would be unable to use the call bell to summon assistance if necessary, and were therefore unable to follow their desired and usual routine. This practice was being carried out without any consideration that it may have been a deprivation of the person’s liberty. There was also no apparent consideration of any less restrictive practice and no thought given to alternatives such as increasing the number of staff overnight.”

Is this Care in the UK?  Or Neglect in the UK?

CQC Reports will change nothing – unless there is also positive action.  Today – not tomorrow.

If the DoLS regulations are “too difficult” for healthcare and social care staff to understand, they must be revised, reviewed and re-written so that they are easily understood by anyone and everyone.  If the DoLS regs are to be a meaningful legal framework, there’s an absolute need for them to be understood and correctly applied.

Attitudes must change; training must change; dementia training must be made mandatory, not optional; staff-to-resident/patient ratios must be increased and enforced, not just left to chance; the postcode lottery of care and safety needs to change.

Will that be possible in the Big Society?  Will that be possible with vicious cuts being applied without regard to care?

Who will care then?

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CQC’s dynamic system of regulation

When I saw Mark Easton’s report on BBC News at Six yesterday about the changes in the way care homes in England are to be inspected, it made me wonder – yes, yet again! – whether the world has gone completely off course, heading for a major collision.

Then I read Mark Easton’s blog ‘Care and the Community’ and the words used by CQC have thrown me completely.

We rely on people who use services and those who care for and treat them to tell us about the quality and safety of services. This feedback is a vital part of our dynamic system of regulation which places the views, experiences, health and wellbeing of people who use services at its centre.

Dynamic system of regulation?  Dynamic?

Dynamism presupposes energy and effective action –   not exactly characteristics for which the CQC has ever been renowned.  Lethargic might be a more appropriate adjective to describe the CQC.

The CQC and its predecessor CSCI have been short of a dynamo – or even more than one – for  years, and there’s not much chance of new-found energy coming via a system of informal regulation which will rely on the already depleted energies of older vulnerable care home residents and their relatives.  It’s unfair to place such a burden on their shoulders.  But it will make it easier for care providers to cough out the old chestnut “well, nobody else has complained”.

Care Services Minister Paul Burstow said in Mark Easton’s report “…. we’re determined to actually make sure responsibility sits where it should be, with the commissioners, with local authorities and with the providers”.   Burstow almost implies that those commissioners, local authorities and care providers never had any responsibility in the past to ensure quality care in care homes.  So what were they commissioning, authorising and providing?  Crap Quality Care in the UK?

Anyone who has ever tried to shake awake either CSCI or CQC and to try to get some kind of dynamic action from them will be in a state of severe shock now.  It has never been possible in the past to get anything that resembles ‘concern’ from CSCI/CQC, so I have little optimism for the future.

Especially as the cuts currently being forced through in local authorities up and down the land will make dynamic localism an empty promise.

But if the plans to abolish councils’ legal duties to provide social care come to fruition, there will be no care homes.  There will be no care.  Social care will be gone into the hands of the private providers, available only to those who can afford to pay the charges of those private providers.  I wonder what it will be called if it becomes a discretionary rather than obligatory provision of care.    Local care?  Discretionary local care?  Survival of the fittest via neglect of the needy?

Is that a civilised way to support vulnerable adults in need of care?  It wouldn’t be allowed if it were cats and dogs we were talking about, so it should not be considered good enough for older people.


Filed under care, care homes, growing older

The continuing story of the dire state of care homes for the elderly

Oliver Wright’s piece today in The IndependentDire state of care homes for the elderly is only going to get worse, says top inspector – has left me scratching my head. Some of the statements made by Dame Jo Williams, Chair of the Care Quality Commission (CQC), astonish me.

She seems to approve and accept without question, almost as a fait accompli, that ‘service providers’ will cut corners, will not provide suitably trained staff, will continue to scrape the barrel when it comes to staffing by paying the minimum wage.

One of the Essential Standards is that ‘you can expect to be cared for by qualified staff’.  So the CQC cannot allow service providers to cut that corner.

You can expect to be cared for by qualified staff

  • Your health and welfare needs are met by staff who are properly qualified.
  • There will always be enough members of staff available to keep you safe and meet your health and welfare needs.
  • You will be looked after by staff who are well managed and have the chance to develop and improve their skills.

She says that more needs to be done to recruit, train and retain good staff, but in the same breath she condones the fact that “many staff are already on the minimum wage so there are not many savings there”.

It is the function of the Care Quality Commission (CQC) to ensure that service providers don’t cut corners.  To ensure that staff are suitably selected and trained for the job they are required to do in care homes.

Dame Jo seems not to have made the connection between the appalling standards of care provided in some parts of the care home ‘industry’ and the ridiculously low wages paid to staff, resulting in problems with staff recruitment, retention, quality and loyalty.  The care ‘industry’ needs to pay a living wage, rather than a minimum wage, in order for things to improve.   Then Dame Jo might find that in the South-east the workforce might be less transitory.  Didn’t the Mayor of London set up a Living Wage Unit a while ago?  How on earth can anyone expect decent standards of care when little respect is shown for those who provide the hands-on day-in-day-out care?  If they are undervalued, they will undervalue the people they are serving.

If only the care  ‘industry’ cared enough to guarantee staff training – especially dementia training – and to make available a decent career path, the right quality of care could be found more often by those of us who have no choice but to arrange for our own older people to move into residential care.

Whose side are you on, Jo Williams?   Has the CQC become the Trade Union for Service Providers?  I read little of Dame Jo’s empathy for people in care paying an absolute fortune (to them) for sub-standard care.  The CQC is there to regulate and to guarantee that a good standard of quality care is provided to those vulnerable people who need care.  The CQC is there to ensure that the Essential Standards are met, without short-circuiting.  The CQC and the local authorities and the care home providers all need to be reminded of the fact that nobody moves into a care home unless and until they have to do so.  It’s not a flimsy lifestyle choice – it’s a necessity.  All care home residents deserve respect and deserve to be valued.  They must be at the centre of thinking.

Is Dame Jo Williams serious when she says “Quality in our terms is making sure a service is safe – but it is also about how you’re treated.  It’s about staff remembering your birthday, calling you by the right name and engaging with you as well as maintaining your dignity.”

A birthday comes but once a year.   The remaining 364 days of the year in care are equally important, if not even more important.   Calling you by the right name?  That’s not rocket science, so it should be fairly easy to instil that quality into the staff.  Of course dignity is essential, but it hasn’t been present in the world of care for far too long now, so forget the birthdays (the chances are there’s a piece of software that will ping out a birthday!) and concentrate on the quality of care.  That quality of care involves the setting, the building, the decor, the provision of good nutrition, medication, care planning, monitoring and supervision …. … to name but a few of the essentials of care.

She talks about “looking at those services that are risky and are likely to put the public at risk”.  It’s the residents who are at risk, not the general public.  I hate constant references to ‘services’ and ‘service users’ and ‘institutions’.  It de-personalises, it removes the person and the personal from the debate.  By all means use those terms in your own offices, if you really must, but remember the people first.  It’s almost as if the word ‘service user’ gives permission to the profession to forget that they are dealing with real people, people who have a lifetime of experiences, people who have contributed throughout their independent life.  And without whom we would not be here.

A person who moves into a residential care home becomes a resident.  They reside in their new home.

A person who provides care in a residential care home is a care provider, a provider of care.

Sort out the language of care, Dame Jo, then we might all be able to understand each other better.

But ‘nursing home’ seems to be creeping back into use, just to confuse us even more when trying to navigate the CQC website!  There used to be only two types of care homes: residential care homes (without nursing), and residential care homes (with nursing).  There are care homes with a nursing section/wing/unit/floor.  There are care homes with no nursing at all.  Some people talk of EMI homes.   Are they the same as care homes registered for dementia?  Are they nursing homes?

I’m intrigued by this security-services style software that she mentions.  Scanning the thousands of reports the Commission receives each month looking for ‘trigger words and anomalies’.  Anyone who has ever approached the CQC or its predecessor the CSCI – by phone, by letter or be email – to draw attention to a particular concern in a care setting will know only too well that software isn’t required.  The CQC just needs to listen, to note, to reflect and then to act promptly.  You don’t need software to alert you to problems.  That’s what we’re here for – real people.  All you need to do is to listen.

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Johann Hari’s plan to solve our care home crisis

Johann Hari, journalist and columnist at The Independent, has come up with a 10-point  manifesto to transform the shabby system of care of the elderly in place at present.

Very recently, he wrote an extremely moving account of the last ten years of his grandmother’s life in care, as she suffered atrocious treatment in various care homes.  His article – My grandmother deserved a better ending than this – was apparently the catalyst for the tsunami of emails he received from relatives of people in care homes and from care workers, all sharing their own experiences.

Today Hari cries out again in The Independent, with a list of proposals that some people may think are unnecessary, judging by some of the fatuous comments on his previous article.  But sadly, some of us know only too well how essential this manifesto is – and how long we have been waiting for it.

I do so hope that he will attract more attention than those of us who have been pleading for years now, begging the ‘authorities’ to take positive action to improve the care system.  But our cries were bootless.

Please listen, world, please listen now.  Trust us, believe us, listen to us, hear what we have to say and improve the system once and for all.

It’s not necessary for me to comment on the ten ‘Acts’ of Johann Hari’s plan.   But I applaud each and every one of them.  If I could add just one further point to your plan, Johann, it would be one single acronym for the care system to acknowledge and to live by:


Be honest – be open – be truthful. Because so far, our so-called care system has been far from HOT.  It has been frozen into inactivity.  Heartless, uncaring, and deaf.

I’ve tried to do my bit to improve some of the Acts too, as have so many people before and since.  I failed miserably in part, because the might of the local authority is great.  As is the might of the mental health care of older people team, able to engage and pay for massive amounts of legal advice when I challenged the shoddy standards of that particular mental health care of older people team, and their ‘convenient’ interpretation, use and abuse of the Mental Capacity Act.  (I’m still working on ‘others’ involved.)

That legal advice was all paid for from the public purse, of course.  The tax payer and the Council tax payer paid the price of that.  All to preserve the dignity and reputation of the local authority, the care home provider, the CQC/CSCI, and the reputation of all the other weasels involved.

My relative paid the ultimate price.

I would have preferred the ‘authorities’ to have spent that money on care, rather than on legal advice to protect their puffed-up selves – and to protect the puffed-up care provider.

Where were you then, Paul Burstow?  Neither you nor your predecessor was willing to listen then.  You are all there when it comes to talking about money and funding, but you’re strangely absent when it comes to the discussion of care standards and quality of care.

The CQC/CSCI is blind, deaf and toothless.

The policy in place to protect vulnerable adults from abuse carried the name ‘No secrets’ – but secrets is precisely what the authorities operate, preserve and protect.  In their own best interests – but not in the best interests of the vulnerable adults.

We should be ashamed that such a manifesto is necessary – but it is absolutely essential.  We are supposed to be civilised – but we are not.

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Sex and the senior citizen – in Germany!

A different kind of care for the older person is  emerging in Berlin, according to The Independent

Sex for the elderly facilities have been introduced at Artemis, Germany’s largest luxury “wellness” brothel, in the Berlin district of Charlottenburg, where seats have been installed in showers and clients’ changing rooms have been enlarged to accommodate wheelchairs.

 ‘Helpful personnel’ takes on a whole new meaning. 

The need to provide sex for the elderly has also been recognised by some German retirement homes. The woman director of a Berlin home, who did not want to be identified, said recently that she wanted to offer a “room for intimate encounters” in her establishment.

Memo to the Care Quality Commission: are you suitably equipped to carry out inspections?  Will you rely on self-assessments?  Would this be a requirement too far?

The Age of Enlightenment?

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