Care home concerns

[catgirl1976]

DF is in a care home. He has dementia.

I am not hugely happy with the hole generally. They don’t seem to do any activities or enrichment just leave them sat in chairs all day. His clothes are often filthy and he smells. I visit at least once a week as do DB and DSis but it’s getting harder to take him out as his
mobility is getting worse and his dementia is progressing.

Last night about 8pm DB got a call from our local hospital saying DF had a fall and had been admitted to A and E. He’s ok but it now transpires he had the fall about 12 hours earlier and was taken to hospital by ambulance yesterday morning. The home did not contact any of us. DF had been left in A and E alone and confused for 12 hours by this point. Had we known we could have gone up and been with him, made sure he ate etc. he is diabetic and would not be well enough to advocate for his own needs. He’s also under DOLS. The hospital did not know this and did not know he was diabetic. They only rang my brother because DF was asking for his wife (they’ve been divorced years and have no contact) so they rang to get her details. Had that not happened we would still not know he was in hospital.

We went to see the care home today. The person in charge did not know how he had fallen. It was in observed.

He had a less serious fall about ten days ago. I asked after that first fall what measure had been put in place. She did not know. I asked if a risk assessment had been done or any changes to his care plan. She did not know. She said it might have been but I pointed out even if it had if the person I. Charge at the weekend didn’t know it wasn’t much use.

They insisted they had rung both me and DB. We showed them our call logs from yesterday clearly showing no one had called. We checked the numbers they had on file which were correct.

We’ve got a meeting tomorrow with the actual manager but I am so unhappy and feel this maybe needs formally raising or he needs to move to a better home. He’s council funded so I’ve no idea how this works

AIBU to think this simply isn’t good enough and to consider raising as a safeguarding issue and looking for an alternative home?

No, it's not good enough. Did the care home have a member of staff with him at A&E?

My mum had a fall in her care home and they called me as the ambulance was leaving at 3am. The manager called me as soon as she arrived at 9am. Long story short, my mum died as a direct result of that fall and social services got involved. A good number of changes were made there as a result - social services kept me up to date.

Meet with thr manager and express your concerns. I would follow-up in writing. I would also look for a new home.

I am so sorry, your poor Dad.

I would consider moving him, too. Normally I caution against moving once settled as moves can destabilise and accelerate deterioration. But in your Dad's case I would move to a 'nicer' setting. Make sure you choose a home with nursing and with dementia expertise, to future proof against further moves.

This is terrible. Did no member of staff stay with him in A&E ?

I would move him and I'd report it to the Care Inspectorate.

When I worked in a dementia care home years ago, a staff member would always accompany a resident in an ambulance & stay with them at A&E until either a relative arrived or they were admitted to a ward.

If your dad was left alone and especially without any explanation of his basic health needs that’s just appalling. Poor dad.

Thank you - no, no one stayed with him in an and e he was left completely on his own. He could have wandered off, he had no money so I don’t know if he ate, he would not have known how to get a drink or ask for one.

Im so upset. If they had contacted us one of us would have gone and sat with him and kept him calm and made sure he’d eaten and his conditions were known. It’s awful

I will report to the CQC

YANBU.
I would make a complaint. Also to the hospital. I would also be asking why the hospital didn’t contact family on admission either and I am surprised they didn’t know he had diabetes as it will be on his GP care record which they will be able to access.

A person with dementia in unfamiliar surroundings can be very frightened so the next of kin should be contacted as the care homes cannot always send a member of staff.

Has the cause of the fall been eatablished and that it wasn’t due to low blood sugars?

That's awful he should have been accompanied by care staff I'm guessing they didn't have spare staff.
Home doesn't sound good

I personally think you need to go a bit further and raise safeguarding concern with social services. He is an incredibly vulnerable man whose needs were not met by the people who have a duty of care to him. They didn't tell A&E about the diabetes and DOLS? Poorly managed diabetes could have led to very serious health consequences including death. And like you say what if he wandered off? The fact they didn't contact you, didn't stay with him in A&E and didn't put any measures in after the first fall is enough that they have failed in their duty of care and risking your father's safety. With council funded places I have no idea how easy it is to move people but raising a safeguarding concern might help.

They don’t know why he fell but the hospital have done a scan and bloods which are ok so assuming it’s just his general frailty.

They are discharging him but waiting for transport and said this could be many hours so DB has gone to get him and take him back to the home rather than have him wait in an unfamiliar place

Im just a bit hear broken at the thought of him on his own for so long when I could have gone up. Our hesitant great either. It’s Blackpool. A and E is like a war zone with 30 hour waits and beds all over the place and a lot of alcohol and drugs related admissions so police and security everywhere. It’s a scary place if you DON’T have dementia let alone if you do 😞

@AttachmentFTW thank you. Yes I agree it is a safeguarding concern isn’t it? I’ll contact adult social services tomorrow. They might also be able to advise on any process for moving him

I have often found they are useless. Still may worth reporting however.

I would do what another poster has said and report to social services as a safeguard concern.

i would also complain to PALS re his recent admissions and not being informed, that way it can be put on his notes that family must be contacted on all admissions. You shouldn’t have to do that as they but there seems to be clear need this is the case.

Immediate report to CQC and to the local authority the care home come under. Absolutely disgusting. I am a care coordinator and this would be an Immediate safeguarding.

That's awful and it must be very stressful for you and your family to see this happening to your father. Report to CQC and make it a safeguarding issue.

Is your dad self funded or social services funded - if self then you can go wherever you like as long as it's suitable for your father needs. If social service funded then get them involved - it has to be fit for purpose as they are paying for a service.

The home should have contacted family as soon as the decision was made to send him to hospital. No way should he have been on his own in an and e.

The level of care sounds appalling. He shouldn't be sitting in dirty food stained clothes. There should be some suitable activities laid on

My mum has dementia and is in a nursing home fortunately she's been moved to a better more caring home as her previous one closed down. I had to complain and complain and make safeguarding complaints. it was so stressful but it seemed like the only way to get the home to do their job.

Hope you can get this resolved. I feel so angry on your behalf

Just got the care documents the home gave the ambulance team and it does have his diabetes in so don’t know why th hospital said they were not aware but where it asked if DOLs in is place the home have put NO! 😱

There’s some really helpful advice on this thread i am very grateful to you all

My late DMs care home was supposedly one of the better ones. Her dementia made her swallow reflex poor and she was on a pureed diet. Except they failed to do this, resulting in a serious choking incident and had to be resuscitated. Except they covered it up for 2 weeks.

I found the deputy manager to be strangely hostile toward me. I never figured out why. Our first meeting when she had to take me to a meeting room, she told me to huŕry up. She dashed ahead and I couldnt find where she had gone. I began to worry for the residents. My dm died not long after.

Your poor dad is not receiving basic care. These situations are very difficult. Fwiw my mums care was better in her Council home, but her dementia became too severe to manage.

Your poor dad, this is most definitely not good enough.

My DF is in a dementia care home. He is most definitely a difficult patient, with Lewy body dementia & Parkinson's, where lots of hallucinations and anger issues are the norm, and he often "puts himself on the floor" (this is often witnessed) but each and every time this happens the home have to inform us and call paramedics to check him out.

Even though he is completely fine 90% of the time and is unfortunately often doing it for no reason at all they have to get him checked every single time.

I've had a very similar situation with my father and he had an orbital fracture and bleed on the brain.It took the home 12 hours to contact us, conveniently they waited until their manager started work.
We had a meeting with the SW and manager of the home and insisted our issues

were recorded and should never happen again.All you can do is advocate for them as much as you can.

if it's Blackpool, OP, my mum died at the Glenroyd (this wasn't the home she was in prior to her fall) and I would recommend that one to you (next to the walk in on Devonshire Road) but it is 5 years or so now since she was in there. Do talk to social services - I found them incredibly helpful and supportive when the fall happened. The home not recoginising him as DOLs is unforgiveable and they're lucky something dreadful didn't happen with him walking out of A&E. It's getting harder and harder to be seen at the Vic. I hope you get answers - I certainly found Social Services dug hard into care home routines and pulled out the inadequacies.

Move him asap. After you have moved him, report the original place to the CQC, with detailed reports of what you have seen. If it is difficult to find somewhere else, raise your concerns with his GP, and social worker if he has one, to see if you can get help in doing this. This is totally unacceptable. My 87 year old sister-in-law is in residential care where virtually all the guests have dementia, the place is spotless, and all the guests are clean, fed, and properly medicated. We visited about 15 homes before we found this one, it was by no means the most expensive one we saw. It is a charity, not a for-profit business.Good luck.

That is absolutely appalling in all the ways you have outline. IMO you should make a formal complaint outlining each issue or part of the story, what was wrong (including lies about having phoned family) and insisting on a detailed explanation of what went wrong and how the systems and procedures are going to be put right so similar does not happen again. Copy the complaint to all relevant parties, including owners of care home and your DF's funding body. You might also want to ask for a copy of your DF's care plan and the actual care records for the days in question. I would also add to your complaint the issues about dirty clothes and smell, and ask what the relevant policies are to ensure good standards of hygiene.

100% raise a safeguarding concern with social services. This is absolutely not right and you worry what else goes on behind closed doors. At the very least they will know not to mess with you if you push back. Residential and nursing homes stand or fall on the quality of the leadership so they can degenerate very quickly if there is a change of management.

All the care homes I know about have a list of activities printed off each week and given to the residents.
They also.put their activities on Facebook. They have entertainers in singers, pet therapy,and you can see it all. The activities people also get them doing things l8ke games, puzzles, a few trips out. Christmas parties etc
Did you not ask about that when FIL went in?

A place that dosent have any entertainment going on sounds awful. I would move.

Terrible, you need to put in an official complaint.

They should ring the emergency contact straight after calling the ambulance.
I will be totally honest, I would move him. Filthy clothes and stinking are not acceptable.