To be shocked at what I found at mums care home today?

[Downnotout]

Mum has Alzheimers. Her DP died suddenly a couple of months ago and me and DSIS had to put mum into full time care.

We looked around a number of places close to us- mum lived 200 miles away and thought we had found the right place.

Mum has, for the last couple of years, had to be "coerced" to get out of bed. There is no physical reason to stay in bed but I think she feels safe there. She also has history of refusing to eat. This has continued, on and off, at the care home. They normally manage to get her up at some point. My sis or myself go most days and she always gets up when we arrive. I take her out for the day and she always eats her meals then.

Now usually, one of the carers will come and find me if they have concerns about mum not eating, because she will eat for me. She has been much better for the last couple of weeks, getting up and going to the dining room for her meals. Today when I arrived at 3pm mum was still in bed. It was clear she had not got up at all. Her breakfast, a slice of toast, was still at the side of her bed untouched. Along with a stone cold cup of tea. I know if anyone had been in to offer lunch or a fresh cup of tea the toast would have gone and there would have been some covered sandwiches if she hadn't got up for lunch.

I went into her bathroom. Oh God there was poo splattered everywhere. All over the seat, the floor, I tried and couldn't flush away what was in the bowl, so much stuff it had blocked! Her dirty underwear was in the sink with a dirty flannel that she had used to try and clean herself with. In the bedroom were her trousers from yesterday, also covered in dried poo.

I got mum up and dressed and sat her in the day room and went to find a carer. She, the carer, had just come on duty, she couldn't tell me if mum had eaten anything, I told her about mums accident and she got it all cleaned up. Then she found there were no sheets on mums bed. She apologised. DD then needed the loo and went into mums bathroom. When she flushed everything came back up. I can only think that mum had had dreadful diahorrea.

But it was clearly yesterday. And no one noticed. Anything. Til I reported it at 3.30 today. Tell me that's not right.

Thank you all. Yes mum is self funding so it would be easy to move her.

I think they might have been short staffed as when I arrived there was no one about, and I went looking.

It was Tuesday when neither of us visited and Wednesday afternoon when I discovered all this. As her trousers were filthy with dried poo I could only assume they were Tuesdays clothes- she must have been up and dressed on Tuesday because I could tell she'd had her hair done.

There is a call button in mums room so she can call for help, but she doesn't because she doesn't remember it's there.

That is absolutely appalling, Down, I think you perhaps should have called the duty manager then and there and showed her the bathroom, and the tray which had been left there since breakfast, and the state your DM was in.

They should certainly be monitoring her fluid and food intake several times a day as well as checking on her regularly, (my mum is checked more than once every hour in her nursing home) as well as seeing to her toileting needs. This is a most serious failing, if she had diarrhoea and was not given any fluids at all she could have been extremely dehydrated -- incredibly serious for elderly patients.

I think you need to get chapter and verse from the home on exactly what went wrong that day, in great detail, and how they propose to ensure it never happens again. For them to say 'Staff shortages' is just not good enough. And yes, get onto CQC asap. If you don't get any decent answers ring the newsdesk of the local paper and say you've got a story for them.

Bloody hell

The dehydration aspect is what would concern me most, sounds like it could have been 24 hours she went without a drink.

Something has gone badly wrong there and I would be giving the manager a very hard time.

I think the mistake I have made is that the home is not a specialist dementia home, although dementia is listed as one of the conditions it covers. It is also not a nursing home- mum doesn't require nursing yet.

The issue was that mum can be quite lucid, does not wander, is very gentle and we wanted her to be able to just go out into the garden if she wanted. It also promised activities and has people living there who are just elderly, so we thought that she would have some social stimulation.

But that has not happened. The residents who are able just seem to go about their business and sit around chatting or watching tv etc and then there are the ones who are bed bound and never come out of their rooms. Mum isn't in either catergory as she is mobile and able but needs prompting to do anything. Ie she may have a jug of juice in her room but she wouldn't think to pour herself a drink. If I leave the room and come back in she thinks I've just arrived.

If you ask if she wants a cup of tea she says "I don't know." so unless you physically give her a drink, she wouldn't get one IYSWIM.

I think I might have to find somewhere that is a specialist dementia care place, but that means her being somewhere where the residents may be much worse than mum and she would not have the same freedom to go outside when she pleased. And of course, she wouldn't ask, because she can't hold the thought long enough.

My DM is very similar, Down, if I'm visiting her in the lounge and go and get something from her room, when I come back she thinks I've just arrived too.

IME, dementia patients do need lots of help in joining in general activities, preferably with the help of a trained dementia activities co-ordinator. It doesn't really sound like it's the right place for her -- any care home that accepts dementia residents really ought to have a staff member like that in place.

My mother is in a nursing home because of her complex needs, it has a 'dementia' wing which is separate from the other residents but they do mix in the main lounge for sing-songs, talks etc. Just off the 'dementia' lounge there is a small, safe outside area that they can or be taken into, as well as a large courtyard garden in the main bit of the building where people can sit if it's fine. But even at that home there is often not much going on. I hope you find something suitable for her.

Thanks tartyfletteThere is a brand new dementia specialist home nearby. The facilities were amazing BUT it was almost empty and we just felt it was too quiet. There was a resident just sat alone crying and I couldn't get that out of my head. I felt it would have distressed mum but maybe I'll go and have another look.

So sorry to hear about this, Downnotout. I hope this never happens again - or if it turns out she'd be better off somewhere else, you find somewhere right for her. It must have been such an awful shock to find her room in such a state, and as others have said, the potential for dehydration is especially worrying. I agree that in the short term, raising hell with the manager is the best way to proceed.

The dementia specialist facility might be busier now?

The state that you found your mother in was unacceptable. If you get past about 10am today without a totally horrified manager contacting you with profuse apologies and explanations then I would take that as an indication of how bothered they are about this.

The way that you found her does seem to indicate failings in the system in that home rather than one member of staff.

I would definitely make a complaint about this - people with dementia are in a vulnerable situation, and at least if people have a fairly low threshold for making complaints then it gives the regulator a chance to put them all together.

:( move her out and lodge an official complaint. This is not on.

That's shocking OP. I really hope you sort something out for your mum

If you move her would you be prepared to name and shame? While we keep quiet about these awful situations and places they will never change.

Echo what people have said but u old also document the events and write to the care hone copying in the CQC. Your mum is vulnerable and clearly needs to be somewhere that they are bake to give her a better quality of life . What does your DSis think?

Sounds like your Mum is very lucky to have you watching out for her interests. You seem to be doing a great job and should be proud of yourself. I agree with mellen that if no one contacts you to discuss it, that may suggest they're not taking it very seriously

Could you go in today, speak to the manager and have a written list of specific concerns you want to discuss. Does she have a care plan with a daily record of who has checked her? Could you see that? If the records state that she was checked 20 mins before you arrived, that might suggest they're just box ticking and not actually following through.

You could ask the manager if he / she has spoken to staff who were on duty caring for her yesterday, & if so, what are those members of staff saying about it? If manager tells you they've started an investigation / disciplinary route, that might give you some reassurance that they're taking it seriously

A little postscript to reassure. We had a terrible time with my mother... too many dramas to post! In short her care was terrible. It took us ages to find a good place for her (she moved from residential to nursing), and we landed up having to move her to a new area. FYI she is not self funded.
Anyway after all the heartache it has been the best thing we could have done for her. Although she is very, very poorly, her carers do the best for her, treat her with love and respect. They home ensure, despite her illness, she has the best life she can.

Ah I see you found it. Hope the situation improves.
As they say it's the 'squeaky wheel that gets the oil'
So don't be afraid to shout up.

Poor you and your mum, that's shocking. I've worked extensively with care homes and that's very poor care. Also dangerous as having torrential diarrhoea could potentially have caused her to faint and then when would she have been discovered? Speak to the manager and also to CQC, as others have suggested. It sounds as though your mum might be happier in another home, there are some fabulous dementia units out there. You sound like a lovely daughter, by the way. Hope she's okay now.

I work in a care home (nursing) and it doesn't sound as though the staff are skilled enough to provide dementia care. It doesn't seem that they're able to provide the levels of supervision and care that your mum requires.

Do they weigh your mum regularly - it should be done at least once a month? There should be a record of her weight and BMI - if there is a recent history of sustained weight loss, then they should have addressed this by providing nutritionally enhanced food (this can be prepared in house), or have contacted the dietician to arrange an assessment and for high nutrition products to be prescribed for her. She would also benefit from a visit by her GP to assess for any signs of dehydration and for a general checkup. Physical neglect can be hidden, but will be revealed on closer examination and by a few careful checks - is her skin sore, does she suffer from frequent infections, is her mouth dry and dirty, are her eyes clean? etc.

She would possibly benefit from a move into a home that provides nursing care and is a specialist dementia facility.

Also, don't rely on CQC to sort things out. If you think neglect is an issue, then contact your local Safeguarding team - you will find their contact details by entering the term - Safeguarding Adults Team and then your local area, or contact your local council or Social Services department and they will point you in the right direction. CQC only really deal with home inspections, whereas Safeguarding deal with individuals and neglect/abuse issues.

I have some experience of homes and 'carers'.

Sadly I would say that each 'carer' has pretended not to notice and left the mess for the next person.
In fact I would put money on it. :(

I've just spoken to the Alzheimer's Society to ask for advice.

They were horrified, said its neglect, and that they have a duty to report it to social services. I am going in to meet with them today to discuss everything.

That sounds really good, down; it should move things forward and ensure it is investigated thoroughly. Good luck in getting it sorted out and your DM moved to a better home.

Be thankful that you go and see your mum worst days, I'm sure there will be other residents who have been left in even more appalling conditions

Absolutely disgusting. Definitely complain, also consider moving her. I've also worked in a care home before, things like this are not usual and definitely not acceptable.

Your mum is very fortunate to have you and your sister to act as her advocates and to notice when things are not right. It is incredibly sad and just wrong that so many people in this country (and others, no doubt) are not so lucky. Your mum will be fine because there are people who care, and who are interested, and who visit and check up. All the best with getting this situation investigated and making sure your mum is safe and comfortable.

I worked in a care home where this happened regularly. There were four carers looking after 30 patients with dementia, half of those who had to use wheelchairs and couldn't get around by themselves. It was massive stress. We were actually upset when someone chose to stay in bed because it meant limiting ourselves even further because we'd have to do regular checks to their rooms. We'd aim to do this half hourly, but in between tea trollys, taking people to the toilet, medication, people getting undressed in the lounge and having to be redressed etc etc it usually was an hour or so. In that time we'd often find them in a bit of a mess. It's so so sad and I'm actually nearly crying writing this but it wasn't our fault, it was lack of staff and lack of training of the staff that worked there.