Frustrated at how people in care homes are denied basic freedoms

[Nananananana]

Work in various homes as agency staff. A lady has just asked me if I can get her up at 10am instead of 8:15.. reported this back to the permanent staff and they said, no, she has to get up now. Tell her she needs to get up now.
Why?
Or they have to be put to bed at 7am.
I understand that some have morning medication etc. But this can be given whilst they're in bed still if needed, just woken up for it/something to eat then back to sleep if they want.
I've seen this across different homes, it probably happens in many.
Feels like they're in a prison sometimes, why should they be denied basic freedoms?
They pay thousands to live here.

NellesVilla Until I saw for myself, I'd have considered it the height of rudeness to not call an agency if a carer wasn't going to be needed.

But here, you wouldn't get paid if the call was cancelled, and would be unlikely to be given another call instead. But, if you'd turned up, then you'd get paid as if you'd been able to provide a service.

Cancellation was a disaster for carers on zero hours contracts.

It leads to a lot of difficult situations especially when outpatient patient transport services are also involved.

Carer often couldn't get there in time to do the job, but if they'd turned up, they got paid, cancelled they got nothing but a forced unpaid break.

@BellePeppa and @Greenqueen40 yes you are correct of course and context is everything.
My mum has dementia and forgets she has carers so is not there occasionally (plus they don't come at the same time - appears to be between 6-8 pm).
The carer was following procedure by calling me and was panicking a bit, suggesting calling the police.
My mum as I say has dementia but is not at the wander around in her nightie stage.
My comment around my mum being free to go out was to talk her down somewhat.
I can't cancel the carer in advance as I don't know my mum's schedule and I haven't been given a number to call to get hold of carers proactively, despite having asked several times. This is council care paid for by my mum that's been decided for her and around which she has no choice.
@Itsallok I'm not sure how you came to that opinion about how I would scream blue murder at people. I'm always polite and conscious that it's an extremely delicate line we are treading. I will concede that my writing style is somewhat dry however.

Thanks for posting. I had no idea.

So out of interest, after they are woken, got ready for the day, etc. would they be allowed to go back to bed for a rest with their clothes on if that's what they wanted?

@scoopoftheday I understand. I know why people put their relatives/parents in homes. I was trying to stress the point of how it looks from the carers POV. Just above in this thread a poster told a carer that her mother isn't a prisoner when the carer arrived at 7:30 and she wasn't home. Things like that really grate as oftentimes they're paying their own travel, may not get paid. It's really difficult. As I said it's a terrible industry to work in.

If you cared that much then take your mum home with you.

Sorry but this comment from an ex caters is grossly unfair.
Some residents need to be in a care home and cannot get the required level of support at home. This isn't because their family doesn't care about them. It's because they simply don't have the money to provide it and for some the time - if you've got your own full time job, a family of your own with dependent children and your own household to run. They likely don't have a spare room to bring mum into their home or the money to upsize.

And it's almost like saying that those residents who genuinely don't have a caring family deserve the indignity and loss of autonomy took

For the amount these residents pay they should be given at least the simply dignity of choosing when they go to bed!

I have worked in health and social care for over 20 years, including a stint as a registered manager of a care home.

If a person says they want a lie in, they get one. End of.

People are not cattle to be herded into dining rooms for breakfast. Choosing some of these basic things are for some people the only bit of control they have over their day to day lives.

Often, carers would come to me apologetically to tell me x,y and z were still in bed at dinner time-by choice. I used to tell them "good". I did not want my care staff dragging people out of bed to meet some mythical regime that all people must be washed and dressed by x time. The whole point is you support people to live the lives they want to lead. Not dictate it to them.

When inspected by CQC, I was asked "what time is lunch" and they were told, truthfully-it depends on the residents and where they are up to in their day-it is flexible to them. I can give an approximate time slot of a couple of hours, but just like I don't eat my lunch at the same time every day, neither do the residents unless they choose to.

It can be hard to change the mindset of staff who have always been pressured to get people up in the morning, but when staff are empowered and supported to do the right thing by people, they usually want to. There is nothing worse than walking in to a care home at 6am to find a number of elderly, frail people fully dressed and fast asleep in lounge chairs.

OP, it sounds like the culture at the home is focused on what is convenient for staff and the home not the people who live there, and as pointed out, this can be institutional abuse.

And there's a reason why carers mostly hail from a particular demographic. It's an utterly thankless job.

Unfortunately there aren't enough hours in the day or enough staff for everyone to be able to get up and go to bed exactly when they'd like to

Not only do you need to get everyone up in time for breakfast but you have other people who are on bed rest who need getting ready/turning and changing if needed every 2 hours/help with feeding . you then have people who are already up ringing for help to use the bathroom and people who need help moving to and from the dining room

There's less night staff on so the majority of people are put to bed by day staff . The night staff then have to help anyone who's still up go to bed while checking everyone else every 2 hours and toileting anyone who needs it etc

It's pretty shit trying to keep on top of everything

Ideally she would have let the carer know so as not to waste her time?

Then the issue is how staffing is arranged. If enough staff are deployed at the right times to meet people's needs, this should not be an issue.

This isn't your fault and is unfortunately a common fault in the care sector. But it can, and should, be reviewed so people are cared for in a person centred way.

When DF was in a nursing home - 48 residents on 2 floors they just arranged the care plan around early risers and those who wanted a lie in
same with putting to bed
it still had to be done within a set time slot of around 3 hours to allow for meals and drugs rounds
also putting to bed doesn’t mean forced sleep! DF would watch tv, listen to radio or music
most of the staff were lovely and if they had extra time and he was bored would put a film on (we bought him a small portable DVD player with own screen) or would loan him an iPad (the home had quite a few) and put something on YouTube for him - he used to like the cat and dog reels

Absolutely. Also residents get checked throughout the night they have staff who are paid to work nights.

There is easy access to a doctor etc, no trying to get appointments and getting there.

Also residents get to take part in activities in the daytime. Lots of organised stuff goes on.

Sounds like a shit care home tbh. The one my grandmother is in would never do this.

My grandparent wanted to do this when she went into a home, she wanted to just sleep all day. They didn’t let her and it’s done her the world of good to be honest, she’s more energetic, getting involved in all the activities. All the sleep she was getting before did her no good at all.

If your mum required a carer then of course you were rung if she wasn't there. Your mum should have advised she wasn't going to be there, it's so incredibly selfish not to. It's a wasted trip for the carer, who more than likely has other jobs to go to.
It's not hard to ring a care agency to advise you don't need a carer one day because you'll be out.

How did that work logistically though? Did some have cold food all of the time? Did you manage to have a chef all day? Was it in their best interests health wise to stay in bed every day- Did they have capacity to make informed decisions about whether a lie in was worth muscle wastage etc? I see what you're saying but most care homes don't have those resources sadly (although they should), and I'm sure families wouldn't be overjoyed to know their health had been severely impacted by something avoidable. Just genuinely curious really.

We did have a chef and kitchen assistant all day, yes. This is pretty standard in most homes I have worked at. You get to know the people that live there and their own normal routine, so fairly simple really to manage really. There was a menu on place, with hot and cold options. Additionally, people would ask for things "off menu"-this was cooked to order (within reason, of course-if someone decided they wanted a ribeye steak, we would have to order it in advance!)

People didn't stay in bed every day, that isn't what I was saying at all-but just as you or I could choose to stay in bed later, so could people at the care home. People do not get muscle wastage from an occasional lie in. People who have a lie in might stay up later in any case, so their "up and about" time would be the same, just adjusted to their preferred waking hours.

Re: Best Interests, Best interests only come into play if someone lacks the capacity to make the decision themselves. There is always a presumption of capacity unless there is a compelling reason to question it. People are allowed to make unwise decisions.

All care homes should have dependency assessments indicating how many hours a person needs support. These hours are added up for everyone and then inform staffing levels. How you arrange those hours should reflect the needs of the service.

For example, I introduced a twilight shift, a rolling rota and some short shifts which incidentally helped with training as staff could do a "normal" shift length, with some off the floor time to learn. It worked very well.

My nan lives over 100 miles from us so I've only recently seen her since covid hit as a combination of covid rules (she's in Wales)and my illness.
She was in hospital for a while before finally being placed in a "care" home when a place became available. In hospital she was allowed to sit in a chair and whilst not being particularly mobile, was able to feed herself etc.

In the home they apparently don't have the equipment to get her out of bed despite her asking. She was there for a couple of weeks before getting a bed sore meaning she can't go on her back.
She is supposed to be turned every couple of hours, which according to the paperwork is happening, but, someone wrote 3 times in the date column then scribbled them out, there are dots where someone has counted where they need to put their time counting through the rows that have been missed.
There are discrepancies in the paperwork, one set says she was asleep so not offered a drink, another says she was turned over.
They claim to always be on the hour.

When dh and I were allowed to visit for our half hour slot, we arrived 10 minutes early. The paperwork for for that hour had already been completed saying she had been turned. She had also had breakfast and lunch although it wasn't yet midday.
Nan drank a cup and a half of squash while we were there.
We had to call for help at one point as Nan was complaining of pain, the staff member basically told her to suck it up. The buzzer was hooked back on the wall out of reach.

We were then told our time was up and asked to leave.
Dh asked to see the nurse to discuss pain relief and was told that Nan had received it at a time we were in the room. I had leave or I'd have lost it.

We left the bed in such a way that when they moved Nan the bedspread would change. My relative went in a few hours later and nothing had been altered although they turned her pretty quickly when this was pointed out to them.

We are expected to trust these people with our loved ones, yet during every method of communication with us they lied, yet according to my relative there has been a huge improvement since they started getting other professionals involved.

There were other small things, a tv channel showing police chases/arrears etc, despite her facing away from it and lightly sleeping a lot. We put classic fm on for her as she used to like that, keys hung on a hook above the door which makes me think they lock people in. We didn't see any other residents while we were there, only staff who were sitting in the dining room looking very relaxed, having a nice chat.

At some point the manager and I will be meeting to discuss this, I just have to calm down so I don't end up being arrested!

This is apparently a good home, run by bupa. I hate to think of what a poorly run home looks like.

Sorry, I wrote an essay.
To sum it up yanbu

@Butitsnotfunnyisititsserious yes she is very selfish and self absorbed.
The council has decided she needs this care, she disagrees. So what's next?

I was horrified when I was a student nurse, on placement in a care home. When a 95 year old lady with all her faculties was made to get up early. She really wanted a lie in. Fortunately my friends care home lets him do what he likes.