Tag Archives: Helga Pile

CQC and Castlebeck and whitewash

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

It took a BBC Panorama programme to open CQC eyes to the abuse that was going on at Winterbourne View hospital in Bristol, and for the CQC then to realise there were ‘serious concerns’ about the quality of care being provided by Castlebeck.   It took an undercover reporter to force the CQC to do the job it should be doing: inspecting thoroughly, reporting efficiently and demanding that action is taken to prevent any care provider from providing neglect rather than care.

When I first contacted the CSCI (as CQC’s predecessor was called then) about my serious concerns about the care my relative received in a care home, CSCI’s Inspector told me that she would contact the manager of the care home.  I heard nothing from the CSCI, so I chased for a progress report.  Much to my surprise, I was told that the manager had informed CSCI that a meeting had been arranged and that “all my concerns had been resolved at the meeting”.  The CSCI believed the manager and closed the book.  There was no ‘meeting’ and my concerns were not resolved.  Far from it.

Then, the mental health care of older people team carried out an investigation into the circumstances surrounding the death of my relative in care.  I was excluded from all meetings, from everything other than an initial ‘interview’ with the investigator.

Then, the Local Authority ‘claimed ownership’ of the report – and continued to exclude me from all meetings.

The CSCI took a back seat, knowing full well that it would bring a cloud over the care provider, the CSCI inspectors, the Local Authority commissioning department etc. if all the details were to be ‘in the public domain’.  It all remains closeted behind closed doors.

How many similarities are there between the report into the circumstances surrounding the death of my own relative and the CQC report on Castlebeck ?

Try these for starters, although I have paraphrased some:

  • problems that need to be addressed at a corporate level – the company needs to make root and branch improvements to its services and processes
  • we have demanded improvements
  • Where there were immediate concerns about people’s safety action was taken.  In the case of Winterbourne View this action led to its closure.  In the case of the care home I was dealing with, it was not allowed to admit new residents for a year, a massive improvement plan came into existence which had to be worked through before any new admissions were allowed.
  • lack of staff training,  poor care planning, failure to notify relevant authorities of safeguarding incidents
  • The registered provider did not have robust systems to assess and monitor the quality of services provided in the carrying on of the regulated activities.
  •  The registered provider did not identify, assess or manage risks relating to the health, welfare and safety for the people who use this service.
  • The registered provider did not operate effective recruitment procedures.
  •  The registered provider failed in relation to their responsibilities by not providing the appropriate training and supervision to staff, which would be required to enable them to deliver care and treatment to the people who use the service.
  • Medication issues
  • Communication issues
  • There was a lack of leadership and management and ineffective operation of systems for the purposes of monitoring of the quality of service that people receive.

As for staffing issues, there are so many people in the real world aware of the fact that care homes are endangering people’s lives by running their operation with too few staff, poorly trained, badly paid, unsupervised staff.  Families are aware of it – what took the CQC so long?

How many Castlebeck’s are there in the world?  I know of one providing Care in the UK!  An animal that is growing daily, getting bigger and fatter and likely to become even fatter.  As long as everything shabby and shoddy is kept hidden, the world will never know.

It took an undercover reporter to shock the CQC into action!  Disgraceful.  I know I’ve banged on about this one before, but it really does begin to make the CQC look even more ridiculously toothless than some of us know it to be.

Why should the Castlebeck report be in the public domain – yet the damning report into the neglect of my own relative is concealed from view?  I wonder whether Andrew Lansley might like to comment on that one!!

As for Paul Burstow’s statement, “as a Government we intend to ensure that that doesn’t happen again” – I’m sick and tired of hearing that one.  Because it does happen again – and again – and again.

Helga Pile, Unison’s head of social care, said: “Elderly care is a service where mandatory regulation is vital to protect their interests. The privatised model means that the time carers can spend with each person is minimal, forcing corners to be cut, and employers see basic training as an expensive luxury.”

“It is not right to try to get elderly care on the cheap.”

The rich care providers grow richer – the people in need of care are neglected and die as a result.  The CQC is part of the problem.

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Filed under care, care homes, dementia care, neglect

The homecare companies that couldn’t care less

UNISON, the UK’s leading public sector union, today slammed private homecare companies for exploiting staff and leaving elderly people without the care and support they need.

Private care companies routinely employ staff on zero hours contracts, that often means huge swings in paid hours for staff. By refusing to pay for travel time between visits, many home carers are effectively paid below the minimum wage.

They are not offered even basic training, including how to administer medicines, despite having to give them out as a part of their work.

Some companies book back-to-back calls with no travel time at all. This forces carers to shave minutes off already packed care slots, and means elderly people are short-changed, missing out on vital support.

Out of their low wages, many care workers have to pay for their own transport, mobile phones and uniforms – all essential to do the job.

And as I sit here writing this, You & Yours on BBC Radio 4 is discussing the very same problems.  With continuing talk of reverse auctions, call cramming, lousy training.  “There’s a gap between what’s in the Standards and what’s actually happening” are very true words that I’ve just heard from Helga Pile, UNISON’S from National Officer for Social Services.

And yet there is another contributor Colin Angel, Head of Policy & Communications at UK Homecare Association, who almost denies there is a problem and suggests that everything is regulated by the Care Quality Commission.  He’s a provider of domiciliary care, of course.

An anonymous contributor to the programme became so disillusioned, exasperated and thoroughly fed up with the careless carefree homecare that she was able to access for her 94 year old mother with dementia that she placed her mother into a care home.  I will keep my fingers crossed and hope that she has been able to find a genuinely careful and caring care home.   The scenes she described are not a one-off.  The cultural differences between cared for and caregiver resulted in extremely odd combinations of food being served.  Smoked haddock and gravy!  Communication made impossible because of the lack of English in the caregiver.  Problems with time schedules.

Money, money, money! That’s what far too many care providers care about.  With their shares in the company, enormous salaries, bonuses and so on, it’s not likely they would consider working for £5.80 per hour (a measly 5p above the minimum wage), a mileage rate of 17p per mile and on a zero hours contract.  So why are they prepared to exploit their staff and the very people they purport to care for?

But nobody really cares about those on the receiving end of careless carefree care – who are, in the main, elderly people without the inner resources to question it all.  The vulnerable elderly people in need of care often have elderly relatives trying to do their best for them, so their elderly supporters are often also challenged.

Pamela Wells called on care homes to up their game, when her own report was published last week.

Caroline Bernard – Counsel & Care’s Policy and Communication’s Manager – suggested that the homecare companies ought to be monitoring the work of their staff.  Cultural differences were again discussed, and the need for dementia training.  For the second time Paul Burstow Minister of State for Care Services declined to appear on the programme and said that everyone ‘should’ receive a good standard of care and that many agencies are rated good or above.

Should receive a good standard of care – yes, of course they should.

But the fact is, Mr Burstow, that it is not a reality in many cases.

My own relative had something like 14 different homecare workers visiting her in any one week; she came to resent that.  They mostly had a very poor command of English which was a huge problem for an elderly person with dementia.  They filled in the ‘daily contact’ record book with many untruths, giving the impression they had understood and carried out the task required of them when that was far from the case.  (That must be one ability they are trained for!)  Meals were not prepared – “she said she’d already eaten”.   She may well have said that, but she has dementia and she has diabetes too.

Medications were incorrectly ‘prompted’, at the wrong time of day, or on an empty stomach.  Or just left on the table in a plastic pot – “for you to take later”.  Result: my relative stored those meds up.  Who would have carried the responsibility if she had taken them all in one go?

I complained about the appalling homecare service.  I asked for continuity of care worker – the Manager told me that the staff preferred to have maximum variety in their work.  The Manager suggested to me that I should not complain “because some of the workers are now refusing to visit”.  That’s what I call mis-management.  Tail wagging dog?

Paul Burstow, I welcomed your appointment recently.  I look forward to being able to continue to welcome your appointment.  But only if you understand the numerous meanings of TLC.  Not just tender loving care.  Work out your own permutations, Mr Burstow.  A few suggestions for you to play with: training; care; trustworthy; lasting; careful; loyal; compassion; tested; long-lasting; life; controlled; considerate; … … … over to you!

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Filed under care, domiciliary homecare, growing older