This is a looong posting, but all this is horribly familar reading and there's so much that's needs saying. The care home I have worked at is mainly for elderly people who are terminally ill and/or with dementia. I've done residential care work before, in learning disabilities, and, sorry to say it, but I'm amazed just what a backward time-warp elderly care is by comparison. The field of learning disabilites is streets ahead in terms of Person-Centred Planning and advocacy. I'm also amazed just how ineffectual the Care Quality Commission is in dealing with care homes that are basically sub-standard, abusive environments. 'The Independant' newspaper's Johan Hari wrote some great articles on this subject some months ago, concluding that the CQC is a 'toothless paper tiger'. He's dead right. It won't get better either, as the inspection bodies are being merged into even bigger, clumsier, cheaper to run organisations. I have met some wonderful CQC officers, but their hands are tied by higher forces in government.
Yes, the CQC does shut some homes down, but not until things have gone DISASTEROUSLY wrong. The problem is that is that the biggest private care companies have such a monopoly on 'the market' that they have made themselves almost indespensable, and David Cameron's new 'light touch' regulation is designed to protect the care company fatcats even more. For all the lip-service they're trying to throw at us, the bitter truth is that they don't really want elderly care to have intelligent, well-trained, well-qualified staff because that would just COST MORE! And who wants to invest in a dying population? I am sad but certain that this is the paradigm of thinking in the corridors of power and anyone who tries to change it, from the inside or outside, will be given a very rough time! I know many dedicated care workers and managers who have tried so hard to make things progress, and these are the ones who have always been singled out for bullying by the system, and sometimes their careers put on the bonfire. The whole system really does stink!
The main problems:
Schoolies:
Too many care assistants are kids barely out of school. I've seen some of them browsing Facebook on their mobiles while residents are dangling in hoists! WHY THE HELL DO THEY EMPLOY THESE PEOPLE? Ah yes....because they're cheap and easily expendable!
The Old Guard:
On the other age extreme, you always get the 'old guard' care staff who are defensive, bitchy control freaks who despise change. It's always the long established care homes in provincial small towns that have these mindless, grumbling drones. They do every aspect of their job with robotic stoicism...everything that is, except actually talk and interact with the residents. ( That's not 'real work' you see! ) Do things differently to them ( i.e, do your job the way it's supposed to be done in the 21st century, with compassion, kindness and positive mind-set ) and they'll gang up on you like a flock of rancid old pigeons! Never mind institutionalisation of residents...these staff are also institutionalised into crappy old care practices, programmed to be carried out without question.
Language:
Whose bright idea was it to employ recently arrived foreign care staff with rudimentary grasp of the English language to help people with severe communication/cognition problems?
Pay:
Care work bears insulting pay levels leading to high staff turnover and demoralisation. "Who cares?" they say at 'care' home head office. "There's plenty more where they came from!"
Nurses:
Nurses are often put in charge of elderly care homes, but, as lovely, valuable, and hard working as many of them are, what's this sacred cow about Nurses? Dispensing/monitoring medication and dressing bed sores are of course important, but why does this give them this special authority? It's just another vestige of Victorian institutionalism. Care homes should be run by multi-discipliniary care teams from a variety of backgrounds. Clinical uniforms should be dispensed with....they create an 'us and them' barrier between residents and staff. Just plain black trousers and white T shirts would be fine, and just as hygienic. This whole Nurses in charge thing is based on the notion that all old people need to have a clinical cacoon built around them. If you want to make someone even sicker, more institutionalised and feeling even lower than they were before they entered the home, this is the best way to do it! Yipee!
Lack of social interaction for residents:
Why is this? Time for social interaction needs higher staffing levels, and that means MORE MONEY! Obvious really.
Tatty environments:
Fresh paint that isn't 'Nicotine Sunset' colour? New carpets that are not intricate floral designs that confuse the hell out of dementia sufferers? Nice clean window blinds instead of yellowing lace curtains? Unthinkable! For yea, it hath been carved unto the rock of elderly care home decor rules, that all elderly care homes must be created like this, for it is right and good. And it also saves a bomb on redecorating costs.
Shared rooms:
Yes...they STILL have SHARED ROOMS in many care homes. No privacy. No dignity. Can you imagine having to listen to another demented person's chunterings and bodily noises all night? The last government was to rule this practice out, but it's failed along the wayside. This latest government will certainly not bother to change this disgusting practice as no rich Tory MP has to face this prospect.
Conclusion:
If this was the exception rather than the norm, I wouldn't be writing this. On a more positive note, there are new care companies springing up who may be changing things to some extent, but it will need US, those working in care, and the CUSTOMERS ( in these days of market forces ) to demand the best for our loved ones in care. If you're a relative, don't do this by neurotically assuaging your guilt in picking on staff at the bottom of the food chain...eg, moaning about the socks left under Ethel's bed. This will alter nothing. If you feel the care home is cutting costs at every opportunity, confront the owners personally and investigate the big picture. Ask questions before you use their services, like staffing levels and ratios of carers to residents. Look at the outings activities on offer and see if they are actually used and attended. If answers are vague, make them be more specific. If that fails, seek out another care company with a clear mission statement and PROOF that that they are carrying it out on a day to day basis.