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Frank Hovis

Care Homes - The Gathering Storm

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Another one has had big problems:

A care home in Surrey has been shut down after inspectors found residents were "at significant risk of harm".

The Care Quality Commission (CQC) said it ordered the immediate closure of Merok Park Nursing Home after an inspection found it was dirty and unsafe, with an "overpowering" smell of urine.

The home's 25 residents were moved following the closure on Tuesday.

http://www.bbc.co.uk/news/uk-england-surrey-30409296

And the whole of the Southern Cross group went in 2011:

http://www.bbc.co.uk/news/business-14102750

These are just the first. There is a serious problem with the sector for two reasons:

  • Private equity firms bought up a lot of these companies, and put vast amounts of debt on their balance sheets meaning that their margins were incredibly tight.
  • Councils have cut the amounts that they pay across the country for care, e.g. home care £20 an hour down to £12. At these levels responsible providers drop out and only the cheapest corner-cutters can tender.

As a result the whole sector is teetering on the brink; closures and poor inspecton results will become common because of under-staffing and under-paying the overworked staff that they do have and an interest rise will finish off many of them.

No link, just a bit of inside knowledge. If you have elderly relatives in a care home I suggest making more regular checks and asking more questions; homes that may have been (genuinely) lovely five years ago are likely to have gone downhill.

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My mum, who has advanced dementure, is in a St John's care home, and I cannot fault it.

At about £40k a year, it should be faultless of course.

As for the smell of wee, that happens in any care home, unfortunately.

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And, bearing in mind that the CQC already have 55 homes "under enforcement" many of whose inadequacies include staffing, and a further 4 recently inspected rated "inadequate", FH's warning is timely.

Remember if you have an elderly relative in a care home that you suspect has problems, you can report it to the CQC here: http://www.cqc.org.uk/share-your-experience/guidance-sharing-your-experience-us

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My mum, who has advanced dementure, is in a St John's care home, and I cannot fault it.

At about £40k a year, it should be faultless of course.

As for the smell of wee, that happens in any care home, unfortunately.

Known quite a few widows in care homes with dementia and I think we place the values of a normal person onto those with dementia. Just because we would be appalled by the idea of being in one of these homes, I get the impression most dementia patients are blissfully happy, probably worse for those that haven't got dementia.

I had noticed that Prunella Scales had been behaving rather bizarrely on television this last decade or so in interviews...and yes she has dementia. On the Today programme this morning...she is blissfully happy and unaware she has changed, Timothy West devastated.

http://www.radiotimes.com/news/2014-03-04/timothy-west-reveals-prunella-scales-painful-battle-with-dementia

A friend of mine visits an elderly lady in her nineties who has not lost any of her mental capacity...unfortunately she is depressed and lives in terror of dying. Wonder who has the best end of life experience, the dementia patient who thinks they are back at school with the prospect of their whole life before them (or so they think) or the terrified person with all her faculties.

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Private care homes. A national scandal.

Britain has taken a wrong turn somewhere along the line.

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Private Equity. Finance. Financialisation. The fast buck. Debt

That's where it all went wrong, aided and abetted by our Glorious Leaders.

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Private care homes. A national scandal.

Britain has taken a wrong turn somewhere along the line.

Don't think there is a practical alternative where dementia is concerned. Family care at home is almost impossible, it requires 24/7 attendance; though some do manage it.

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Yet again we see the weak, frail, sick and vulnerable those who are unable to stand up to the injustices, those being exploited by others for gain......where are their loved ones, their family in all this? The people to stand up and speak out for them being used and abused by others.

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There are a lot of very good care homes out there, but we hardly ever hear about these - only the awful ones. Because we've had so much of it in the family I'm a regular visitor to the Alzh. Soc forum, and many people are very happy with their care homes. But there is the odd case of shocking lack of care, inc. one lately where they had not visited a parent with advanced dementia for some time because the other parent was critically ill. He had been a self-funder at £1200 a week - of course they had assumed that this would ensure good care - only to find that he was being grossly neglected. As soon as they turned up again and complained in the strongest terms, things magically improved. But they moved him anyway, to a place they were very happy with, and lodged a complaint with the CQC, having taken photographic evidence.

So much will depend on the manager(s), and in turn whether the owners are only concerned with making as much money as possible.

My mother has been in an Abbeyfield specialist dementia home, purpose built, for over 7 years now. Abbeyfield is non profit making, and IMO we were very lucky to have one close to home, with a room available when it had become an urgent necessity.

One thing I would say to anyone looking for a care home - we have looked at masses over the years - is to discount instantly any that asks you to make an appointment just for an initial look around. It smacks of something to hide. Any good care home should be happy to let you look around at any time within reason. And do not be over influenced by smart or 'stylish' decor. It does not necessarily indicate good care and is IMO often there to impress the relatives who will be choosing.

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Right on cue here's one affected by the squeeze:

A number of elderly care home residents in Somerset could be forced to move within a month if their families are unable to pay an extra £125 per week.

Oaktree Court in Wellington has asked its 13 council-funded residents to pay the top-up fee, blaming costs which have "increased substantially".

In a letter seen by the BBC - dated 28 November - the home said the new fee would commence on 1 January 2015.

Care provider Majesticare has refused to comment despite repeated requests.

Somerset County Council funds 1,500 care home beds across the county and spends a weekly average of £575 per person for nursing care and £444 for more straightforward residential care.

'Avoid upheaval'

The authority said if the fee was a problem, affected residents would be offered relocation to "a suitable alternative care home" in nearby Tanuton.

Majesticare has written to the families to say the council grant has "not kept pace with inflation" and although the required supplement would not meet costs in full, it would allow a continuing service to be provided.

http://www.bbc.co.uk/news/uk-england-somerset-30394065

There you go, first of many. Happy Renting says he's paying £40k for a decent standard home so £800 a week is the marker for this.

The council is paying £575 and the home is asking for £125 to bring this up to £700; suggesting that £35k a year is the bare minimum and the council is only paying £30k.

Start scaling that up by the number of people in these care homes and you can see that there is a severe funding problem.

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Right on cue here's one affected by the squeeze:

http://www.bbc.co.uk/news/uk-england-somerset-30394065

There you go, first of many. Happy Renting syas he's paying £40k for a decent standard home so £800 a week is the marker for this.

The council is paying £575 and the home is asking for £125 to bring this up to £700; suggesting that £35k a year is the bare minimum and the council is only paying £30k.

Start scaling taht up by the number of people in these care homes and you can see that there is a severe fudning problem.

How much is a hotel to live in all week with breakfast, lunch and dinner?

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How much is a hotel to live in all week with breakfast, lunch and dinner?

And 24 hour nursing care available.

A lot, £800 a week sounds about right. And as councils aren't funding at these levels there is a problem.

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Known quite a few widows in care homes with dementia and I think we place the values of a normal person onto those with dementia. Just because we would be appalled by the idea of being in one of these homes, I get the impression most dementia patients are blissfully happy, probably worse for those that haven't got dementia.

I had noticed that Prunella Scales had been behaving rather bizarrely on television this last decade or so in interviews...and yes she has dementia. On the Today programme this morning...she is blissfully happy and unaware she has changed, Timothy West devastated.

http://www.radiotimes.com/news/2014-03-04/timothy-west-reveals-prunella-scales-painful-battle-with-dementia

A friend of mine visits an elderly lady in her nineties who has not lost any of her mental capacity...unfortunately she is depressed and lives in terror of dying. Wonder who has the best end of life experience, the dementia patient who thinks they are back at school with the prospect of their whole life before them (or so they think) or the terrified person with all her faculties.

Sadly, many dementia patients do have insight into their condition and suffer as a result. my father was one such. Before he was well gone in Alzheimer's he expressed a wish to kill himself. Unfortunately for him, and my mother, he just didn't have the capacity to carry out his wish. In a lucid moment a couple of weeks before he died, he asked me to help him die. To ask me took him a superhuman effort. To be unable to help him will be a regret that I will carry to my own death.

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Private care homes. A national scandal.

Britain has taken a wrong turn somewhere along the line.

Agree. You can tell a lot about a nation by looking at the way it treats its old people.

And in Britain, we let the elderly freeze/starve to death in their own homes, leave them alone or ship them off to remote homes to be abused.

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And 24 hour nursing care available.

A lot, £800 a week sounds about right. And as councils aren't funding at these levels there is a problem.

Who is making money from this?.....the front line carers?......£800 PW sounds steep. ;)

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Known quite a few widows in care homes with dementia and I think we place the values of a normal person onto those with dementia. Just because we would be appalled by the idea of being in one of these homes, I get the impression most dementia patients are blissfully happy, probably worse for those that haven't got dementia.

I had noticed that Prunella Scales had been behaving rather bizarrely on television this last decade or so in interviews...and yes she has dementia. On the Today programme this morning...she is blissfully happy and unaware she has changed, Timothy West devastated.

http://www.radiotimes.com/news/2014-03-04/timothy-west-reveals-prunella-scales-painful-battle-with-dementia

A friend of mine visits an elderly lady in her nineties who has not lost any of her mental capacity...unfortunately she is depressed and lives in terror of dying. Wonder who has the best end of life experience, the dementia patient who thinks they are back at school with the prospect of their whole life before them (or so they think) or the terrified person with all her faculties.

Not everyone with dementia by any means is happy. Quite a lot are often angry and aggressive, suspicious of those trying to care for them, failing to recognise their own spouse, etc., failing to recognise their own home, demanding to go 'home" to a house they have not lived in for decades. Or they may be constantly anxious, fretful and frightened of things they cannot even name. My mother was one such for a long time, until she got so bad that she's just a pitiful shell, hardly aware of anything.

OTOH there was an old lady in my mother's CH who told me nearly every time I went that she was waiting for her mum and dad and grandma and granddad to come - any minute now - and they were all going to the seaside together. She was very happy, back in her sunny childhood idyll, and I used to wish so much that my poor mother could be the same.

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Who is making money from this?.....the front line carers?......£800 PW sounds steep. ;)

That's for the good home. The cheapo on £575 a week is making money for nobody. The staff will be underpaid and over-worked; they won't stay long either.

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Who is making money from this?.....the front line carers?......£800 PW sounds steep. ;)

It depends a lot on where you live, but what is the cost of bed and breakfast in a reasonable hotel or B&B nearby? £800 a week works out at just over £114 a day, which includes all meals, snacks and drinks, often a great deal of help with washing, dressing amd 'toileting', as they like to call it, not to mention laundry (often a lot). And then there is heating, which is nearly always on quite a bit higher than in a normal environment. Plus staff on duty all night, since esp. with dementia, people often lose all sense of time and may wander around half the night - my mother often goes through phases like this.

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That's for the good home. The cheapo on £575 a week is making money for nobody. The staff will be underpaid and over-worked; they won't stay long either.

There are some very good homes that cost in the region of that, ones that provide excellent care £575 a week is not cheapo ....like good schools it is down to top management and well trained staff that care and value their residents and work closely with the residents families......the more money you pay does not always mean better service.......down to the company and the debt they carry, are they in it for the money or in it to do a 1st class caring job? ;)

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It depends a lot on where you live, but what is the cost of bed and breakfast in a reasonable hotel or B&B nearby? £800 a week works out at just over £114 a day, which includes all meals, snacks and drinks, often a great deal of help with washing, dressing amd 'toileting', as they like to call it, not to mention laundry (often a lot). And then there is heating, which is nearly always on quite a bit higher than in a normal environment. Plus staff on duty all night, since esp. with dementia, people often lose all sense of time and may wander around half the night - my mother often goes through phases like this.

I understand....not all residents are high maintenance, some need more attention than others and create more work than others....I have a lot of respect for the dedicated carers, I do not think they are valued and recognised nearly enough. ;)

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There are some very good homes that cost in the region of that, ones that provide excellent care £575 a week is not cheapo ....like good schools it is down to top management and well trained staff that care and value their residents and work closely with the residents families......the more money you pay does not always mean better service.......down to the company and the debt they carry, are they in it for the money or in it to do a 1st class caring job? ;)

and the (inadequate) level of council funding. Which is precisely my point.

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Agree. You can tell a lot about a nation by looking at the way it treats its old people.

And in Britain, we let the elderly freeze/starve to death in their own homes, leave them alone or ship them off to remote homes to be abused.

That is the sort of very unfair cliche usually spouted by politicians who don't have a clue. There are many, many relatives in the UK doing their absolute damnedest to look after their elderly. And the vast majority of people in care homes are not abused.

Between us Mr B and I have had 4 relatives - two parents and two aunts - in various care homes - ordinary residential, specialist dementia homes, and a nursing home. In every case 24/7 residential care was necessary either because dementia had got to the stage where constant care and supervision - ALL day, ALL night, was necessary, or because physical frailty was such that hoists or two people were needed for lifting the person several times a day,

We visited all of them regularly, and had no complaints about the care in any of the homes. Maybe we have been lucky, but I do think rotten homes are very much the exception.

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and the (inadequate) level of council funding. Which is precisely my point.

There is no easy answer.......so where should the money come from? I am sure are they are discussing this problem which will only get worse in the future.....whatever decision/s they come to it will have to be fair for all.......then keep your fingers and toes crossed that you or yours will not have to face that dilemma. ;)

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