Care homes and safe guarding women- what am I missing

[Appleofmyeye2023]

I am in a state of shock and alarm frankly. I want to question something with a care home, but don’t want to piss staff /management off, and just wondered if someone knew anything about why/how this sort of thing can be allowed to happen …as follows

My dad is in late 80’s and is diagnosed recently with mixed dementia. He was sectioned for a good while, and then thanks to a fab acute dementia unit was able to be discharged into a care home.

his type of dementia (Lewy bodies), leads to a lot of issue with REM sleep disturbance, hallucinations, paranoia and he’s also registered blind.

he was fine for around a month, seemed to be having a really good period, got a lot of old dad back, but he’s now back to REM sleep issues and hallucinations

hes coming out his room at night and wandering, but he’s wandering into residents bedrooms. Most of them are women. Old, frail and with dementia or other issues. He’s been telling them they’ve all got to move out of home (don’t ask it’s part of his regular repeated delusions 🙄🥴) but is trying to move them out of bed etc. I’m aware he’s touched some of these women …but not in sexual way.

but his inhibition are varying. He does have morbid jealous type thoughts re partner (not helped thst they aren’t, obviously living with each other now) and I’m really concerned nereid in his confusion, he’ll sexual molest these women thinking they’re his partner.

he could walk in on a women using bathroom, naked or in a vulnerable state !

and I’m thinking..god in heaven how on earth can this be allowed to happen to these poor women (or men for that matter). Where is the safe guarding? Thst could be me in 25 years! I’m so alarmed at this, and frustrate beyond belief. Why aren’t there magnetic activated locks on doors to stop residents wandering but allow carer to enter easily, and residents to get out whenever? It’s not an issue with him wandering, but the issue he can wander into other women’s rooms and their beds!

Right now they’ve moved him out of his lovely room, stuck him in a dingy room in a closed ward, and have supervision on more. But I’ve been now informed he can still enter others rooms, it’s just there’s more staff at night to intervene to stop bad things happening.

is this the best they can do? Is this standard? Is there a reason other than cost saving for this? How many confused, frail mental incapacitated women are being manhandled, distressed, touched or worse by random men entering their rooms.

im so mad at my dad. Read him the riot act, but he doesn’t understand (I didn’t shout btw). I’m afraid he’ll end up being kicked out of the home and end up back in a really shitty ward in mental hospital again. And it all seems down to lack of Will to prevent it happening in first place

anyone help me with understanding this, or experiences on this

not sure of board- but seems like it’s lack of duty of care for women, like mixed sexed wards and the issues this poses

Locks unfortunately would lock residents out of their own rooms as well as other people's.

Could they block his roorn with a stairgate, or is he still able to operate things like that?

Hi
You could ask for an NHS Continuing Healthcare Assessment or, if he’s already been assessed recently, as for a review. This is a serious issue and is putting other vulnerable people at risk. Your Dad should have a Carer 24/7 that is one to one care and his care should be paid for by the NHS.
Dont be fobbed off it’s your Dad’s right to have a full assessment.
Good luck and you may have to be very insistent.

Or a fall alarm mat immediately outside his room to alert staff when he leaves?

Well they can have lanyards too, but locking himself out and wandering corridor and lounges for 10 mins till night staffrealiseis better than him entering vulnerable womens rooms surely to god!

He can’t have mat. They had them routinely and as blind he tripped. Safety issue. He shuffles like parkinsons

to other poster, I’d think he’d dismantle stair gate pretty quickly…but again with his site it’d be an issue

They should have sensor mats on the floor of his room that triggers an alarm and also a sensor on his door. This is what the dementia care home I've visited has.

Just seen your last post!

A lot of them wont be able to use a lanyard, and it's not fair (and possibly not legal) to lock other residents into or out of their rooms.

If they can't keep him in his room, or get to him as soon as he leaves, then it would have to be 1 to 1 supervision.

Are there times of the day it happens most? See if care home are keeping behaviour charts so you can try and see a pattern. One to one care is the only option so he's supervised at all times, but this is obviously costly. Can be funded through CHC sometimes. Has he been checklistsed?

Any care home that is saying it is able to meet the needs of a man with complex dementia and sight impairment should have a way to manage this and keep all the residents (and your dad) safe.

I would ask for a meeting with the manager and escalate your concerns to the local safeguarding team if needs be

He was sectioned . He’s on a 117. He’s was 1:1 when sectioned but improved under the most recent nhs dementia unit. He’s with community mental health team still, and the nurse saw him last week when care home reported the incidents.
im afraid of him being returned to mental ward. He was in really shit places for6 months going backwards, before they moved him to that brilliant unit. But that’s not a long stay unit, it’s a rare beast hard to get a bed in, and for acute treatment to stabilise patients.

the care home he was discharged from that specialist unit to is so lovely. His views from the room they’ve moved him out of this week, were familiar to him and grounding him with where he was. I’m devastate his lost his room and essential back into a “ prison” like ward. Even if he can still wander dangerously in there 🤦‍♀️

he is still on DoLs even in his nice room. Bu so are those women I assume. Mixed corridors, and all allowed to wander around into each others room.
my brain can’t compute how dumb this is 🤯

it’s really not help d by him knowing exactly he’s not at home in his hous, nowt wrong with memory, and bored witless, sad and without hope. Poor sod.

Ok, in terms of safeguarding team…is that social services? Or nhs type thing?

Wandering is very common

There are lots of things they can do - door alarms on the persons door to alert staff if they are on the move, increased supervision, increased activities with staff, a room close to the nursing station/office, meds review etc.

If sexual assault is a genuine risk then we would usually consider same sex wards/units/floors or a move as a last resort if needed.

Sexual assaults between residents are sadly also common in places where there are hugh numbers of people with cognitive problems , they happen to both sexes and usually very robust measures are put in immediately to manage the risk and the local authority safeguarding team should be notified (and the police if necessary) . It's rare there is any intent to harm, just very confused people not really understanding. Care homes are usually good at minimising the risk as far as possible but they can't have eyes on all residents at all times.

The care home should be considering the measures I've described above but while they wait for alarm equipment to be delivered or extra staffing to be funded it sounds like they are doing what is in their power to do at the moment which us supervise more from a room they can keep an eye on.

I think there may be extra funding options available under a 117. So that might help fund a night sitter.

Night time.its REM sleep disturbances. He’s not pulling the stunt during the day 🤷🏼‍♀️. He can be obstinate, refuse to go somewhere, or go off in a hyper “ organised project” mode during the day, but he’s not going into rooms during day

thats the bloody awful hing- these vulnerable people will most likely be asleep

As an alternative to sensor mats, they could NFC tag him. You can geofence them, similar to the way you can limit a security camera's field of vision. Then (as long as it's in Bluetooth range) you just need a phone app to alert staff when he goes past the 'fence'.

In a similar vein, motion sensors outside his room would work but staff will have to remember to switch them on/off or sign in/out.

Ok, that’s worth an exploration, thanks
im not “ nearest relative” under mental health act. Sibling is, so will need to persuade them to look into,this.

is it normal to have unlocked doors though? Or is it this home being skint to not install hotel-like access?

Unlocked room doors are completely normal.

Don't be mad at your dad if you can. It's a normal part of the disease. My gran also night wanders looking for a female gang to protect her from the (non predatory) men. In my mind the care staff need to comfort and distract when they wake but I understand it's not that straightforward.

These are also great ideas to look into, thanks for that

Why? ( that’s what I don’t understand). I realise he can’t be locked in, staff ned free access to all rooms and fire access etc, but don’t get why they can’t have hotel type doors to stop these poor women having to be exposed to this 😢

Not generally.

S.117 just compels The State to pay the full cost of someone's care to meet their care needs after they have been detained under the Mental Health Act.

It doesn't really provide any function to provide additional funding for that care. Care provision for someone s.117 eligible is just determined through a Care Act Assessment or CHC assessment the same as anyone else.

Can you expand on CHC. Not heard this, but he’s maybe had that….

Mat - see above..is safety issue for falls
on door? Nope. That’s one to follow-up on, thanks

His 117 pays his nursing but not his “ residential “ cost…but hey, it’s a massive help he gets a fair portion paid.