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)

Care in the UK – 5 years on – Part 2

This day, 5 years ago, was obviously a day of quiet reflection for us, as will be today.  It’ll give me a chance to update this blog over events while you were in intensive care.

All we could do when you arrived in hospital, on Saturday 8 December 2007, was sit with you in ITU, where you were transferred once you had been stabilised in A&E, and once we had discussed with the Consultants.  Questions were beginning to formulate in our minds, caused by the very questions we were asked by the Consultants, but it was a weekend so there was no chance of contacting the social worker or the care home manager.  We left messages on the social worker’s answering system.

The first question we were asked was to explain how your diabetes had come to be so out of control.  Our answer: we never knew it was out of control.  It was as if we were being held responsible.  Only later did we discover that, for some unexplained reason, the paperwork indicated that you lived with us, rather than that you lived in Lennox House in London.  That was our first realisation that the paperwork needed to be looked at with a close eye.  We were asked many more questions, of course, and we were told much about your condition on arrival.  Shocking was your condition.

On the Monday, still in ITU, I had a sudden thought.  The social worker had declared herself “the decision maker” when it came to deciding where you should live.  We were not even invited to the ward round meeting where this important decision about you was made.  She was “the appointed decision maker”, she said.

So, I wondered why she had not responded to my phone message.  After all, surely she should be making decisions now too, shouldn’t she, if she had taken so much power away from us, and from you.   But the social worker was conspicuous by her absence and by her silence.

Then, you were moved into isolation because it was decided you had C-Diff (Clostridium Difficile).   So you spent the next few days in isolation, with us as close as we could get to you.

Still no contact from the social worker.

We had to leave you to go to the funeral of a dear friend, and we were away for a couple of days.  I managed to speak with the social worker and with the care home manager.  I was polite but firm when I asked the care home manager to explain to me exactly what had happened in the days that I hadn’t been with you.  The social worker told me that she had asked for a report from the care home, so I asked to see a copy of it when it emerged.  I never did get to see it.   I also asked the Lennox House care home manager for a copy of every single page of the care home notes, records, paperwork that arrived with you, paperwork that went with you when Lennox House care home sent you by ambulance to A&E.

When I mentioned that you had C-Diff, the care home manager told me that you had had an episode of C-Diff when you were in Highgate Mental Health Unit’s assessment ward, just before discharge from there. That was news to me.  I said I found it surprising the care home had accepted you, and I asked why it hadn’t been mentioned before.  Her words will never leave me.  She said that it often happened that people arrived in the care home with C-Diff, but it wasn’t necessarily mentioned on the paperwork.  She said the same applied to MRSA.

To say that I was stunned would be an understatement.  I was beginning to get used to shock.

I learned that you had been seen by  a GP  – the manager said you’d been seen the Wednesday before admission to hospital.  Not true.  A GP had only been summoned  by the sending of two faxes – yes, faxes – two hours apart on Friday 7 December 2007.  But nobody declared that when the first investigation was carried out.  (More about that another day.)

You were moved out of isolation and ITU to a general ward.  You regained consciousness only briefly, and one day they managed to get you from bed to chair.  Just the once.

You spoke only two words.  “Thank you.”  The last words you ever spoke.

Tomorrow is another day – and it certainly was, 5 years ago.

You deserved better care.

(To be continued)

Neglect and abuse in care in the UK in November 2012

Some people try to convince me that cases of neglect and abuse of vulnerable people in care in the UK are extremely rare.  Some people also try to convince me that those who talk of such cases are scaremongering.

Below is just a selection of cases of neglect and abuse of vulnerable people in care in the UK over the month of November 2012.  It is a selection and by no means all of the cases I came across.  The dates are the publication dates.

5 November 2012:   Britain’s biggest care home owners ‘have £5 billion debts’.      Read more here.

5 November 2012: Nottingham – Police are investigating an elderly care home in Nottingham which closed after  having its council contract suspended.  Read more here.

6 November 2012: Suffolk – The great care home giveaway: Tory council calls in the private sector.   Suffolk County Council has agreed a multimillion pound deal with the private sector to take over its care homes amid fresh calls for financial regulation to protect elderly residents and the taxpayer.

The council’s 16 aging homes will be closed by 2015 and 10 new homes (and wellbeing centres) built – giving the county 104 extra beds to help meet growing demand.

The first five will be built and owned by Schroders UK Property Fund – who will lease the homes back to Care UK. The land is being given to Schroders for free by the council with unrestricted freeholds.   Read more here.

9 November 2012: Dementia patient found wandering in the freezing night ten miles from home after carer ‘forgot’ about him – Read more here.

9 November 2012: – Devon -Council breached equality duty in setting care home fees.  Authority to review care home fees after High Court found it failed to consider impact of possible home closures on vulnerable residents.  Read more here.

19 November 2012: Hayling Island – three women arrested as police investigate claims of neglect at a care home – Read more here.

19 November 2012: Olney, Northamptonshire – two women charged in connection with neglect at a residential home – Read more here.

19 November 2012: Luton – woman denies neglect after an elderly woman with dementia was left on a bus in Luton overnight – Read more here.

19 November 2012: St Saviour, Jersey – A care home nurse threatened to teach a  colleague a lesson by beating her up ‘in the African way’ during an aggressive  outburst, a tribunal heard. Read more here.

20 November 2012: Buckinghamshire – two care home workers charged with neglecting patients at care home for dementia sufferers – each charged with 19 counts  of wilfully neglecting a person without capacity between August 18 and 19, 2011 – Read more here.

23 November 2012: Archway, London – Whittington Hospital – two senior nurses ignored plight of epileptic 17 year old who suffered 5 epileptic fits in the space of 24 hours and died four days later – Read more here.

26 November 2012: Swindon, Wiltshire – Selena House Care Home, Stratton St Margaret to close in December “over safety fears” – The CQC report said the home had failed to meet 11 government standards,  including care and welfare, dignity, cleanliness and infection control. Read more here.

27 November 2012: Goole, Yorkshire – Three Women Arrested after elderly woman is injured ‘while unattended’, allegedly, in care home . Read more here.

27 November 2012: Chingford, Essex – Chingford rehab unit so understaffed patients were left to wet the bed, watchdog finds.  Vulnerable patients’ dignity was compromised by poorly trained staff at a rehab unit where dementia was mistaken for a learning difficulty, according to a damning watchdog report. Read more here.

27 November 2012: Cambridgeshire – Abacus Care Cambridgeshire  has been issued with a formal warning by a health watchdog after failing to meet standards for a second time. Read more here.

27 November 2012: Great Wyrley, Staffs –  care home worker stole cash and personal belongings from residents and staff to help fund her drug habit.  Read more here.

28 November 2012: What can be done to ensure care home residents get quality healthcare? Reports suggest the availability of doctors in care homes has fallen short of what residents are entitled to. So what can be done to ensure these patients get the care they deserve?  Read more here.

30 November 2012: Maltby, Sth Yorks – Melton Court care home residents face pre-Christmas move after it emerged the home’s owner is in prison serving a sentence for causing grievous bodily harm.  Read more here.

And finally, as December 2012 arrives we find:

1 December 2012: Care home regulation not fit for purpose, says care minister Norman Lamb.  Read more here.

Better late than never, I guess, but what took you so long to work that one out?