The Care Quality Commission has recently confirmed that 4 out of 10 care homes, across England and Wales, are failing to provide adequate care for the people who live there.
It is always difficult for families, and friends, to make a decision that their loved one needs specialist care which can only be provided in a Care or Nursing home and then, once they are in a home, to ensure that they are safe.
One of the important things I always recommend to anyone who is looking at care homes for their loved one is to firstly check the Care Quality Commission’s website to see what the rating of the home is and also consider whether the last inspection was recent. Unfortunately even if the care home has been rated good or outstanding sometimes the standard of care can deteriorate quite quickly. Therefore, I always recommend that you visit the care home without making an appointment to see how the care home is run when they are not expecting visitors.
Once you have chosen a care home you would expect that your loved one is cared for safely and supported in the home with access to stimulating activities.
Sometimes families, when they have gone to visit their loved one in their Care Home, notice that things have changed or have a feeling that something is wrong.
I always advise family members or friends when they are visiting their loved one in a Care Home, to look out for a number of warning signs.
A strong smell. If when you enter the home, it smells strongly of faeces or urine then it is clear that there is poor care. Apart from the personal hygiene issues and the lack of dignity for somebody who is left in dirty incontinence wear there are significant health issues as well as the distress that person feels. If someone’s incontinence wear is not changed regularly then there is a real risk of them developing bed sores.
When you enter the home is it dirty? Is the home being cleaned? Are there areas which are dirty or is there a lack of maintenance around the home? If this is the case then there could be an issue with how the home is managed or investment by its owners.
Dehydration. This is a significant issue which has been picked up by both the Care Quality Commission and the National Health Service. If your loved one is very thirsty, and drinks a large amount of liquid when you visit them have they not been provided with sufficient water or juice or their preferred drink during the day? If they have been provided with drinks does their medical condition mean that they will forget about the drink unless they are supported and encouraged by the staff to drink. Another issue is that sometimes waters and drinks are placed out of reach of the person who may not have the physical ability to reach and obtain that drink and therefore they cannot meet their own needs and need help to remain hydrated.
If you think your loved one has lost weight that is another warning sign. It could be that food has been packaged and they are unable to open that packaging to access the food or that food has been taken into the resident but left on a table out of their reach, or they may need help and assistance to eat their food. If a loved one needs help when eating are they being supported by staff and given time to eat their food or are they put under pressure to leave food if it is taking some time. It is very important that if you feel your loved one is losing weight to ensure that the Care Home has referred them to a General Practitioner or a dietitian to investigate the cause of their weight loss.
A sign of understaffing can mean loved ones having to wait a long time before call bells are answered by staff. Call bells need to be within reach of residents, if not they are unable to call for assistance. Also, if they suffer from dementia they may not be able to remember to press the call bell for help and may call out for help. Therefore you need to see if staff answer those calls swiftly and with respect and kindness.
If you have been informed that your loved one has suffered from an overdose in medication or been advised that they have not received their medication this could affect their overall health. The Care Home has a duty to ensure that the medication that they give to their residents is correct and reviewed regularly by the General Practitioner. There is a significant risk that if there is no procedure for the medication to be reviewed or checked on a regular basis that the resident may not be having the correct medication.
Fire doors and access to premises must be secure to prevent residents who lack awareness of risks wandering out of the premises and that fire exits are in good condition so residents do not accidently walk through them and fall. There should also be locks on the windows to ensure that residents cannot fall out of a window.
Veronica Male is the Chair of Northamptonshire Dementia Action Alliance and is also an experienced Chartered Legal Executive at Tollers Solicitors who specialises in Care Home neglect. Veronica, whose family members have been in care homes, is concerned about poor care and abuse in Care Homes. She is able to provide advice to families who are worried their loved one may have suffered because of poor care or abuse.
Veronica is happy to give advice and support to families who find themselves in this very difficult position.
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