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

That doesn't recognise individuals, though, does it? So unless it's inside or.right on the door it will go off every few minutes because of staff or other residents passing it.

That's why I suggested setting it for night-time only. If permanently active, staff would have to switch them on/off all day, which would be a pain & unreliable.

Door sensors are an easier option but contain him to his room, which may not be sensible. Depends how often he leaves the room at night.

NFC tagging the man himself would be closer to ideal, but require more know-how to set up.

Actually, if OP laid out less than £100 for a small Tapo kit, other residents could have sensors added if their families or the staff found them useful. I think one hub can handle 64 input devices.

You don't want floor sensirs as they are a trip hazard, you need bed sensor so that it alerts staff when he gets up. If he is s117, he doesn't pay anything toward his care, its not just the nursing element, however it may be that he pays toward the board /food (although this doesn't happen in the council I work in).

He cannot be assessed for CHC if he is s117 funded, its one or the other but they can reassess the risks and put more support in, but bed sensors would be the first step.

Sounds like he or someone on his behalf is paying a top up on his s.117 aftercare.

It is highly unusual for the nursing and resi costs to be split out under s.117 and only the nursing costs paid by the s.117 - usually its both as standard.

Worth checking because if he is paying a top up for a premium room then he shouldn't be if he isnt currently able to use it.

When we receive a safeguarding alert one of the measures we use to determine if we need to be involved or not is whether distress has been caused to anyone. It is taken very seriously.

Ok, they’re saying if he can’t go back to his nice room in 2 weeks they’ll let it out again. So I’ll talk to my sibling ( legal nearest relative) to get costing calculated again. I know at one time they said all costs covered by 117 during assessment but then came back on that home with a top up needed .

My mum has a mat on her bed, an alarm rings if she gets out of it. Would that help? They do them for chairs too.

A bed connected motion sensor would be the most straightforward solution. The issue you really have is staffing at night. The home I work in simply doesn't have the numbers at night to ensure that no wanderer ends up where they shouldn't. The best we get is 2 staff to 15 residents, but often it's 1 to 15. If you have a number of wakeful wanderers, even with sensors, you can't be in two places at once. And if both staff are doing personal care with a resident who is a double, there are times when a sensor simply cannot be responded to instantly. If you have agency staff who don't know the residents it adds a whole other layer of problems.
Fwiw, we respond as quickly as possible and permanent staff know what issues each resident presents and challenging behaviour is documented so measures can be put in place. But the horrific reality is that Care Homes are profit driven, management is focused primarily on that, and the front line care is left in the hands of under-resourced, poorly paid carers who are demoralised in the face of a physically & emotionally draining vocation. I really wish I could do more to allay your concerns.

Your poor dad. Dementia is such an awful disease. I think there's a gap in the market for single sex care homes. It's not unusual for men with dementia to become less inhibited and display quite sexual behaviour. It must be so confusing and scary for the women who find themselves living in close quarters with men. Especially if the woman has experienced sexual or domestic violence at some point in her life. It could be really traumatic.
Sorry I don’t have any practical solutions for your dad.

There are care homes that have doors which lock from the outside (either with keys or keypads) residents would have their own code or key or staff would assist them to get back into their room if they needed help. All doors can be opened from inside just using the handle.

It doesn't always fully solve the issue of residents entering each others rooms, doors don't always immediately close behind someone (and you wouldn't want them slamming shut!) and it comes with it's own risks and difficulties too but it can certainly help where there are people with disinhibition or who might get confused about which room belongs to them and be surprised and pleased to find a member of the opposite sex in "their" bed and get the wrong end of the stick.

It sounds like they need modified ANPR systems.

Sensor on each door, unique code badge on each resident or staff member (sew or stick it to residents' clothes if they won't wear a lanyard). Each door programmed to auto open on approach of the correct codes. Staff have access to multiple doors, residents only to their own. Communal spaces don't need them.

It's costs again, though, and maintenance. Automatic doors need specific edges, regular maintenance checks etc etc.

The closed ward and higher staff ratios are good, however if unable to keep others safe with these changes an urgent reassessment needs to take place.

It's been many years since I last worked on an EMI ward but we were doing trials to see how well distraction works.

Simple things like a brightly coloured tea towel wrapped around a door handle or a mirror standing in front of a door (we were watching them so safety wasn't an issue with this) would make them stop and turn around.

We also tried safety tape across doorways as it was easy to duck under but confused patients and brightly coloured strip fly curtains.

It was impressive how well these little distractions worked. I'm surprised products haven't been developed commercially to use in these settings. The handle coverings have to be placed at nighttime and rotated or some patients were getting used to them.

I hope you can find a solution.

It's a care home, not a prison.

If we want proper care we must be prepared to pay proper wages to the staff. But nobody wants to do that because "they are just care workers".

I doubt there is anything much you can do. But if you are worried for your future then why no start campaigning now for better pay for care workers. Maybe then it will attract more people and the conditions will improve.