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?