Care Circus is back in town next week

Well, here we go again.

Next week the Care Circus is back in town.

The latest batch of NMC hearings is about to stir its loins again and get on with the work that it was charged with handling long ago on 1 October 2008.  That was only a few very short months after you died, thanks to the rubbish care that came your way, courtesy of Care UK and Lennox House so-called care home in Islington, London.

It was also a few very short months after I’d asked so many questions of Islington’s Mental Health Care of Older People team, and then Islington’s Social Services, and then the CQC (or CSCI as it was called back at the beginning of 2008), and the Coroner’s Office, and Islington’s Safeguarding of Vulnerable Adults Team, and  most of all of Care UK … well, you will know how many questions I asked of them all, each and every one of them.

They don’t like answering questions, do they?  Especially if those demanding but necessary questions are likely to cast a very dim and dark shadow over their (lack of) accomplishments.

Last December 2012, the NMC decided that one nurse involved in your demise should be struck off, from their register of nurses allowed to nurse in the UK.  Another nurse was delivered a 3 year caution order, requiring her to be on her best behaviour.

Next week, 15 to 19 April 2013,  the Circus is back in town.  Fifteen months after the NMC hearings first started, looking in depth at the circumstances surrounding your rapid decline, within 10 days of arrival in that so-called care home, Lennox House, and your admission to hospital in a diabetic coma.  You died 3 weeks later.

The  final 2 cases, still waiting in the wings, are to be dealt with by the NMC next week.

One case  is that of the care home manager, who is mid-way through an interim 9 months suspension order, placed to allow time for her to seek permission for a Judicial Review in the High Court, of the NMC decisions thus far.  The High Court refused permission to seek a Judicial Review.

The clowns will all be wearing their costumes.  Their faces will all be heavily disguised beneath the cake of their make-up.  They will all have their props to support them.  Their scripts will all have been written, re-written and then written again.  Edited, heavily edited, and then edited again.

You weren’t allowed to write a script of  your own, were you?  Let alone edit it.

The script of your final years, months and weeks of your life was snatched from you.  Grabbed by thugs.  The uncaring, unqualified, untrained, unmonitored, unsupervised, unsuitable thugs who were charged with the most basic and fairly simple duty of looking after you.

Next week, they will still be wearing their masks, their costumes  and their heavy make-up.

As they will continue to do year after year.  Uncaring as always.  Unkind in their presentation thus far.  Unwilling to admit that they failed miserably in their duty of care to you, for you and about you.  They didn’t care enough to care.

The chance to wear your dresses, your gentle make-up and to present your smiling face to the world was taken from you.  By the thugs of care.  The thieves of care.  The robbers of care.

Care in the UK – 5 years on – Part 4

The next days were spent making arrangements for your funeral. 

I began to follow up some of the questions I’d already asked in mid-December 2007 of the Mental Health Care of Older People Team, part of Camden and Islington NHS / Mental Health and Social Care Trust.  Their social worker wrote to me the day before the funeral to inform me that she’d no longer be the allocated worker, but that her Deputy Manager would be coordinating the “on-going enquiry” into the circumstances leading to your admission to hospital. There was to be a comprehensive investigation under their Adult Protection Procedures.  I asked to be allowed to attend all meetings and to receive a copy of the Report of the Investigation.  The Deputy Manager of the MHCOP team said she didn’t envisage any problems with that request; she knew by then that I’d want and need to stay fully involved.

I’d contacted CSCI (now the CQC) on 20 December 2007, while you were still alive,  to tell them of my concerns about your care, or rather lack of it.  It took them a while to find the right department dealing with Lennox House.  CSCI had not been notified of your sudden admission to hospital on 8 December 2007,  so the inspector I spoke to said they would write to the manager of Lennox House and to me.  I heard nothing back from CSCI, so I phoned them again on 21 January 2008,  to be told that CSCI had indeed written to the manager after my phone call and that they’d received a call back from her to say that she would reply in due course. 

But CSCI  received no response from her, so they contacted her again on 21 January 2008.  That’s when I first discovered that the manager told CSCI, that very day,  that she had ‘arranged’ a meeting with me on 31 December 2007 (as I mentioned here) and that all my ‘concerns had been ironed out’ at that so-called meeting.  That is far from the truth.

Your social worker had a few busy days too, round about 20/21.12.2007, and when I received a copy of your notes (much later in February 2008) I was able to know more.  According to the notes, she’d apparently tried to phone me so many times but had never been able to reach me or to leave a message for me.  Strangely enough, many other people had managed to do just that.  I knew nothing of Adult Protection Procedures or the ‘Form AP2’ that was completed then.  Islington’s Adult Protection Coordinator was busy too, but I did manage to speak with her just the once. 

When I received your notes, sent to me on 12 February 2008, I read that the Adult Protection Coordinator had advised your social worker on 2 January 2008 – well before the funeral – that your family had the right “to request an inquest, though MHCOP would not do this”.    (They are the exact words used in the social worker’s notes.)

Why is it, do you think, that absolutely nobody at all cared enough to pass that vital piece of information to your family?  Not one person told us that we had the right “to request an inquest, though MHCOP would not do this”.  

MHCOP (Mental Health Care of Older People) were well aware that there were serious concerns about the lack of care provided to you by Care UK’s so-called care home Lennox House. 

But nobody cared enough about you or your family to tell us that we had that basic human right.  There were a few other things noted that they could have transmitted to your family too, but nobody cared enough to tell us.  In the best interests of whom was that decision made to withhold vital information from us?

According to the notes, MCHOP were faffing around trying to work out whether there was anybody available in MHCOP with the ‘capacity to conduct an investigation’.  Not wishing to be facetious, but I do wonder whether they meant the ‘mental capacity’ or the ‘physical capacity’ to conduct an investigation.  In the event, an Independent Nurse Consultant was commissioned by MHCOP to carry out the investigation and to write a Report.

The social worker signed off on 8 January 2008 and departed by writing that she would no longer be involved in your case as “the only remaining work is the completion of the POVA enquiry”.  POVA was the Protection of Vulnerable Adults.

You deserved better care.

(To be continued)

 

 

Care in the UK – 5 years on – Part 3

This day five years ago, 31 December 2007, was a difficult one for many reasons.  I know that you won’t wish me to go into the detail of some of those reasons here.

We drove to London again and spent 4 hours at the Whittington Hospital dealing with various formalities. Most of the morning we spent in the PALS office (Patient Advice and Liaison Service) and talking on the phone with the Coroner’s Office and with one of the hospital doctors involved in your care.  We grabbed a coffee and  left at about 1 o’clock, having decided that we did not want to have to return to that part of London again in the near future.

That’s why we went – on the spur of the moment, unplanned and unannounced – to Lennox House to collect your belongings and avoid the need to go back there again.  While you were still alive, just, I’d already asked the manager to send me a copy of everything on your records.   On 20 December 2007 I received a copy of a document that Care UK calls the ‘Daily Record’ .  It was only 9 pages so I asked the manager to copy and send everything else.  It was the only document I’d seen then, but it gave a good indication of the very days when you must have been desperate for help, but no indication of any help being given.

We parked the car and were able to walk straight into Lennox House.  So much for security.  The manager was at reception, but she didn’t recognise us.  She’d only met us once before,  back in August 2007 when we went on a recce to Lennox House, just one of the care homes we looked at.  There was no reason she should have recognised us.  I introduced myself and explained that we’d come to collect your belongings.  She said she’d just been speaking with your niece on the phone and she was planning to collect your things.  It was easier for us to do it there and then, as that niece doesn’t drive.  She also said that she was just writing a note to me, to accompany the paperwork I had asked for.  I said I’d take it all with me and save her the trouble of posting it.

We went to your room, and packed your things; a few were missing, especially two rings.  I asked for them – but I was assured you had not had any rings on your fingers when you arrived in Lennox House.  It was an uncomfortable thing to hear, because we ‘d bought one of those rings, the ruby ring, for your 80th birthday.  The sapphire and diamond ring had been on your finger for the last 60 years –  more years than I care to remember.  I’d noticed you were wearing both rings when we last saw you there, in November.  Eventually, the staff managed to come up with one of the rings.  The other one never surfaced.

We went down to reception.  I was asked to go into the manager’s office, while “His Lordship” as you always called him took your things to the car, before returning.  In that office, I was subjected to an inquisition.  I was expected to go through every single line of the Daily Record and explain my concerns to the manager, as she wrote alterations on the pages.  I thought I’d already done that on the phone earlier in December, but I still had to go through it all again.  It became impossible for me, and I left the office in tears saying I just couldn’t go on with it.  We had spent 4 hours at the Whittington Hospital, and I was exhausted.

I told the manager much of what we’d been through when you were in hospital, including being asked to explain how your diabetes was so out of control.  I’d already spoken with the GP who hadn’t bothered to look at the meds you were taking, when she’d been called to the home, and who told me she was not aware that you were a diabetic.  If she had been given a list of the meds you were taking it would have been obvious to her that you were a diabetic.  If one of the nurses had told the GP you were a diabetic, she might have treated you differently.   (She’d never met you before, as you were new to the care home and new to the surgery providing services to that care home.)  Interestingly, it was only from that Daily Record that I discovered the GP had spoken with Lennox House (on 14 December 2007, while you were in hospital) before she returned my call to her that day.

The manager told me that there were no available glucose strips in that home,  because the GP does not prescribe them.  The manager told me that Care UK wouldn’t provide them either.  To say that I was shocked, again, would be an understatement.  I volunteered to pay for a year’s supply so that no other person with diabetes would ever arrive in A&E in a diabetic coma, like you did.  With much of your bloods and tests ‘deranged’ .

I’m still trying to work out why those same words about glucose strips being unavailable are written in your care home notes, in the Daily Record for 7 December 2007.  It’s such a strange few lines to have been added to someone’s personal care record.  After all, you weren’t the only resident with diabetes, so  it strikes me as a very strange addition to your records.  Contemporaneous?  I doubt it.

The manager said “we have taken steps to make sure this never happens again”.

That was too late for you.  You only had one chance.

What I didn’t know until much later (namely July 2008)  was that a ‘Complaints Form’ came into being on this day, five years ago.  Its purpose was to indicate that ‘a meeting had been arranged’ to discuss my concerns, all of which appear to have been resolved that very day.  I learned from CSCI (Commission for Social Care Inspection) that a ‘meeting had been arranged’ this day, 5 years ago, to discuss my concerns.   It must be the first ‘meeting’ where people stood to ‘discuss’, rather than sat comfortably.   CSCI asked for a copy of the minutes of that meeting.  CSCI is now the CQC (Care Quality Commission).  There were no minutes – because it was not a meeting.  It was a chance encounter.   (More about this all another time.)

I left Lennox House in tears.  This day 5 years ago.

You deserved better care.

(To be continued)

Shoesmith, Balls & bucks

And so it came to pass that judgment was handed down yesterday in the case of  Sharon Shoesmith v. OFSTED and Others. Shoesmith has achieved a strange victory and in doing so has only managed to highlight the fuzzy and muddled standards that operate in the world of care and local authorities.

I’ve just listened to an interview with Shoesmith on today’s  BBC Radio 4 Today programme where she had the brass neck to say that she’s not into the ‘blame game’ using the words “I don’t do blame”.  She also said that ‘you can’t stop the death of children’.

So she’s presumably not into the ‘personal responsibility’ game either, and she presumably doesn’t ‘do personal responsibility’.  Yes, she did mention the word responsibility, but almost in passing as if it meant nothing at all, which it may well mean to Shoesmith – nothing at all.

Well, I’ve got news for you Sharon Shoesmith: that is what management is all about, and you should stop playing with words and accept that you failed miserably as a senior manager.  Senior management must be prepared to take responsibility and be held accountable for the procedures that they allow to operate in their own ’empire’ and when those procedures are found to be sadly, tragically lacking, the buck stops with you.   After all, that is the reason you were employed in the first place in this role in Haringey, because of the miserable failings of the department in the case of Victoria Climbie a few years earlier.   You were placed in a newly created post of Director of Children’s Services to ensure that procedures were ‘watertight’ – but you failed.  You can’t have it both ways – or can you?

In December 2008 Shoesmith was sacked from her position as Director of Children’s Services in Haringey, following the damning OFSTED report into the procedures in place in her department at the time of the tragic death of Baby Peter Connelly in 2007, at the tender age of 17 months.  Those found guilty of involvement in the death of Baby Peter are in prison, serving sentences for their crime of causing or allowing his death, and if my memory serves me well, Baby Peter’s mother pleaded guilty of the charges brought against her.  A dysfunctional family in need of support and care – and that was supposedly being provided by Haringey, under the control of Shoesmith.

Doctors involved in the case were referred to the GMC for investigation and were suspended and/or had their positions terminated.  Social workers were dismissed.   I can’t remember how many, nor whether they appealed and were cleansed, so I’m not naming anyone here.  It’s all available for anyone who needs to know.  Doctors, nurses and social workers have a professional code of conduct with standards that they are required to work to.  That code of conduct calls upon them to accept personal responsibility for their actions, for their demeanour, for their lack of actions too.  They can be held accountable.

But Sharon Shoesmith – alongside others in similar positions of seniority and ‘decision making’ in Adult Social Services, as well as Children’s Social Services – is not required to accept personal responsibility for her actions because there is no professional body that is likely to investigate, examine and pronounce on her failings.  She remained in her job, despite calls for her resignation from many.  She said she wanted to remain in post in order to support her staff.

Ed Balls made a statement on 1 December 2008, in his then capacity as Secretary of State.  That statement published in full here gave a fairly balanced reasoning for his decision to direct Haringey Council to appoint John Coughlan as Director of Children’s Services, and to remove Sharon Shoesmith then Director of Children’s Services from her post with immediate effect.  Since then, she has been unable to find work, but today says that she wants to continue with her career with children in some capacity of other.

Her first interview after being removed from post, was with The Guardian on 6 February 2009.

It would have been acceptable for Shoesmith to have been allowed a chance to give her opinions, before being removed from post.  I don’t argue with that.  But I don’t think she was unfairly dismissed.

Procedures may not have been followed in detail by Ed Balls – but she is surely used to procedures being ignored.  Or did she never read the OFSTED  report?  But the ‘outcome’ should and hopefully would have been the same: she should and would have been sacked.  This is where the double standards of the world of care and local authorities  come into the story, and where there is sweet nothing that the average person can do about those double standards.

I don’t know Shoesmith but I do know Haringey.  I have never had anything to do with any local authority Children’s Social Services but I have had dealings with a neighbouring London borough’s Adult Social Services.  My own relative died as a result of neglect in a care home.  The care home provider allowed the Manager, the Deputy Manager and some of the staff to ‘resign’ from their positions – rather than having to face disciplinary procedures.  The local authority allowed that to happen, as did the CQC.  The Director of the mental health care of older people team managed to arrange for an independent investigation into the circumstances surrounding the admission to hospital and death of my relative.  But he carefully avoided any investigation into the involvement of his own team, his own social workers who had been seconded from the local authority.  He also carefully avoided any investigation into his own involvement in the care of my relative – which would have been most revealing.  Not to mention investigation into the bundles of ‘legal advice’ that he had to seek, just in order for him to reply to my ‘letters of concern’.  While my relative was in his care, before arrival of my relative in the care home, during the hospitalisation of my relative, and then after the death of my relative.  And then months and months and months after the demise and destruction of my relative in care.

The local authority carefully avoided any investigation into the failings of their own departments – from Adult Social Services, through to care home provisioning and regulating.  The CQC carefully avoided any investigation into the failings of their own care home inspectors.

And yet the care home was prevented from admitting new residents for a full year while it was dragged up from the bottom of the barrel to provide the kind of care it should have been providing from the beginning.  Systems were introduced that should all have been present – and seen to be present – when the care home provider, the local authority, adult social services, adult housing, the CQC/CSCI allowed it to open and receive residents who were already known to be ‘at risk’ because of the very reasons they were all in need of residential and/or nursing care.  Staff recruitment, staff training, staff monitoring, staff supervision were all introduced, as were the very basics of care.

Which begs the question: who was responsible for allowing such a pathetic care home to  operate?  The Director of Adult Social Services – the equivalent of Sharon Shoesmith; the Commissioning Department within the local authority; the MD and Directors of the private care provider providing the service to the local authority and residents of that local authority; the CQC/CSCI regulatory body which carried out an inspection weeks before my relative arrived there, but then carefully and conveniently took a back seat from then on.

My MP and the MP for the borough where my relative lived didn’t give too much of a thought to the whole tragic system of care for the elderly in place either.

My relative was not a baby aged 17 months. 

My relative was aged 83. 

Now there’s the difference.

The buck has to stop with you Sharon Shoesmith.  I hope you will find a way to forget all about the bucks you will now receive as a result of what you describe as  Ed Balls having been “staggeringly irresponsible” and his actions having  left children’s social care in “complete disarray”.  Nonsense!

Sharon Shoesmith has to be made accountable and seen to be accountable, so I hope she will find a way to remove her smugness, her arrogance, and her continuing ability to try to blame others – even though she claims not to ‘do blame’.  That’s what responsibility is all about.

From yesterday’s judgment in relation to the OFSTED review and report:

“The Review will need to undertake an urgent and thorough inspection of the quality of practice and management of all services which contribute to the effective safeguarding of children in the local area. It will be important to ensure rigorous scrutiny of the quality of practice and decision-making by front-line workers and their managers and of the effectiveness of management practice and performance management systems in all relevant agencies …” .

I  invite everyone to substitute safeguarding of adults in place of safeguarding of children in the above.

A further quote from yesterday’s judgment:

“The inspection has identified a number of serious concerns in relation to safeguarding of children and young people in Haringey. The contribution of local services to improving outcomes … is inadequate and needs urgent and sustained attention.”

Again, substitute adults and ‘a neighbouring borough‘ in the above and you will see where I am heading.  Why else would the local authority in my own case, and following on from their conveniently ‘targeted’ investigation, have felt the need to scrutinise closely the systems in place in its other care homes for adults at risk?

The ‘ten main findings’ in the OFSTED report – unchallenged by the latest judgment – could also be written in similar vein to encompass the failings of ‘a neighbouring borough’ and its systems in the case of my own relative.

“has got no grip and relied on No. 2 who couldn’t hack it” – same here, except that the reliance was on Nos. 2, 3, 4, 5, 6, 7 …. plus a few more, both within and without the local authority’s Adult Social Services department.

Procedural fairness?  Now, don’t get me started on that because the local authority’s understanding of ‘fairness’ differs vastly from my own.  As for procedures, the local authority has a powerful knack (not even witnessed in the knackers’ yards of old) that nudges procedural fairness into a silk purse to be cherished and opened only by the local authority.

I then noticed a reference to being party to “an orchestrated litany of lies”’ – my  feathers are now being seriously ruffled, because the parties to the ‘orchestrated litany of lies’ (and what I have always referred to as being economical with the truth, polite person that I be!) or rather facts that were withheld from the investigating team, a whole load of relevant and damning information which – had they been decent enough to reveal to the investigators – would have shown them in a very bad light.  In fact they’d have been in the darkness of a dungeon by now.

A fundamental breach of trust and confidence?  Without a shadow of a doubt.

Common law requirements of fairness?  As above.

.

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.

Reflections on Mimosa Healthcare Ltd and connected matters

The CQC recently introduced a new system of monitoring the quality of care provided in residential care homes, relying more on paper-based self-assessments by the care providers, and also relying heavily on whistleblowers to alert the CQC of the need for its involvement, all with the hope that the CQC will inspect and act promptly to deal with suspected neglect or slipping standards.

26 November 2010 – This is Bristol article: The owners of Sunnymead Manor, Southmead, Bristol a ‘care’ home where vulnerable residents were left to fend for themselves in dirty and unhealthy conditions have been warned they face prosecution unless they take immediate steps to improve the situation.

Mimosa Healthcare, whose slogan is Where People Matter, has been given seven days to draw up an action plan and has agreed not to take on any more patients until a string of problems are dealt with.

Sunnymead, which specialises in looking after people with dementia and “high care needs”, has been in trouble with the authorities in the past but appeared to have cleaned up its act last year.

Mimosa has since apologised to residents and their relatives and has promised to clean up its act.

So that’s more than once that Mimosa Healthcare Ltd has promised to clean up its act.  It hasn’t managed to do so for yet in spite of new management being in situ.

CQC’s Review of Compliance – published today.

May 2006 : CSCI inspected Sunnymead Manor ‘care’ home in May 2006 (the first inspection under the ownership of Mimosa Healthcare Ltd): Cost ~£456 – £508 per week plus additional charges.  All 5 requirements (under the previous owner) were seen to have been complied with.  However, 9 statutory requirements were made, plus 5 recommendations.

The company are clearly striving to improve standards; however the significant shortfalls in two main areas must be addressed as a matter of urgency to ensure that residents get the care they need and new staff are equipped with the skills they need to meet those needs.
A number of requirements have been issued in respect of: –
• Pre-admission assessment processes
• Assessment and Care Planning processes
• Identification and meeting changing care needs
• Meeting care needs in a respectful and dignified manner
• Effective communication between staff and residents
• Induction programme for all new staff
• Staff training records be kept for all staff
• Home Manager must make application to register
• Safe working practices must be followed in respect of moving and handling of residents and in infection control procedures.

They are serious failings in care, already highlighted in 2006.

June 2007 : CSCI inspected Sunnymead Manor in June 2007:  8 statutory requirements were made, plus 4 recommendations.  Cost £471- £600 per week plus additional charges.  “…. the home must always ensure that residents do not come to any harm, and get the help they need” – so the Regulator was aware then that staff were not ensuring that residents did not come to harm, and that residents were not getting the help they needed.

“A stable staff team and improvements in the induction process for new staff and ongoing training, will benefit residents by ensuring they are looked after by staff who are better trained.”  That speaks for itself – the Regulator was aware of staff and training inadequacies resulting in sub-standard care to residents.

April 2008 : CSCI inspected Sunnymead Manor ‘care’ home in April 2008:  3 statutory requirements are made, no recommendations.  CSCI rating 2 star = “good”; Cost £498- £560 per week plus additional charges . “The care plan reviewing process is satisfactory in the nursing unit however needs to be more effective in the dementia care unit.”

November & December 2008 : CSCI inspected Sunnymead Manor ‘care’ home in November 2008 (2-star rating = good) and again in December 2008 (zero star rating = poor) after concerns were raised about the quality of care.

In November 2008 there were still 3 outstanding statutory requirements from the previous inspection; a further 4 immediate requirements following the November inspection; a further 4 statutory requirements following the November inspection; plus 1 recommendation.

In December 2008 (zero star rating = poor) there are now 5 outstanding statutory requirements; a further 18 statutory requirements from the December 2008 inspection; plus 4 recommendations.  “The Registered Person must ensure that the home is conducted so as to promote and make proper provision for the health and welfare of people who live at the home. “ When you read that  December 2008 inspection report in full, it is clear that December 2008 was the point at which CSCI should have heard enormously loud alarm bells ringing.

And yet, a mere 5 months later, all is apparently well and seen to be well by CSCI.

May 2009 : CSCI inspected Sunnymead Manor ‘care’ home on 6 May 2009; all 18 requirements and 4 recommendations were seen to have been met; following this inspection there is one statutory requirement made (concerning residents’ valuables) plus 2 recommendations (concerning the placement of non-flattering photographs of residents, and the use of the term ‘wandering’ in records giving a negative image of individuals).    CSCI rating:  two-star – “good”.  Cost: £498 – £560 per week plus additional charges.

The CQC dates are as confused and as confusing as some of CQC’s inspectors.

Step back to April 2009 and a Nurse from Sunnymead Manor – who was suspended from the care home in August 2006 – is before the NMC:  The work of Nonhlanhla Nkomo at a Bristol care home showed severe shortcomings, a hearing of the Nursing and Midwifery Council in London heard.

The 52-year-old allegedly left an elderly man at the Sunnymead Manor care home with a “hugely swollen” face by not treating a tooth infection.

She also did not know another patient was a diabetic, it was claimed. The hearing continues.

Ms Nkomo, known as Ivy, was suspended from the care home in the Southmead area of Bristol in August 2006.

Ms Nkomo, who began working at the home as a registered nurse in April 2006, is also accused of failing to record whether she had administered medication to a further eight patients.

February 2009

Kingsmead Lodge, Shirehampton, Bristol –  Mimosa Healthcare

A care worker who allegedly witnessed abuse at a Bristol care home has been suspended.

The 18-year-old is one of five care workers who have given statements about incidents at Kingsmead Lodge in Shirehampton at which are being investigated by police, social services and watchdog organisation, the Commission for Social Care Inspection.

None of the care workers allegedly involved in abuse has been suspended.

But the teenager, who looked after dementia patients at the nursing home, has been suspended on full pay after speaking out.

The care worker said she had not been given adult protection or whistle-blowing training.

And the CQC is about to rely on whistleblowers????

December 2009 : Honeymead ‘care’ home and Bishopsmead Lodge ‘care’ home – Mimosa Healthcare Ltd

New evidence of failings by a major care home provider in Bristol has been uncovered by a BBC investigation. The findings come after concerns were raised about Mimosa’s other two Bristol homes, Kingsmead Lodge and Sunnymead Manor, earlier this year.

November 2010 and Mimosa Healthcare Ltd still has the effrontery to boast on its website with the following words: Where People Matter; We know all about caring – and so do the people who live with us; Mimosa is passionate about Dignity in Care; Experience a very special place where people matter.

I beg to differ, Mimosa Healthcare Ltd.  It does not appear to me that you care enough about the standard of care in some of your care homes.

Has the time has come for the Advertising Standards Authority to find a way to regulate the misleading content of marketing messages on companies’ own websites?  The ASA does not currently have any remit over marketing messages on companies’ own websites.  Trading Standards don’t care either, nor does the CQC.

In fact the CQC inspection reports could do with regulating too.  That is where most people looking for decent care for their relative, or even for themselves, turn to first of all – the CQC website.  But it is all fudge.  We are becoming an internet-governed world.  We are being encouraged to rely on internet connections for numerous sources of information.

If the CQC really cared it would have found a way by now to put maximum pressure on care providers to provide care rather than neglect.

If our governments really cared they too would have found a way.

Mimosa Healthcare is not alone – read up on Compassion in Care’s analysis of care.  Read a few of the inspection reports that Compassion in Care has put under the microscope.

My heart goes out to every single resident of every single Mimosa Healthcare ‘care’ home.  How many of you have been neglected when you should have been cared for?  

You all deserve better care.

Care homes ‘closed’ for poor standards remain open

And then another story flashes before my eyes.  BBC News brings the chilling words that Care homes ‘closed’ for poor standards remain open.

Failing care homes which were officially closed down have been allowed to continue operating.

The Care Quality Commission (CQC) claimed 93 homes and agencies were shut in the past year due to poor ratings.

But a BBC investigation has found a dozen were still open under the same ownership.

The CQC admitted errors, but said it was determined to clamp down on providers where there is a risk of neglect or abuse.

In some cases the regulator had allowed homes to close and then reopen on the same day, if the home applied to do so, which they can under the current rules. Damning reports about their past records were then removed from the CQC’s website, so potential residents and their relatives could no longer read them.

The ‘regulator’, the CQC, sanctions the removal from its own website of damning reports about the past failings of care homes, and then allows those same so-called care homes to continue to operate.  I  had little faith in the Commission for Social Care Inspection (CSCI).  I tried to find something that would allow me to place my trust in the Care Quality Commission (CQC).    My loyalty, faith and trust in one particular Care Provider went out of the window long ago, in spite of the repeated assertions that came my way that our experience was not the ‘norm’ for that care provider. They’re all in this together, to borrow a phrase.

BBC programme this evening File on 4 at 2000 is unlikely to restore my faith in this world of care.  Care Homes: When An Inspector Calls.

For those who read Private Eye – have a look at No. 1275 – page 29 – CQC no evil – care home closures.  Read how the CQC squirmed (same Eye, page 15 Letters) when found out.  And then go back to Eye no. 1274.  Sorry, I can’t post a link to it because it’s pay-to-view only.  Thank you, Private Eye!

Failing care homes and the failing care industry

This latest BBC report alarms me.  As does the video in this updated BBC link to the same report.

A new way of checking up on care homes for the elderly in England will put vulnerable residents at greater risk, says a union representing inspectors.

Unison claims the system, which relies more on written self-assessments, will mean thousands of homes will avoid inspections if they look good on paper.

Thousands of residential care homes (with or without nursing) are to be allowed to inspect themselves – without rigorous care and quality control by anybody other than themselves, certainly not the CQC, the very body that allows them to become registered in the first place and to accept vulnerable residents in need of quality care.  All a care home will need to do is to provide a good written self-assessment, then it may remain inspection free, unless serious complaints are brought to the attention of the CQC.

The BBC report states The new system replaces yearly automatic inspections for all homes. It came into force in October and now means that homes which provide a good written self-assessment may not be inspected again, unless there is a serious complaint made about them to the commission (CQC).

I question that, BBC, because there are many many care homes and domiciliary care agencies that have not been inspected for years, so October may only be the date when the CQC declared its hand!

I’ll begin with a domiciliary care agency that I know of.  If only to indicate a point about inspections and reports, let alone the dangers of self-assessment.

The care provider that provides the domiciliary care agency and also provides the extra-care sheltered housing (where my relative lived for a while) went three full years between inspections and has only had 3 inspection visits since it came into being in early 2003.  The first inspection (two years after it opened) resulted in 3 statutory requirements being made, plus 2 recommendations, in order that it should meet the Care Standards Act 2000, Domiciliary Care Regulations 2003 and the National Minimum Standards.

Next year, there were no requirements made, but the report mentions issues about medication, record keeping, ‘issues about truth telling’, but no requirements made.

Three years on, the same extra-care sheltered housing was given a 3-star excellent rating.  It’s only when you read the report in full you see that the residents are not as happy about their living as the 3-star rating might imply.  And it’s only if you know what is not mentioned in the report that you can possibly realise how misleading some of these inspection reports can be.

One statutory requirement was made – that had also been made 4 years earlier in 2005 – plus two recommendations, one of which was that The registered person should review the staffing situation to ensure the meeting of needs and a more responsive service for people using the service.  The residents had complained about shortages of staff, about staff-changeover to different areas every couple of weeks, about lack of any kind of continuity of care.  All in the best interests of the staff, of course, not the residents.

The second recommendation was that The registered person should review the risk management plans in respect to medication management for people suffering with seizures.  The report refers to mistakes being made with medication, and bad record-keeping with regard to medication.  The manager needed to be reminded to instruct staff of the serious consequences for any individual if prescribed medication was not being administered regularly and correctly.

Would they be described as ‘serious’ concerns, CQC?  Or would you see those as relatively inconsequential.  And would the care provider be likely to note those in their self-assessment?

What is missing from any of the inspection reports are most of the ‘before and after’ day-to-day and day-by-day experiences of the residents.  When we visited for the very first time before signing a contract, there was a large notice on the front door to say that the premises were being decorated in advance of an inspection visit by the CSCI!!!   The flat we were shown was in good decorative order – and we were assured that would be the flat where our relative would live.  Not so!  (But it may well have been the flat shown to the CSCI inspector.)  Three weeks later, a different flat was made available – in need of decoration; filthy, stained carpets; dirty smelly bathroom; shabby kitchen area.  All would be put right, we were assured.  A year on and we were still fighting to get those things put right.

Before admission, we were assured the place was lively, with good activities going on, with regular events, lounge where residents could meet and chat.  All were non-existent, in the reality.  Not even watchable television reception – we were told the building had never had good TV reception.  It does now – because we fixed it!!  The support workers fabricated all the daily contact logs, with fictitious times of arrival and departure; they knew nothing about ‘with food’ requirements of meds; couldn’t tell the difference between a painkiller and an antibiotic; would not/could not manage to ensure  that vulnerable elderly people were cared for properly, with the ‘extra care shelter’ that had been promised.

CSCI then could not identify and deal with serious concerns.  Would the care provider have notified the regulatory body about any/all/each and every single serious concern via a self-assessment form?

How does the CQC define a serious complaint?

CQC chief executive Cynthia Bower has said “pockets of poor practice” remain – but if one in five nursing homes is failing  to offer good care, those pockets should be mended – and quickly – before you allow those failing care homes to slip through your future net which will also be full of holes.  This is the same Cynthia Bower.

I’m not known to be a fan of the Care Quality Commission (CQC) and I was even less keen on its predecessor, the CSCI (Commission for Social Care Inspection) for personal reasons.  CSCI failed miserably in its inspection of many care homes, and it looks as though the CQC is about to sink into the same abyss of neglect.  If it takes a serious concern or complaint for a care home to be inspected, that’s a disgrace in my view.  No matter how many of us, the relatives of people in care, complained about the quality (or lack of it) provided in care homes for vulnerable elderly people, CSCI/CQC never listened.  The CSCI and CQC merely referred us back to the care home manager.   Pass the buck, eh, and just devise a system whereby the buck will never stop with you, CQC.  And that’s what you’ve now done, with this latest plan of yours.

Now, I’ll move onto care homes and the way in which I am feeling scared, on behalf of all care home residents, present and future.  What follows all came to pass under the CSCI, so I may refer to CSCI, even though it’s only a name change from CSCI to CQC – only the name has changed.  I was pleased when the CQC announced that it was to do away with the star-rating system, because it trivialised the assessment and inspection process.   But now that Social Care Inspection is also about to vanish, apart from worthless paper-exercises, the reason for the name change all begins to become clear.

How is a whistleblower to blow a whistle that will engage the listening ear of the CQC?   CSCI was conveniently deaf to complaints, did not challenge care home managers sufficiently, did not inspect care homes vigorously and cannot even publish coherent inspection reports with speed and reliability.  It has always taken about 3 months or more for a report to appear.  Understaffed?  Underpaid?  Undervalued?  Under the influence?

CSCI operated hand-in-glove with local authorities, the commissioning agents, and with the care providers.  When you learn that you have a choice of only 3 care homes in one particular London borough, then subsequently discover that those 3 care homes are all made available by the same care provider, with three 25-year contracts to run those 3 care homes, you begin to understand why you have had three hard years since then.  The power of the number 3?  Or the weakness of the number 3?   The failure of CSCI, the local authority and the care home provider to provide care.

A care home opens.  It is described by both the care provider and the local authority as a new flagship care home,  promising to raise the standards of care for the borough’s vulnerable older people, including those with dementia – well, that sounds pretty good, you must admit.  It’s a real achievement and great news for older residents; its completion brings residential care closer to ‘our’ vision of the kind of care we want for older people.   We look forward to working closely with them to provide first class care for elderly, vulnerable citizens in the area.

You visit; you ask as many of the really basic and sensible questions you can think of asking; your questions are all answered well and convincingly so; you are impressed; you look forward to your relative being able to live in carefully caring care.  It’s so brand-spanking new that there cannot be anything you might have missed in your own assessment of it- or can there?  The care provider is one of the most highly esteemed and most valued (especially by some of our closely-connected politicians) in the country – even though serious failings in its domiciliary homecare services came to light later and featured in a Panorama programme.

Within weeks, your relative has arrived.

Within days of arrival, your relative is in hospital in a coma.

Within weeks, your relative is dead.

That’s when you have to become a Whistleblower. Not by choice – but by force.  You have no other option.  Your dead relative would expect that of you, and if you fail your relative as much as all those responsible for providing care failed – well, you wouldn’t  be able to sleep at night.  But you have a heart, whereas they have none.

You blow and blow and blow your whistle, first into the ear of your Social Worker, then into the ear of your SW’s boss, because the SW’s hands are tied (especially as the SW is from another country, is on secondment to the mental health care of older people team, and soon after returns to her homeland, and who could blame her).

Then you try blowing into the ear of the care home manager – but the care home manager is unable to hear.

You blow and blow and blow to CSCI, but the CSCI office you have to deal with is only temporarily responsible for that care home, so the CSCI office believes everything the care home manager says to them.  Foolish fools!!

So you blow your whistle into the ear of the Adult Protection Coordinator.

Eventually, there is an investigation carried out into the circumstances surrounding the sudden admission to hospital of your relative, and there are numerous Establishment Concerns meetings held (without family being able to be present or represented).  CSCI is ‘invited’ but can’t be required to attend, because they are all under the wing of the local authority, so CSCI will merely accept the minutes of those meetings.  The report is published – but is considered now to be ‘an internal matter’, so,  no – family can’t be allowed even to see it.

In the blink of an eye, the flagship care home is not allowed to accept any new residents.  There were no systems in place for staff training, staff supervision, staff monitoring, supervision of record keeping, medication knowledge, knowledge of the way the health and medical care system in this country works, knowledge of various medical conditions, knowledge of swallowing difficulties, knowledge of seizures, knowledge of the dangers of dehydration, knowledge of how to deal with dementia, knowledge of the dangers of not keeping a watch on the decline of a person who has only been in your care for a week, knowledge of basic communication with the emergency services … … … … and … and … and …

… … … and yet, it was called a care home, provided by one of the biggest care home providers in the country.

A year later, and the care home was still not allowed to accept new residents, so serious were the concerns about its lack of care.  Umpteen statutory requirements (20 or so, if I remember correctly) were placed on the care home, alongside the massive improvement plan that was forced upon it.   Numerous members of staff from the manager down were all allowed  to resign, conveniently and without disciplinary action being taken.

The next inspection report still contained numerous statutory requirements, with a few watered-down so that they became recommendations – well, it sounds nicer and more user-friendly, even though they are still serious concerns.  But the problems were all still there.

But it all looked good on paper!!!!  It was fit-for-purpose on paper only.

It was seen as suitable for commissioning by the Local Authority’s care commissioning department, by the Local Authority’s Adult Housing and Social Services department, by the Mental Health Care of Older People Team, by CSCI/CQC, and by the care home provider.  Sadly, it was also seen as suitable by me.  But not for long, in my case.

It is nigh on impossible for me to understand why their own inspections and assessments failed to identify the holes in their so-called care system – and I have to take it on trust that they all carried out proper evaluations of the suitability of this particular care home before allowing it to operate.  Or did they merely place their trust in the name of the Care Provider without caring enough to look beyond the paperwork?

They would all have continued to see it as a suitable care home – on paper.

It took my relative to die, and then it took my big mouth to blow the whistle.  And that’s not what I want for the future of the care ‘industry’ in this country.  Nobody should have to go through that ever again.   That is why I am alarmed by the BBC report.

I had been looking forward to a vigorous, rigorous, powerful and thoroughly dependable system being introduced for the  inspection of care homes.

I know WHAT happened to my relative.  I still do not know WHY it happened.

From foster care of children to care of vulnerable elderly people – we care!

A news item from Communitycare.co.uk caught my eye the other day.  ‘Name the bureaucrats who hamper fostering, says minister’ – the minister being Tim Loughton, Children’s Minister at the Dept of Education, who has called on foster carers to tell him which councils are “excessively bureaucratic” when it comes to allowing them to make day-to-day decisions for the children they foster.

Loughton says he plans to demolish some of the ‘myths’, as he sees them, surrounding fostering.  A laudable approach, even though those myths are more fact than fiction according to foster carers.  Even more laudable if he really does manage the ‘cultural change’ that Jackie Sanders, communication manager for the Fostering Network, called for.

I’ve just watched the Tonight programme, and learned a lot about the hurdles that potential foster carers are required to go through, via the fostering panel.  The ‘vetting process’ includes an intensive investigation and examination of a potential foster carer’s early life experience, their family history, their suitable training, CRB checks of themselves and any other family members who may come into close contact with a fostered child, assessments of the suitability and safety of their home, their financial situation; references are all thoroughly checked, medical and mental health checks carried out, schools contacted for information, plus social worker interviews and visits.  To name but a few.  I would not for one moment criticise the need for each and every one of those safeguards.  Where vulnerable children are concerned, they certainly deserve the quality care that may only be ensured by such a volume of ‘risk assessments’.

Gradually, I found myself seeing not the young, vulnerable children featured in the programme, but elderly vulnerable adults living in residential care homes.  I began to wonder  whether  a similar cultural change is perhaps something we should be demanding of Tim Loughton’s counterpart.  Not in the Department of Education, but in the Department of …. ….

Where’s your equivalent, Tim Loughton?  Where is the Older Person’s Minister?  Who is he or she?  And has s/he made him/herself known to us all?  Paul Burstow’s the Minister for Care, but that encompasses old, young and in-betweeners.  So perhaps you’re our man, Mr Burstow.

I challenge you now to provide the same safeguards for all elderly people in care: a vigorous and rigorous vetting process for all care providers and all paid caregivers, encompassing their past history and regardless of the 30 year contracts they may have been handed.  A full and detailed assessment of the suitability and training of all those taking charge of our older persons.

Make that full and detailed assessment available in the public domain for anyone to access – that really would show the loopholes in the current system!   The CQC– and its predecessor the CSCI – failed to provide the safeguards that should surround each and every residential care home for vulnerable elderly people.  The standards of supervision, training, and care for and of vulnerable elderly people are all too often abysmal.

But who cares?

We care.

We really do care.

The person in need of care cares.

The family and friends of those in need of care care.

The family and friends of those in residential care homes care.

But who cares enough to listen to us?

Who cares enough to care about the shabby standards of care that are being allowed to continue?

Who cares about the elderly vulnerable people of this rich country of ours?

One of the young people in the programme, Anita Johnston, said she realised that ‘something needed to change’ in her life in order to make it a life worth living – “so I did”, she said.  She changed.  She managed that change in herself, with the help of her wonderful and caring foster parents.  “Without them, I wouldn’t have a hope”, she said.

Without a similar change in those involved in the care of our vulnerable elderly people, we don’t have a hope either.

Anita Johnston, I wish you a happy and successful future.  With your caring attitude, with the respect you manage to show, with your wisdom you must have a great future ahead of you.  Would you like to become Minister for Older People?  You’d do a grand job!!

You could then demolish some of the ‘real myths’ that surround care for older people.  All is not what it should be there – so your refreshing caring presence would be more than welcome.

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PS. to Tim Loughton – your website biography needs a rapid update!  Or do you still see yourself as a Shadow?

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Briars Retirement home / Briars Care home – and other examples of neglect

The owner and manager of Briars, a ‘retirement/care’ home in Southampton, have been found guilty of ill-treating and neglecting sixteen vulnerable elderly residents with dementia, aged between 77 and 96.  At Southampton Crown court, Annette Hopkins, the 63-year old owner of Briars, was found guilty on 10 charges of wilful neglect, and Margaret Priest, the 54-year old manager, on four.

Both of them had denied all 16 charges.

The Daily Echo reports that Defence barrister Amanda Hamilton asked for Priest to be conditionally discharged, saying she had devoted her time and attention to The Briars.

“She is a kind, caring and altruistic person. She has lost her job, she is unlikely to get another one and she is claiming state benefit.”

That ‘state benefit’ may now be transformed into a different kind of ‘state benefit’, whereby the state places Priest and Hopkins into secure custody, in the best interests of all.  They are both approaching an age when they may need residential care themselves, so I only hope they get the kind of care they deserve.

This is Hampshire, 28 May 2010 reports: “IF ONLY we had had more help.”  Those were the words from the owner of a care home that was closed down over allegations of neglect.    And soon, if she is to receive a prison sentence, that same owner, Annette Hopkins, may well be able to understand that those very words applied to the vulnerable people she was supposed to care for.  They were all desperately in need of care, support and help – that is what they deserved.  But all they found was neglect.  If only they had been given the help they needed.

25 September 2008, and the Daily Echo reported the early beginnings of this case, and that Annette Hopkins, 63 then, admitted she may have made mistakes but denied any allegations of neglect. Mrs Hopkins said a district nurse had assessed up to ten patients – almost half the residents – as needing specialist nursing care after finding they were suffering from bed and pressure sores. That is neglect – and nothing to do with ‘mistakes’.  CSCI had carried out an inspection the previous November.

24 September 2008: Channel 4 news covered the same story in much the same way, as did the Daily Mail.

The list of horrors surrounding the lives of the residents is gruesome reading, again from This is Hampshire:

Police told how the full disturbing catalogue of failures included how:
■ Residents were malnourished and dehydrated
■ The place they called home had a strong stench of urine and the floors were filthy and faeces-stained
■ Dirty bedding and incontinence pads were left lying on the floor, mixed with clean clothing
■ Medication would be handed out by unqualified staff and was sometimes given to the wrong people
■ Bosses were not qualified but claimed they were through years of doing the job
■ Staff didn’t have the right equipment to lift residents who needed to move
■ The wrong beds were used, leaving residents with severe sores
■ Some were so ill or incapable they should have been in a nursing home.

The Basingstoke Gazette yesterday has several items of interest.

The first The Briars: What to do if concerned about a relative gives the contact details for you to voice your concerns, in the hope that your concerns will be thoroughly investigated.

The second The Briars: Could it happen again? mentions Southampton City Council’s newly formed ‘Safeguarding in Provider Services Team’, and also gives the impression that CQC are a completely new kid on the block, replacing the old CSCI with massively improved powers.

The third I always worried about my Mum at the Briars gives the views of Sue Rennie who placed her trust in the Briars when her mother became a resident there in 2004.   Now Sue is calling for six-monthly anonymous spot checks at all care homes and nursing homes.

“They shouldn’t just be checking the facilities and what entertainment is on offer. Qualified doctors and nurses should be checking individuals who are bedridden, incontinent and prone to skin conditions to make sure they are being cared for on a personal level and the appropriate treatment is given.”

I agree with you there, Sue Rennie.  But there’s more to it than meets the eye, and it can take the novice, the beginner, the concerned relative, several years to unravel what goes on behind closed doors.  (see below!)

But what worries me most is the Inspection that the then-CSCI (now CQC) carried out in November 2007.  It’s no longer available on the CQC website, of course, because the home is now thankfully closed.  But the Basingstoke Gazette from September 2008 has a link to that inspection report from 24 November 2007.  It’s deeply concerning to read the following:

• Feedback obtained from professional sources indicate that people feel the staff are knowledgeable, that staff are available to assisted with visits and that overall the service provides and satisfactory level of care.
• Service user and relative surveys continue to raise concerns over the lack of entertainment and stimulation provided within the home, with people commenting ‘not enough activities, the notice board states that residents will be taken on day trips, this has not happened’ and ‘ this is a very nice care home, the only fault being there is literally no stimulation for the residents apart from a pianist once a month’.
  People met during the visit also criticised the lack of social stimulation saying that they prefer to remain in their bedroom as the opportunities to interact or socialise are limited.
• During the fieldwork visit it was noticed that people were eating their lunch in the lounge as apposed to the dining room, which initially seemed the result of personal preference. However, during the tour of the premise it was noted that the home has limited dining spacing, with small dining rooms located adjacent to the main lounges, both rooms only capable of sitting approximately ten to twelve people.
• The dataset also contains information about the home’s complaints activity over the last twelve months:
  No of complaints: 18.
  No of complaints substantiated: 0.
  No of complaints partially substantiated: 0.
  Percentage of complaints responded to within 28 days: 100%.
  No of complaints pending an outcome: 0.
• The Dataset again establishes that policies for the protection of the service users are in place: ‘Safeguarding adults and the prevention of abuse’ and ‘Disclosure of abuse and bad practice’, however as with the complaints policy no review date is indicated.
• Following the last inspection the manager has commenced meeting with each service user for approximately five to ten minute a day, discussing their wellbeing, any concerns or issues which they feel are affecting them. The manager documents each meeting and where necessary actions are taken to address any concerns or comments made. During the tour of the premise one service user mentioned her daily meeting with the manager and expressed a concern that this level of commitment could not be sustained due to the manager’s other responsibilities.
• However, the manager was quick to reassure the service user that ten minutes each day was more than manageable for her and that she enjoyed the one-to-one interactions with people.

There were enough ’causes for concern’ when the inspector called – but the inspector merely ticked all the boxes required and went away.  Mission accomplished!  Or not.  Too many occurrences of “indicated” and “the manager/she stated that” for my liking.  An inspector is supposed to find positive evidence, not indications.  An inspector cannot take for granted that whatever the manager ‘stated’ was fact.

The manager managed to convince the inspector that she could spend 5 to 10 minutes, each day, with each of 34 residents – and document her meetings.  That would consume an awful lot of hours – leaving the manager no time to manage.

There are many other areas within that inspection report that should have rung alarm bells.

Why have I been following the story of Briars?

Because it first came to light in September 2008, just a month after another story of neglect surfaced, at Lennox House, Durham Road, Finsbury, Islington, North London.   Another care home run for profit, this time by Care UK.  The then-manager was ‘allowed to resign’ after she had managed to fail to manage a care home where the bodies of residents who had died were left in their rooms for days after their death.

And that story of neglect came only 8 months after yet another story of serious neglect and sub-standard care emerged.  The Deputy Manager and several staff members were also ‘allowed to resign’.  The world at large will know nothing of that story, because it does not feature in any CSCI/CQC report.  Nor does it feature in the headlines any longer.

The  CSCI/CQC inspection reports for Lennox House:

23 October 2007: brand new care home so this was the first Key Inspection: no major problems are noticed; there are 7 Statutory Requirements made, but nothing to indicate any serious problems.

24 June 2008: 11 Statutory Requirements were made – there were also outstanding Statutory Requirements from the previous inspection of November 2007 when 7 Statutory Requirements were made; Enforcement Action was being ‘considered’ and was taken.

3 December 2008: when the home was still subject to Enforcement Action and still not allowed to accept new residents; 2 Statutory Requirements and still outstanding requirements from the previous inspection;

9 June 2009: and the home is allowed to admit new residents;no outstanding Statutory Requirements from the previous inspection, but a now a further 3 Statutory Requirements made, and 9 recommendations.

You will need a very fine-toothed comb to work your way through what actually was happening, between 23 October 2007 and 24 June 2008, not to mention June 2008 to June 2009.  And you still will not find it in the CSCI/CQC documents – or any other document – easily available to potential residents and their family.  It is all concealed.  The massive Improvement Plan/Action Plan imposed on a care home run by one of the biggest care providers in the country is a real eye-opener.

Behind closed doors much can be concealed from view.  Enough holes to build a golf-course. 

The gaping holes of care in the UK.

And that will be the subject of the next instalment.

No secrets.

These are not isolated incidents.

Sad reflection on the state of care in the UK, but a true one.