How are the elderly treated in different countries and in Britain in particular? There is an interesting selection of letters in The Times today which raises a lot of the big issues in a short space. Does government involvement do more harm than good? How much damage to provision has been done by government regulations? Should people be looking after their aged parents themselves? Is it better for the elderly to be in their own homes, rather than in a care home (the cost is not very much greater)? Here is one of the letters:
MY 98-year-old grandmother has been in residential care since a fall in September left her unable to care for herself. The care home is under-staffed and under-resourced. The food is awful and there is real lack of warmth. She cannot walk and has been given a room two floors up, so is forced to sit all day in a lounge with others or be left in her room alone as there is not the staff to move her. It makes me very sad and angry that her life has come to this.
I looked at several other homes during her initial 12 weeks. I was appalled: many were dirty, smelt awful and the patients were left to sit and stare into space. We have more compassion for animals in this country than our elderly. If I could have had her living with me, then that is what I would have done rather than subject her to this.My dad is also in a nursing home; at just 56 he had diagnosed a degenerative brain disease. Thankfully his experience has been better and the home is wonderful. The catch is that he is 35 miles away in Milton Keynes, as that was the nearest place that could care for him.
Debbie Stokes,
Watford
Posted by James Bartholomew • Indexed in Care for the elderly • NHS
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Carrying on from (2). When I was working in a small greengrocers shop the health and safety inspector commented that we were required to have a nail brush at our sink, but only until September. My boss asked if the inspector knew where we could hire one from, everyone was in fits of giggles... except the inspector.
Posted by: Jack Gunning at May 26, 2005 02:16 PM
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The government regulations are amazingly bad, cost a fortune to both care home owners and the public sector, and achieve nothing.
There are several problems.
(1) They are applied quite staggeringly inconsistently. Some hammer people for minor or invented infractions, some just ignore them. This tends to (IME) bias towards those run by the Public Sector. largely because the inspections are done by the former colleagues of the people in the public sector ; back scratching stuff.
It's a bit like Fire Regulations. With LEA schools the line has always been basically getting them up to scratch would cost an absolute fortune, so they are effectively exempted. Private Schools do not have this luxury. This seems to apply in NCSC/CSCI/CHAI as well.
(2) The Inspectors are laughably ignorant about the actual work, literally, I once had to leave the room because I had a fit of the giggles. It is tickbox mentality run riot. Because they have no clue, they focus on minutiae like how big the windows are, because they have no qualifications or experience to evaluate what is actually happening. The comments in (1) still apply ; the application of tickboxes is variable to say the least. They write what they want.
(3) The standards have to be measured. This forces towards things which are quantifiable. Quality of Care, Happiness of Patients etc is not quantifiable. Forms and Records are. So they require more and more forms and records, which makes less time available for the job of actually caring. Inspection is usually about 70-80% looking at records and forms, and has been done without viewing any practice at all. This is like OFSTED inspecting a school without ever seeing a classroom or child.
(4) They can say and do what they like. The complaints route is all to them and their above levels, and they will ignore the ombudsman, basically. There is a tribunal, but the burden of proof is on the complainant, not on CSCI. A variation on OFSTED is you always get the same inspector, so if you make a complaint the same person will come back effectively wanting revenge. So no-one complains, though I know no-one who thinks any of them are competent.
(5) Like any quango, the main aim is to increase its reach, budget, areas of control. Much effort goes into this. There is a laughable punch up going on where I live between SSD & CSCI, which involves them refusing to invite each other to meetings etc. (for the benefit of the children, doubtless). This is because both want the power and money that comes with "child protection"
(6) Because they don't have to pay for anything, the requirements extend endlessly as a back covering exercise. It is always in their interest to demand more staff, more targets, more forms, more systems. This increases costs, which most users cannot afford and SSDs will not pay. So care home owners sell up and quit, or they focus purely on meeting the targets. You get the impression that as long as the forms are okay they don't care about what is actually happening.
The worst cost increase is staffing. They are demanding minimum levels of staff training, which is fine, except someone has to pay for it at some time. Care Homes are run to some extent on cheap employees to do mundane jobs. Having everyone at NVQ3 (another rule ignored for public care homes and schools) racks up employment costs spectacularly, let alone training costs. At the same time, they want more staff (except for Local Authority provision).
(7) As a carry-on from (1), LAs are dodging the targets by redefining care homes as "rented accommodation with 24-hour support". This way most of the regulations don't apply. So they dodge them (something Private orgs aren't allowed to do), even though the practice is identical. To be fair, there's nothing actually wrong with the homes, they just don't tick the boxes.
(8) It repeatedly reorganises at great expense. Originally it was done by SSD. Then they all went to work for NCSC (late 2002). Two weeks after NCSC started, they were told they would be converted to CSCI and CHAI (early 2004). Now they are going to be OFSTED and CHAI. Imagine the money wasted !
Posted by: Paul at May 25, 2005 10:35 AM