Should I raise an adult safeguarding concern? Carers giving dad Weetabix 3 times a day 😫

[Bake]

My dad was in hospital in November. He had delirium while in hospital and hasn't returned to normal since he was discharged. He has carers coming 3 times a day.

Initially they were fantastic, raising concerns with the GP, calling us to say when he wouldn't get up or refused to eat or have medication. In the last week I feel like they've been neglecting him. My sister has brought over meals twice in the last week, I was over at the weekend and none of the meals have been touched. The carers are supposed to be providing him with food and ensuring he takes his medication. They’ve either been feeding him weetabix 3 times a day or not feeding him at all. 😫
My sister called the care company this morning to express concern about him being given weetabix 3 times a day. We have a camera in his living room as we have been concerned about him falling and can see he was given a bowl for dinner yesterday which I assume was weetabix, carer was there for less than 15 minutes, a bowl this morning, a bowl and yogurt for lunch and whatever was given to him on a plate this evening was less than 5 minutes after the carer arrived, so can't have been a ready meal. There is no soup in his flat, only thing that could be in the bowl is Weetabix. The battery had died so we have no footage for most of last week.

My dad can't remember if the carer has been there and can't tell us what he's been fed. It was such a relief to have the carers there as it's impossible for us to be there all the time, but now I'm angry that he's being neglected.

Does anyone have any advice? Should I raise a safeguarding concern with the care company and adult social care team?

Is it reasonable to ask them to take a photo of what he's given for each meal and then a photo of what is left that they end up binning? They empty his bin so it's impossible for us to tell what he's eating. His weight is down to 7 stone and he's literally skin and bone. It feels like they are starving him.

Yes I would raise this. Poor man. No wonder he’s starving on weetabix alone. Would going into a home be an option?

Someone I know has spent a month building a case with camera /cctv evidence and then will be going to the carer's manager.. Less than 4 minutes in his 93 to dm's home.

3 times a day not the 15 mins he is paying them.
Your poor df op.

The carers are bringing only weetabix for all of his meals? Do they at least supply milk, too?

So they’re only offering weetabix or
is that all he wants? Are you covertly recording the carers or do they know you are?

Definitely ring and reiterate you want the meals you've provided in the fridge heated up and served to him. Maybe ask if they need clearer labelling, a food diary filled in by the carers or a schedule on the front of the fridge - presenting it as a problem or a mistake will work best I think.

Then wait and see with the camera what happens so you have evidence and can complain

Loop in his GP or social services to get some shakes prescribed to help him drink more calories and gain back some weight

Otherwise think about a meals on wheels type thing. Have you asked dad what he fancies to eat ? Could he be requesting weetabix himself?
A care home is nicer for this in my experience, a good care home will fatten then up usually as they eat at set times, predictability and fatty foods.

The carers don't supply the food, we do. All the meals we've brought over are untouched in the fridge. In the last 2 days since battery was replaced on the camera the carers are bringing a bowl and cup of tea from the kitchen to his table.

This has broken my heart ☹️ 100% raise this!

No - don’t jump straight to a safeguarding plan.

Start with a sensible conversation with the manager about the care plan. That will go better if you approach it with an open mind, not allegations. Then move it onto the care visit notes, and ask what notes are kept and can you see them, how is info shared between carers. You’re concerned about his eating and want a way that can get an overall view about what he’s eating over several days.

It might be something straight forward like them not being aware that there’s any suitable food available (particularly if there’s a perceived issue with swallowing) and that weetabix is only available. Or it’s his choice.

All that said, if going to live on one thing weetabix with milk is a pretty decent option.

There is a sign on his front door to say camera is recording and camera is in full view, not covertly.

Carers have instructions to give weetabix for breakfast, sandwich for lunch and warm a meal in microwave for dinner..

Definitely raise it but don't be confrontational. Say the carers aren't giving him the neaks that are left, that you THINK he's only getting weetabix.

Ask for them to complete a food diary, it will take 10 seconds if you prong out a table and leave it with a pen so no excuse. Or you write what you want him to be given.

Does he get to choose? Is it possible he's asking for weetabix?

I'd raise it with the manager initially.
There should be records , if dad has told the carers he just wants weetabix, rather than a sandwich or the prepared evening meal, this should be clearly documented. I'd check that first. Does dad have dementia ( it sounds that way). Eating certain foods only isn't unusual, plus weighing 7 stone hasn't been caused by having a weetabix diet for one week. It sounds like there's been a general decline for some time. If no other food is being offered to dad, that is unacceptable. But I'd definitely speak to the manager first and take it from there.

Sorry, just seen that the topic is dementia and Alzheimer's so that answers the question.

Thank you, I'll phrase it like that rather than going all guns blazing!!

Very possible he's asking for Weetabix, he's really not with it. Seems to make sense if the conversation requires yes/no answers but otherwise is talking nonsense.

Apparently they can't keep written notes, all has to be recorded online for the council, I'll ask for access to them or to at least see the last week's worth.

Is he asking for weetabix? Are his teeth hurting so he can face a sandwich? Ring the care agency, chat with the manager, ask if the carers can log what has been offered and what has been accepted and do they have any ideas to make mealtimes more varied and nutritional?

No formal diagnosis yet. Felt like the right place to post given his current condition. Hospital said the delirium could last 8-12 weeks but we approaching that now and no improvement.

Weight loss definitely has been gradually over years and not in the last week. He lost a lot around the hospital admission last year and as he's so thin now it makes us more concerned about any meal missed as there is nothing left to lose.

I think a care home is completely out of his/our budget. Something for us to discuss with Social Services maybe.

Like others have said, ring and discuss it with the care provider. I used to care for a Lady in a care home who would eat weetabix twice a day most days. 3 at breakfast and then 3 more at dinner (evening meal)
We'd offer her whatever was on the menu, sometimes the kitchen staff would make her something else to try and tempt her. But most days she'd pick at it, push it round the plate and then ask for Weetabix.

Raise it but he might be asking for weetabix and unless the carers are instructed otherwise they will provide what he is asking for. We have a lot of arguments with the care company over similar issues, them claiming that dsd as bodily autonomy and us saying she has no capacity to know what is good for her (she really doesn’t and will ask for hot chocolate, cheese strings and mashed potatoes when asked)

Do they not have written notes? Or is it all done electronically?

If so, you can ask for a copy - they will be doing notes for every visit, and they should be writing what he eats in there.

Fred was a bit down today, he didn't want to wash. Encouraged 3 times, offered flannel and refused. Fred declined a sandwich, so I left his favourite wheatabix. Carer at dinner to try offer again.

That kind of thing.

All electronic but I'll ask for copy of the notes.

You could also raise a concern via CQC if you're in England (the Inspectors of domiciliary care) and they'll link in with the home manager.

I’d ask for a copy of the notes, and also query if that’s what he is asking for as that does change things. My granda also has Alzheimer’s and ALL he wants to eat is Weetabix, he’s currently living at home with my gran and us providing care and despite home cooked meals always made and presented he always asks for Weetabix and most days that does form most of his diet. We can’t force him to eat, so I’d ask the question first just to see if this is driven by them or him. If it’s driven by them- definitely safeguarding issue. If it’s him then it’s harder because as with my granda we can put a perfectly cooked meal infront of him and he will not eat a single bite, but will demolish a bowl of Weetabix, so if you insist on him being served those meals and he chooses not to eat them he will continue to lose weight and some food is better than none.

It's hard as he doesnt remember if they've even been so can't tell us what he's eaten or what he's asked for.

Carer here. My instinct is to get a bigger picture of what’s actually going on. Are they offering different foods? I wouldn’t be too impressed by a family dictating what they expected their relative to eat. Dementia or not he is entitled to make choices even if they are not the ones you would like him to make. So if he is choosing to have 3 meals of weetabix a day that ultimately is his choice. I would however be expecting the carers to prompt him to pick other foods.
If however they are not giving him choices and are just feeding him weetabix then that is not good enough. That level of care is simply not on and if they are skimping on what they are preparing him food wise then I’d also be questioning the rest of his care.

Can you tell me a little more about his care situation? Is he having an agency going in? Have you considered getting private carers instead? Many agencies only offer short visits for a high price. I’m self employed and offer much longer slots at a lower price. This also means I have direct contact with the families of the people I care for so needs can be discussed on an ongoing basis. Which ultimately provides a much more consistent level of care. For someone in your dad’s situation (3x a day visits, 7 days a week) I’d recommend having 3-4 carers who work on a self employed basis.

Does he have concept of time?

And is the cereal in a cupboard or left out for him to see?

It could be as simple as him thinking it's breakfast time, or at some point he's refused to eat, a carers noticed he will say yes to cereal, and it's just spiraled from there.

It's absolutely worth leaving notes in the kitchen also, sticky notes that tell the carers what is for dinner. Gentle reminders.