Tag Archives: GMC

Thoughts on diabetics’ access to blood glucose strips being restricted

A timely reminder appeared on the BBC website today in the form of this piece bearing the title Diabetics’ access to blood glucose test strips ‘restricted’, which led me to the Diabetes UK report Access to test strips – A postcode lottery? (Aug 2013) .  The Daily Record from your short time in Care UK’s Lennox House care home featured heavily at the NMC hearings that started in February 2012 and concluded in April 2013.

One entry in the Daily Records was a strange entry, written almost as a post-script afterthought once you’d been admitted to hospital in a diabetic coma.

That entry (unsigned, by the way) gives the results of a urine test, and alongside is bracketed the following: “There was no available glucose strip since the GP does not prescribe according to Deputy Manager & Home Manager”.

Does that not appear to be a peculiar entry in a record of care?  It almost looks like an attempt to validate the absence of care.  The full urine test results were indeed alarming.  I’m not a medic but it didn’t take me long to work out which parts of the results should have rung bells.  But the care home didn’t find them sufficiently alarming to call an ambulance, because they waited  another 15 hours before doing so, by which time you were in a desperate state, with spasms lasting nearly half an hour noted hours before an ambulance was called.

When I arrived in A&E, soon after your arrival there, I was asked to explain how your diabetes had come to be ‘so out of control’.  I didn’t know that it was out of control, of course, but the hospital for some reason thought that you lived with me and that I was responsible for your care.  Not so.

When I asked the manager to explain to me what that entry in the Daily Record meant, she said that the GP refused to prescribe test strips for the care home, and that Care UK also refused to supply them.  That’s the point at which I offered to pay for a full year’s supply for the care home so that no other person would suffer the way you did.

During the investigation into what happened with your care, the investigators were told that test strips had been bought from a well-known chain of chemists – but no evidence could be found to support that.  Not even a petty cash record.

However, at the hearings at the NMC, there were other and different rationales put forward.  One proposed by the manager was that your diabetes was ‘diet controlled’ and not medication-controlled.  Not so.  When she saw you, allegedly just before she left the building, you were “warm and pink” and you gave no indication of distress, pain or suffering.  What a shame she didn’t have the time to act on your urine test result, that she was surely informed of before leaving the building.

You were not in a position to monitor your own glucose levels.  Vascular dementia made that impossible for you, and in any case your previous GP (not the one providing services to Lennox House) had monitored you regularly, as had your clinic appointment regime.  You never missed an appointment.  It was the responsibility of the care home to monitor your diabetes – that’s what care homes are supposed to do.  Care.

Another memory has been brought forward by today’s reports.  The GMC (General Medical Council) was informed by the GP involved that she had no knowledge that you had diabetes, and that had she known she would have carried out the required test and had you admitted to hospital.  The NMC was told a very different story by the nurses involved, namely that the GP had indeed been informed of your diabetes when she visited you (and prescribed an antibiotic for a suspected UTI).  They can’t all be right, can they?

Again at the NMC hearings, mention was made by the manager and other nurses and their representatives  that there had been no training in diabetes at Lennox House, before your arrival there.  It was even said that there was no specific training in diabetes given for a couple of years after your death.  Not so.  Would nurses never have heard of  Hyperosmolar Hyperglycaemic State (HHS)  (previously called  Hyperglycaemic Hyperosmolar Non-ketotic Coma (HONK) or  Diabetic Ketoacidosis  (DKA) ?

Diabetes UK calls the restricting of access to test strips a lottery.  You definitely did not win the lottery in Care UK’s Lennox House care home where your diabetes was neither monitored nor tested, whether by strip or by other means.

Barbara Young, Diabetes UK Chief Executive,  said “Rationing test strips to save money does not make any sense, because  it is putting people at increased risk of complications that are hugely expensive to treat.”

You’d be a fool to argue with that.

I sincerely hope that Home Secretary Theresa May, recently diagnosed with diabetes, will not find her access restricted.  If she does have that experience, she will no doubt take steps to ensure the restrictions are lifted.

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NMC to review ‘serious cases’ before the employer does so

There’s an old saying, with many variations on the same theme:  ‘everything comes to him who waits’, and my favourite variation is  ‘all things come to him who waits – provided he knows what he’s waiting for’.  I’m not absolutely sure that this next revelation is something I knew I was waiting for – but after years of waiting for the NMC to get its act together, there’s a small chink of light appearing.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Commons Health Committee reports on NMC and GMC – some thoughts

The Commons Health Committee published, today, its reports on the healthcare regulators NMC and GMC.

The Annual accountability hearing with the General Medical Council is available here.

The Annual accountability hearing with the Nursing and Midwifery Council is available here.

Back in 2008, Ben Bradshaw, then Minister of State for Health Services, commissioned a report by the CHRE (C0uncil for Healthcare Regulatory Excellence) – the Regulator of the Regulators.  The report highlighted a poor level of service to complainants (sometimes insensitive or misleading information was being given to them) significant delays in communication with complainants, poor quality correspondence and long delays in fitness to practise hearings.

Nothing has changed since 2008, and the CHRE’s 2010/11 annual review still finds concerns ‘about the number and nature of the improvements that the NMC still had to make, particularly around its customer care and, its management of serious cases and the timeliness of its case progression’.

I agree wholeheartedly.  I may show bias – but after nearly 4 years of waiting for them all to get their respective acts together, who could blame me.

  • ….. the Committee remains very concerned about the existence of low standards of basic nursing care in our acute hospitals and care homes, which appear to be in  breach of the code of conduct for nurses and midwives. We are particularly concerned about this in light of the ongoing inquiry into Mid Staffordshire NHS Foundation Trust, the Winterbourne View scandal and the recent Health Service Ombudsman report into care of the elderly in hospital.
  • This evidence presents a challenge to the NMC which is responsible for  professional standards in the nursing and midwifery professions. Based on its existing guidance on care of the elderly, we propose that the NMC should develop a programme of action to deliver a demonstrable improvement in outcomes for this vulnerable group.
  • Furthermore, the NMC needs to send a clear signal to nurses and midwives that they are at as much risk of being investigated by their regulator for failing to report concerns about a fellow registrant as they are from poor practice on their own part.

The CQC is failing older people; the NMC is failing older people.  They are both reactive, whereas they both need to be pro-active if they are to protect people in care.  Over the last years, I’ve come to understand that systems of all shapes and sizes are sadly lacking.  The NMC report in particular confirms to me what I already suspected, in a way, but it distresses me beyond imagination.  How have we come to this?

To save you from reading the whole report, here are a few more extracts.  (The use of blue is mine.)  Make your own mind up about it all.

The report mentions the transition to an all-degree nursing profession by 2013 and the perception that nurses may have “stepped back” from basic nursing care.

  • However, the Committee raised the issue that many basic nursing care tasks that used to be undertaken by registered nurses are now undertaken by healthcare assistants. The NMC estimates that there are 300,000 unregistered healthcare support workers and an unknown number of assistant practitioners currently working in the UK.  The NMC has “growing concerns” that healthcare assistants (HCAs) are increasingly working on tasks previously undertaken by registered nurses but remain unregulated. This means that there is little control over entry to employment and no final sanction of removal from a register when competence or conduct are not of a sufficiently high standard.
  • The NMC commissioned a scoping review of HCA registration which found that there is evidence of HCAs taking up work having been dismissed from other roles for misconduct, and that they are undertaking tasks for which they have not been trained. Based on these findings, the report states that a strong case exists for regulating HCAs.
  • They went on to tell us about assistant practitioners who undertake complex procedures such as suturing and giving drugs, but are also unregulated.
  • As previously mentioned, the Committee has ongoing concerns about the care and treatment of older people both in hospitals and care homes. Of particular concern to the Committee is the lack of regulation of a range of groups who undertake many basic nursing care tasks.
  • The Committee endorses mandatory statutory regulation of healthcare assistants and support workers and we believe that this is the only approach which maximises public protection. The Committee notes that the Government intends to give powers to the relevant regulators to establish voluntary registers for non-regulated professionals and workers, but would urge it to see healthcare assistants, support workers and assistant practitioners as exceptions to this approach who should be subject to mandatory statutory regulation. However, the NMC needs to make significant improvements in the conduct of its existing core functions (such as in how it manages fitness to practise cases) before powers to register these groups are handed to it.
  • The current standard for re-registration—completing 450 hours of practice and 35 hours of professional development—is wholly inadequate, as this tells patients  and the public nothing about the quality of nursing and midwifery practice undertaken by the registrant. There is also no routine assessment of whether nurses and midwives have even met this minimal standard. The NMC instead relies on honesty within the profession and “whistle-blowing” when registrants are  dishonest. For many nurses and midwives this may well be adequate, but for a significant minority, including those most at risk of manifesting low professional standards, it may not be.
  • Nurses and midwives from the European Economic Area and Switzerland seeking to practice in the UK cannot routinely be language and competence tested by the NMC. The NMC, along with other professional regulators and the Government is  working towards resolution of this with partner organisations across Europe. The  Committee takes the view that the current legal framework is at odds with good clinical practice, which is clearly unacceptable.
  • The Government, the NMC and the other health professions regulators must now grasp this as a significant risk to patients and dramatically pick up the pace in resolving or mitigating it.

What a way to run a railway!

As for the GMC report, it’s much of a muchness and more of the same.

  • Some of the decisions made by fitness to practise panels of the GMC defy logic and go against the core task of the GMC in maintaining the confidence of its stakeholders. Furthermore, they put the public at risk of poor medical practice.
  • The GMC holds the dual but potentially conflicting roles of prosecutor and adjudicator in fitness to practise cases.
  • The GMC has told us that between 120 to 150 doctors must have known something  was going badly wrong at Stafford Hospital yet few raised concerns through the proper channels.
  • A clear signal needs to be sent by the GMC to doctors that they are at as much risk of being investigated by their regulator for failing to report concerns about a fellow registrant as they are from poor practice on their own part.
  • However, in principle, we believe that it is right that regulatory authorities should not merely react to poor practice but should, where possible, pre-empt it.
  • For example, a higher proportion of overseas qualified doctors work in peripatetic locum situations. In moving around within the NHS and not belonging to one organisation, the threshold for referral might be lower because there is no local governance around that doctor when they move on.

After nearly 4 years of ongoing investigations into the circumstances surrounding the death of my own relative in care, I understand more of the pathetic systems of regulation in place.  I had no idea then of the way in which so many of our Regulators are failing to regulate. 

The one thing I omitted to take on board, when I placed my complaints before the GMC and the NMC, is the fact that you cease to be the concerned complainant once you hand over all of the supporting evidence you can think they might need.  You become a witness.

You spend hours, days, weeks putting together your evidence.  You spend more weeks, running into months, which then turn into years ‘assisting’ the legal team working on behalf of the Regulator in question.  You chase, you correct, you supply further information. 

Then the drawbridge is pulled upright.  Silence reigns.  The weeks pass by, the months pass by, the years pass by.  You make polite enquiries as to progress.  Obfuscation and downright untruths come your way, all disguised as ‘business’, but all masking inefficiency.  That’s where you started – with the inefficency of those charged with the duty of care. 

They failed to care, and the Regulators fail to care either. 

On it goes – on and on and on. 

They hold meetings to ‘facilitate’ the investigation and then the planned ‘hearings’.  The Registrants and their legal team are allowed to attend the ‘meetings to facilitate’. 

You, the nuisance complainant turned witness, are not allowed to attend.  You are not allowed to see one single shred of their evidence submitted, but they are allowed to see everything you submitted. 

On it goes – on and on and on.  Slowly progressing – or regressing?  Towards the hearings.  Perhaps.  Perhaps not.

 

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A care home or a disaster waiting to happen?

This is not something I’d planned to write just yet, but the shocking abuse of people with learning disabilities at Winterbourne View shown in the recent BBC Panorama programme, and the reasons behind the demise of private care provider Southern Cross have troubled me enormously,  so I’ve revised my plan.  I will do all I can personally to raise awareness of the crisis in care that is slowly being revealed.  With help from everyone involved and interested enough to care, we will bring about a change for the better.

I had intended to work my way slowly through the failings of the so-called care system that have affected my own family and my own life before reaching this chapter, but the world has changed, so I will start at the end.

The horrors of the torture of adults with learning difficulties at Winterbourne View long-stay/residential hospital have caused many people to ask questions.  The regulator CQC has so far not come up with answers but has promised an internal investigation.  Paul Burstow, care minister, promises action to safeguard vulnerable people in care.  Andrew Lansley, health secretary, managed to use the scandal to plug his questionable Health and Social Care reforms in his statement on Winterbourne View, and he talks of a ‘serious care review’ (sic).

John Healey, shadow health secretary, can manage only this empty comment on Southern Cross: “Thousands of very vulnerable people and their families will be worried sick by what’s being reported about Southern Cross.”  Ed Miliband is turning into the invisible man, so I can’t find anything of interest that he’s said over the last week – but he did get married recently so the honeymoon may be reason for the sound of silence.

It’s almost as if this bunch of ‘representatives of the people’ have only just arrived on the scene from another planet – but, no, they’ve all been on one side or other of the political washing line for years now.  Wearing blinkers, and all turning a blind eye to what so many real people have had to put up with.  Yes, I’ve written long and clearly worded letters to all of them over recent years, but – just like the CQC did to Terry Bryan, the senior nurse with the big whistle that nobody bothered to listen to when he blew it loudly in their ears – they all stick their heads in the sand, delegate matters downwards to someone who has a high qualification in the ‘copy & paste department’, who then creates a meaningless letter of reply quoting platitudes.  Pointless exercise – and a waste of an opportunity to ‘represent the people’ which is what they’re all paid to do.

I listened to BBC Radio 4’s Any Questions at the weekend.  Some of the panel don’t even know the difference between NHS care and social care, but they are the ones with the power to influence the audience, to make decisions about our lives.  Power is dangerous; power corrupts …. but that’s something I’ll leave for another day, and I will try to return to the abuse of power.

For far too long, the sound of silence has done its best to try to deafen and silence those of us who have not turned a blind eye.

Those responsible for the neglect and abuse of vulnerable adults in need of decent care have managed to create a system that arrogantly dismisses each and every major concern that is brought their way.  People ask how a care home could possibly exist that doesn’t provide decent care.  People ask who is responsible.  People wonder who is to blame when things go so badly wrong.   I’m not alone in knowing how these things come about – read on!!

They’re all in it together.  The care providers, the local authority care commissioning departments, the so-called regulator CQC, the formal complaints procedures that take away the will to live from those who dare to complain, the social services departments, the safeguarding of vulnerable adults units, the MPs who can’t be bothered to care, the Ombudspersons, the police who can’t find a way to help, the GMC, the NMC, the PCTs, the ICO – to name but a few.

After the scandal of Winterbourne View, someone asked “Is this the tip of an iceberg?”.  It is one hell of an iceberg.

Is what follows the description of a care home fit for purpose?  Or was it a disaster waiting to happen?

Please share any answers you may have, because I’ve almost lost the will to live too, but only almost.

A residential care home for 90 frail and vulnerable older people, many with dementia, described as a flagship, state-of-the-art care home, showing ‘the way forward for the future care of older people’, but where:

  • there were no systems in place for appropriate staff selection, staff induction, training, and on-going supervision
  • communication with GPs and other health services was seriously, dangerously and sadly lacking
  • new staff received no induction programme
  • pre-admission assessments, risk assessments did not reflect residents’ needs, follow-up assessments were not undertaken
  • care plans were not written up in a meaningful way, let alone looked at by the staff
  • the staff did not understand their roles
  • there were no systems in place to monitor hydration and nutrition
  • the nursing records did not reflect patients’ needs
  • the care plans did not identify needs
  • the record-keeping was seriously challenged and challenging
  • no charts available for the monitoring of decline in a resident
  • there was no system in place for clinical supervision and performance appraisal
  • nursing staff without chronic disease management training
  • no records kept of any training that was provided, if any was provided
  • no knowledge of or training for diabetes management in place
  • no system in place for routine monitoring of diabetes, swallowing or breathing difficulties,
  • unsigned and undated and often illegible records kept, with entries that were meaningless
  • a total lack of understanding of the need for and reasons for accurate medical/clinical records to be kept
  • MAR (medication administration records) with entries unsigned or countersigned, and changes made without signature or date
  • no records available to give details of the suitability of the staff to be employed in their positions
  • no records available to give details of the employment status of the staff.

I can’t list any more now – but I trust you get the gist of this particular disaster waiting to happen.

Was that a care home fit for purpose?  Or was it a disaster waiting to happen?

But nobody noticed.  Until it was too late.

And yet, the care provider provided the care home with nursing and many others; the local authority commissioning department commissioned it and allowed it to open – so delighted was the local authority that it gave several 25-year contracts to the care provider to provide such services; the CQC/CSCI inspected and found all to be in order – before the ship sank, that is; the social services department found it suitable for vulnerable elderly people to be placed there – but placing them at even greater risk.

Unsurprisingly, the ship hit the rocks.

Then, and only then, did they all go behind closed doors, into a huddle, impose a massive action plan, close it for a full year to new residents – that’s the best that could have been done, although there were calls in the area for it to be closed in its entirety.  But, hey, the local authority had entered into a 25 year contract.  The care provider was in splendid ignorance – at first, but is no longer so innocent.  The care provider is not a novice to this business.  That is one of the most distressing and most depressing aspects of it all.  How many other care homes are there, being run in a similarly shoddy fashion, with careless care being provided to some who because of age, disability or illness are at their most vulnerable and who deserve good care.

My patience has been tried and tested, almost to the point of exhaustion, as I worked my way through each and every stage of the complaints procedure, before being allowed to progress to the next stage, and I haven’t yet reached the end of it all.  It is obscene, offensive, corrupt, squalid and unworthy of the word ‘care’ for this system to be allowed to exist, with absolutely no accountability, nobody prepared or willing to accept personal responsibility, and all behind closed doors, so that the wider world remains unaware of what is being perpetrated and perpetuated.

Over the weekend, I decided to look back over quite a few years.  From just a couple of years:

published 13 June 1998 : ‘In the short term, decentralisation shifts responsibility for funding care to individuals. In the long term, the combination of decentralisation and privatisation may make the costs of care higher than they need be to government and society. In the USA, the loss of control over the finance and delivery of long-term care seems to have increased the cost to government and decreased quality and access for individuals. The effects of these policies have not been adequately studied and understood in either country.’  (Allyson Pollock and Charlene Harrington.  I do wish we would learn to listen to Prof Allyson Pollock!)

published 4 April 1999 : ‘Local authorities have to get as many placements as possible with insufficient money,” he says. “If care is going to be determined by people undercutting each other, we’re going to be in an appalling situation.

published 8 September 1999 : ‘Care homes may be forced to close due to government quality measures.  Care home owners are demanding urgent talks with the government because of fears measures designed to improve quality will lead to home closures.

published 11 November 1999 :  ‘Training has been the Achilles heel of social care with about 80 per cent of the workforce unqualified and an absence of clear employer responsibilities and targets. But a five-year training strategy by national training organisation TOPSS England aims to change this.’

‘It sets training standards and new qualifications for local authorities and the private sector covering a social care workforce of approximately one million. It draws together NVQs and post qualification training, spanning care workers in nursing homes and social services directors. As well as setting targets for training and qualifications, the five-year action plan aims to predict what future skills will be most in demand and how the government, employers, and employees should pay for the training.’

‘And the picture of training to emerge in other areas is little better. Only 19 per cent of staff in homes for people with learning difficulties were qualified and only 23 per cent of staff in homes for older people.’

‘Andrea Rowe, manager of TOPSS England, says the new regulatory regime will be judging care homes on the quality of their training as well as service standards being developed by the government. “They will lean on homes and close them down if they don’t meet the new service standards,” she says.’

‘Private residential and nursing homes claim they face a financial crisis, pointing to a mounting number of receiverships.’

It appears that we have made no progress.  We being the real Big Society ‘we’ – each and every person involved in the decision-making process.   The ones to suffer are the ones in care.  They suffer neglect and abuse because of society’s inability to show that it cares. .

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Absolute privilege in the world of politics v. absolutely no privilege in the world of care

The concept of absolute privilege is not something that I’ve ever contemplated seriously before this afternoon. It’s been known for more than a few years that MPs have a comfortably convenient place for them all to ‘protect themselves, in their own best interests’.  It’s called the House of Commons.

Today’s non-world-shattering news is  all about the privacy of an individual to keep their own ‘affairs of life’ private and personal and away from the public gaze, and the public magnifying glass.  I can’t claim to be interested in this particular individual’s personal circumstances, personal life, personal affairs; I can declare that I’m not interested at all in whatever  may have caused the need for an injunction, super though that injunction may have been in legal terms.

But I do care about the double standards that are operating here.

An elected MP  that I’ve never heard of before – sorry,  MP, but you haven’t made your mark in my world – can  overturn something that has been observed and not flouted by our reliably (un?) reliable media.  All it took was for this particular MP – a representative of the people – to open his mouth and speak two words.  Then the rest of the reliably (un?) reliable media can duplicate those two words.  Not that we didn’t know those two words anyway!

At the same time as this ‘Who Done What With Whom?’  trivial pursuit has been going on, the world of care continues to puzzle me by its own absolute privilege.  But with a difference.

A local authority and a care provider can call upon the equivalent of a ‘super injunction’ to prevent me from being able to know the precise circumstances of the neglect and subsequent death of a relative who was at risk.  She was most certainly at risk in their care.  Not that we knew that then, when we agreed to her coming under their ‘caring’ wing.  But their need to protect themselves and their own best interests appears to be paramount.

The person they failed had no rights; her best interests were demolished within days.  As her close  relative, as her named personal representative after her death, her executor, I have no rights either to achieve justice on her behalf.

Justice?  Hush my mouth, for using a word that may before long vanish from our dictionary.

I have tried so very hard to restrain myself, so that I don’t name and shame each and every one of those involved, from the care home staff (names all known to me), the care provider, the care home, the care home manager(s) and their regional supervisors, the GPs involved, the local authority and its many responsible departments, the CQC inspectors who failed to notice ‘absent systems of protection’, the adult protection coordinator who failed, the social worker who failed, the whole team of mental health care of older people who all failed, ….. …. …. and so on.

All because I have wanted to achieve a decent outcome.  According to the laws of our land.  But the latest blow that has been landed on my shoulders – via one of the regulatory bodies involved – is beyond explanation or even understanding.  And yet, I am still – stupidly, perhaps – hesitating to name and shame the whole bunch of them.  Almost 4 years after her death in so-called care,  almost 3 years after I placed onto the ‘responsible regulatory body’ what they call ‘a complaint’, I am being treated still with contempt.  The Case Officer involved could not even bother to inform me about the latest hurdle that I now have to jump.

So,  I’ve played by the rules.  But they still can’t

I’ve been throttled, strangled, constrained by  concepts that come close to ‘super injunction’ and ‘absolute privilege’ but perhaps in a converse way.

Is a bonking footballer worthy of more care than a supremely decent 83-year old person in need of care?

Am I the fool?

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The long and uncaring road to justice for those neglected in care

The latest edition of Private Eye (No 1288) arrived this morning, and a quick read plus a couple of hours spent researching and reading further have proved most revealing. The home stretch (article heading!) may be somewhat encouraging, but then you discover that the wheels of justice have all but ground to a halt.  (Sorry, no link available to the article because it’s subscription only!)  But I hope the Eye won’t object to a brief quote:

“Nine years after formal complaints were first made about neglect and abuse of elderly residents of Lynde House, run at the time by Chai “Diddums” Patel’s Westminster “Care” Homes, the case against two nurses rumbles on – occasionally.

The adjourned disciplinary hearing is not due to resume until the end of July, with other dates listed in November and clearly no chance of reaching a conclusion until  next year.”

According to the Eye – allegedly!

Why has this case caught my attention?  Because I’m only 4 years along a similar road.

A little digging unearthed the Lynde House Independent Investigation Report from May 2002.  Plus a whole host of related information, through each year almost from 2002 to the present.

Jay Rayner from 2002 – A home unfit for heroes in the Guardian.

2005 report on Dr Chai Patel and the GMC disciplinary hearing Care home head denies misconduct – BBC

2008 Lexology allows everyone to see how long and winding is the road to justice, open to manipulation, in the best interests of ….. well, it doesn’t take long to work that one out, but it’s not in the best interests of care home residents who are at risk, their families or their supporters.

If anyone can tell me what has changed since 2002, I would be enormously grateful.

Why am I denied access to a Report produced by an Independent Consultant – commissioned by the Mental Health Care of Older People team but then snatched by the Local Authority as their own property –  into the neglect and subsequent death of my relative at risk in care?

Why is that report concealed behind the closed doors of the powerful but pathetic Local Authority?  The Lynde House Investigation Report bears such enormous similarities and is available in the public domain.

Why is a local authority able to provide such a barrier to justice, protecting itself and its Care provider in the UK?

Why is a Care provider in the UK able to provide such a barrier to justice?

Do they have more to hide than we know?

Am I likely to be required to spend a further 5 years of my life trying to achieve that thing we call justice?    If anyone reading this has any words of wisdom to offer me, I will be for ever in your debt and you will be for ever on my seasonal greetings list.

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Baby Peter doctor ‘missed unique opportunity’

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

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

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

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

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

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

The above is reported via BBC News.

…… …. ….. …..

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

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

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

My relative may have lived.

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

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

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

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Filed under care, dementia care, justice, law, liability