Friday 27 April 2012

BBC Panorama Programme - How To Read An Inspection Report

My next posting was going to discuss the differences between a large care home and a small care home but having watched the BBC Panorama programme showing secretly filmed footage of abuse in a care home I feel I need to talk about this instead.

If you haven't seen this documentary it is currently available at BBC Panorama Programme

The daughter of the woman being filmed said that she picked the care home because the Care Quality Commission gave it an excellent rating.  If this is true, then just how trustworthy are these inspection reports?  How can you be certain that the care home offers quality care if your relative can no longer communicate with you or their short term memory is badly impaired and they can't remember what happened to them five minutes ago let alone the night before.

Well, the short answer is, you can't.  There will always be a risk of things happening from unscrupulous members of staff unfortunately, but there are things you should be aware of when reading an inspection report.

Paperwork

Nowadays, when a care home inspector visits, it is up to the home to provide evidence that they provide good care.  The inspectors often take the stance that if it isn't written down it didn't happen.
One example of this is care plans.  The inspectors want every single thing to be documented in order for these care plans to be personalised and not generic.  Keeping this paperwork up to date takes an inordinate amount of time and often keeps nurses busy instead of looking after residents.  The reason behind this is so that the staff looking after a resident know all their likes and dislikes, what their normal routine is etc.  This is a good thing, but the carers who look after these residents do not have time to read these increasingly unwieldy documents and learn about how to care for a resident during handover from the previous shift and from speaking to the resident and the relatives themselves.  In essence, good care plans do not necessarily means good care.  You should be aware that a poorly written care plan may indicate that the staff focus on the resident first instead of the paperwork and pleasing a care inspector.  And paperwork can always be faked! When you read an inspection report, bear this in mind.

Views of relatives and residents

When an inspection report quotes the positive or negative feedback they have gained from relatives or residents this can give a good indication of the quality of care.  But these are the voices of individuals expressing their own opinion and everyone has their own likes and dislikes.  Also be aware that if an inspector speaks to a resident that this may be someone with a memory impairment who cannot remember that they didn't like the choices on offer for breakfast or that they've had to sit bored for two hours.
And I have heard of unscrupulous managers who have steered inspectors away from 'difficult residents' who are known to be dissatisfied with the service.

Complaints

The SCSWIS website (see my previous post Click Here) allows you to look at a list of complaints that they have received about a home and whether they were upheld or not.  I cannot see this information on the CQC website but I feel this is very useful.  If the home has been receiving good inspections and yet has had several upheld complaints it may indicate problems.  People who complain to the Inspecting Bodies are normally residents and relatives who see what goes on in the home on a daily basis and not over a one or two day period.  They normally resort to complaining when they feel that the management of the home has not addressed their concerns, or are unapproachable, neither of which are a good thing.  Bear in mind that there are people out there who are never satisfied and who complain for complaining's sake, but if this is so, their complaints should not be upheld.


But the thing from the BBC programme that I think speaks volumes is that the daughter felt concerned, so concerned that she placed a hidden camera in her mothers bedroom.   Her instincts told her  something was wrong.  And so, this is the best piece of advice that I can give you...

...Trust your instincts!


I would love to hear your views on this subject.
Would you consider secretly taping the care home where your relative lives?
What's your story?









Saturday 21 April 2012

Create a List of Possible Care Homes

So
Now you have some idea of what you are looking for in a care home, and what you think they should be able to offer you it's time to search the internet.  To get a really comprehensive list of care homes in your area it is useful to use the websites of those that inspect homes.

In Scotland this is Social Care and Social Work Improvement Scotland (SCSWIS) and can be found at http://www.scswis.com/

In England and Wales it is the Care Quality Commission (CQC) found at http://www.cqc.org.uk/

A useful website in the USA is http://www.medicare.gov/
although I will admit that there may be others as my area of expertise is UK based.

Each of these websites allow you search for a care home within a specified area and will give you a list of potential homes.  They will all tell you how many people are accommodated at that care home and allow access to recent inspection reports.  Don't concentrate on these or any gradings too much initially. Just write a list of homes within the area you choose to live.  I'll help you to sift through these in future postings.  If you are computer savvy you might like to start a spreadsheet to help you contrast and compare these homes.  It doesn't need to be anything fancy.  Just write the names of the care homes you find in a list down the left hand column. See my example below.



Next Time : Does Size Matter?

Friday 13 April 2012

First Things First

So, where to begin in this minefield that is choosing a care home.
I think the first thing to do is to think about your lifestyle, what is important to you and what makes your life worthwhile.
If a care home is going to provide you with quality care they will need to give you the freedom to live your life the way you want to live it.
Think about what you do during the day and what you enjoy doing. Do you have lots of visitors? Do you like to watch television. Do you play the piano? Do you like to go shopping? The list is endless!
The important thing to consider when choosing a care home is to remember it is a care HOME and a good one should be able to help you continue to live as if it is your home.
So before you start trawling websites and getting lists of homes in your area, write a list of things you would want a home to be able to provide for you. This will be a good starting point to help differentiate between the multitudes of homes out there.

Thursday 12 April 2012

Welcome to Choose a Care Home Blog

Welcome to the first posting on this new blog.  

I am a nurse and have worked in Care Homes in the UK for over twenty years.  I have worked my way right up to senior management positions.
I have often had to show people around the homes in which I have worked when people are looking for a care home either for themselves or a loved one.  This has made me appreciate what a difficult decision this can be and often people are unsure what to look for, what questions to ask and how to tell if the Care Home provides good care.
This is why I have decided to start this blog - to help people who are having to make this difficult decision.

I am currently employed full time and so am unsure how much spare time I can commit to this blog but I will endeavour to post at least weekly on a Thursday as I generally have this day off.
I hope that this blog will prove to be invaluable and look forward to hearing from others experiences.