Would you expect a care home to stay with care user when going to urgent care/ a&e

Its one of thd things I hated most about working in a care home. We were staffed to the lowest legal limit, which means no spare staff to do anything. I got in one morning to find a resident had a fall just before we got there. The ambulance crew were there. I said I was happy to have her ln my list to get ready to make sure she knew what was happening. I was told we didn't need to do that as the ambulance crew would sort her. I went anyway. The paramedics were so pleased to have extra help, they said it never happened in that home usually. It just meant they weren't rooting around looking for hearing aids/clean knickers etc as I knew what she needed and where it was.

Id previously worked in a mental health setting and we'd always send a support worker with the patients. Even if it meant paying extra staff for multiple days and nights.

The problem is that staff shortages in the care sector are so great that there often genuinely won't be anyone available to take on an ad hoc, open ended shift. Sometimes there will be, but if none of the bank staff are up for it and an agency isn't forthcoming, a carer can't be magicked up out of thin air.

I think the problem is staffing levels, the home can’t spare a carer. So they’d have to get in bank staff or ask someone to come in and do an extra shift.

I would consider contacting care agencies thst do home care/ bank staff and ask. Trickier for emergencies but I’m sure they could cope with routine appointments.

BTW the county council block funding for an ordinary residential bed in my county last year was actually £650 per week and even nursing was under £1000. Is anyone surprised that care is crap if that is what is being paid. It is no secret that places survive by cross subsidy from higher private fees. If you have no ability to attract private residents or live in a poor area where people don’t have expensive houses to sell to pay fees you are buggered.

No. I don't think the care home always has the staff to deal with this. But something should be in place should this situation arise. But it's usual to call a relative.

Well yes that will be the difference. She has 24-7 funded 1:1 so of course they should be where she is

In the case of someone who just has funding to share care with many others then those other people will be left uncared for if staff accompanied one resident to hospital.

For planned appts bank staff might be booked for unplanned emergencies it’s much more difficult and expensive to do that. From the care home POV the duty of care passes to the NHS when they get to hospital. The very long waits in A&E in limbo with no one responsible are where it breaks down. A care home might have been willing to spare staff for an hour or two but not for an entire shift when it won’t be a rare event. You might as well argue that perhaps A&E need to pay some care assistants to tend to people in waiting areas.

People think that care homes can afford it because fees seem expensive but when you think it is including accommodation, all bills and food as well as staff pay it actually isn’t. Compare it to a cheap hotel without any care and you will see what I mean. Council funded residents barely cover the costs there is no money to have extra floating staff for hospital visits.

I don’t own a care home but I know someone who does and I see the other side of it in my NHS job. It’s not easy at all to run a good care home with social care rates as they are and wages and NI going up and now bans on foreign workers. The whole system may well fall over

I was a senior manager. I know exactly how it works and how it works in the best run establishments. It isn't the fault of staff, managers and owners need to make proper provision. It certainly can be done on £1500 a week.

I feel like people are being unfair to care staff here.

IME, care homes have the exact number of staff needed to run the shift. By this I mean they have the exact number of staff needed to complete normal, rota'd duties.

When you add phoning 111/999, waiting with a resident for an ambulance to turn up, phoning relatives who never answer the phone the first time, packing bags, and reassuring a frightened, confused resident, you add a massive amount of pressure to the staff, who still have at least 12 other residents who need medication, food, personal care, etc. to look after.

And yes, care is expensive, but you need to remember you are not just paying the carer's wage, you're paying for the admin staff, training, IT infrastructure, holiday pay, sick pay, building maintenance and rent, heating and fuel costs. insurance etc. £1500 a week is a bargain for what you get. Can you imagine finding a hotel, all inclusive, with a 24/7 maid/butler service who will literally wipe your arse for you, for £1500 a week?

If people want better care, they need to be prepared to pay properly for it, but as we see so many times, on so many threads, they're just not.

You have to pay a carer from an agency to go with her

When my dsd goes to hospital (alas regularly) her carers take her and stay with her the entire time though she is funded 24/7 1:1 care so this may be the difference. Thankfully she’s not needed to be admitted though can be there 12-18 hours per episode. Years ago my dh or his ex would have taken her but now she’s not at home this works well - the carers text us to keep us in the loop but nothing we can can do nor the doctors really alas

My mother was sent to hospital from her care home without her hearing aids, phone charger, glasses, handbag. My brother was in California at the time and I was at home in London 70 miles away with covid. I had to ask a very kind and understanding neighbour to go to the care home and collect these essentials and deliver them to the hospital. You'd think they'd have some sort if check list?

Yes they can. It is up to them when charging £1500 a week to make provisions for these events which aren't rare. I've seen it done and it can be done.

My local hospital expect residents without capacity to be accompanied. The hospital does their bit, they have a special nurse on duty who can help and advice in a&e or on a ward.

We do have integrated health and social care so maybe that makes a difference.

Yes. A dementia patient can't go alone or even in a hospital transport. Family might choose to go but in the two care organisations I've worked in they would definitely accompany. If staffing ratios don't cover it then the manager would go or make up the numbers so someone else to go.

When my late mum fell and broke her hip in the care home no one even went in the ambulance to A&e.

I have a parent in a care home for the past 8 years with Alzheimers.

At the beginning when we'd take her for appointments the hospital staff would ask her to confirm her name, address, DOB etc

One time she was going for an MRI and my sister and I were with her (Her mobility was bad and it took both of us to work with her) we explained to the machine operator that mum had Alzheimers and wasn't really capable to being left alone, even in the room. My sister asked if one of us could even stand at the door and reassure mum with our voices. We were told no.

It still stays with me hearing them ask before they slid her into the machine what her name, address was... despite us having told them, but that was nothing compared to her crying her eyes out and shouting for her mum. 😞

I lodged a complaint after that with the hospital, the health minister asking for further dementia training etc and the hospital sent me back a long response weeks later saying they had plans in place for every member of staff to have dementia training.

But yes, any time there's an emergency either my sister or I are called and we go to meet the ambulance at hospital. During covid the care home was locked down and mum fell and needed hospital - it was the only time we saw her face to face in 8 months.

Im so sorry to everyone who has had similar experiences.

I had to do this for my dad. Care home would ring, tell me they'd had to phone an ambulance and then would ring back to confirm he was on his way to hospital.
I'd cancel my (NHS) clinics - sorry patients - and join him in A&E. He had v little language, little understanding, on a good day he could consent to a cup of tea .

I did a 4pm-4pm shift and then 2w later I did a 30hr 10am-4pm but that time DH came in for half an hour before school to let me go and get breakfast.
I ensured dad drank, got appropriate medication which the care home had sent in (because it took 35hrs to be admitted to a ward where they took responsibility for feeding and medicating him. Ensured he got food (he couldn't ask for it, or feedhimself), Discovered that it took 2 mins between him having a drink and needing a wee. (I gave him a drink, figured it would take 15 mins at least to go though, nipped out for a wee myself and came back to finish him wandering around A&E in an un tied gown, chuntering at people and v distressed because he needed the toilet and nobody understood and then having a wee on the floor by the nurses station.).
There was no care. There were too few staff and they were too stretched. 8 years ago they would have found an HCA and provided him with a 1:1. But not now.

Its not even just finances, there quite often won't be a staff member available. We struggle to staff care homes just for the normal shifts.

No care staff have ratios/ staff needs this is t part of their role tbh your lucky they accompanied her. My grandad was sent in a ambulance and we had to meet at hospital, but had we not been available hospital would be responsible for him. If no one came social care would get involved.

That’s not remotely the same thing.

It's so frequent for care homes to have to send a resident to hospital that they can't possibly staff it. They might have 3-4 residents going to different medical facilities on any given morning or afternoon. If staff are out and there's another medical emergency then there's no one to sort it. Your aunt was safe in hospital so was no longer a priority.

I hope things get easier soon.

I can’t believe they went with her / that doesn’t happen in my experience

sadly but true

I’m a nurse and in my experience the only time this happens is if someone is funded for 1:1 care for disability, mental health, elderly challenging behaviour. If where they come from they have a 1:1 carer, then they often stay the full time with the patient. Caters that are responsible for the care of multiple patients in a setting then it would be a no as they are factored into staffing of multiple patients in their setting

I've always gone with DM to a&e as she was a frequent flier due to epilepsy following a bad stroke. Care homes may only have a couple of staff on overnight on each floor and so they can't be spared to go to a&e. I'd also prefer to be there to advocate for DM as I know her medical history in detail.

Does your aunt know how to request patient transport so she could get home that way?

Oh this is terrifying. Another thing for me to worry about as an old person who will have zero relatives!