The biggest Care Home scandal of all

Although my father passed away in 1987, there is probably not a day when I don't think about him. When Iw as growing up, he was a massive figure in my life. He was far from perfect, but I doubt there is a man in the world I could possibly admire more, despite all his many faults. Many of the throwaway things he would say have stuck with me. I remember him once saying that truly wise men don't say very much. I found this to be a strange thing to say and asked him why. He said that this was because they were thinking things through before they said them.

Often it is such wisdom that gets passed by, missed or disregarded in the barrage of noise we hear from the less insightful people in our world, who gobble up our band width. To learn we have to listen. So it was that I found myself at my brother in law's mums funeral on Wednesday. He gave a very nice eulogy about his mother and her life. At the end of it though, he chose to make a point to the gathered congregation about the treatment of his mother, who had spent the last three years of her life in a care home.

Like many of us, his mother had struggled at the end of her life with the issues of age and dementia. His father had made sure provision was made for her and she wisely took the decision to move to a care home, when she realised that living independently was too much of a struggle. We are all aware of the horror stories of mistreatment we hear about when frail and elderly people enter such establishments. The terrible stories of abuse, the shocking footage of the vulnerable being subjected to the most vile and inhuman acts. For many of us, when we think of the old and infirm in cafre homes, we have images of unhappy folk staring blankly at TV's, smelling of wee and simply counting down the days till they pop their clogs and they are no longer a burden on anyone.

And this was the point my brother in law chose to address. For me it made me reailse that there is actually a far bigger scandal than any of the horror stories we hear. You see my brother in law sought to tell us that we never hear the other side of the story. We never hear of the vast majority of care homes, where the staff do care, the residents are not mistreated and nothing is too much trouble. We never hear about all of the staff who have gone into the business because they want to make a difference, they want to care for people and they want to ensure that the people we haven't got time for in our busy lives are safe, secure and comfortable. My brother in law told me that his mother had been treated impeccably. That the staff had gone way beyond his expectations to ensure that his mum was happy and well looked after. At the reception afterward, I discussed the issue with him. He said that he'd been at the home and he'd realised just how fantastic the staff were, when he saw them taking an old lady of 100 out for a birthday party. She was in a world of her own, but as she was leaving, one of the staff was picking little bits of fluff off teh back of her coat, so she looked as spic and span as possible. It brought home to him that they really did care, who would have noticed a couple of bits of fluff on the back of an centenarians coat?

As I thought about it, I realised that the real scandal is that we don't appreciate such people. I've been to dozens of funerals over the course of my life. Often doctors are praised. Family carers are praise. Priests and Vicars are praised. How often though, do we forget to thank those people who do the daily mundane tasks in the lives of those we love, who can't care for themselves. As I thought it through, I realised that there was more to this scandal than even perhaps my brother in law had considered as he gave his moving eulogy. You see for many such establishments are kept running by an army of low paid staff. Often at many establishments, the cleaners and carers are on the minimum wage. Often they effectively work for less, as they will work beyond the hours they are contracted to and not get paid for it. They will pick up items from the shops for the residents and run errands in their own time.

We live in a society where we are happy to rely on such people, but we are not prepared to give them the financial reward which such a contribution deserves. A person working 35 hours a week on the national minimum wage earns £985 a month. The average price for a one bedroom flat in Mill Hill is £261,000 which means that it is 22 times the salary of a person on the minimum wage.  So we have created a society where someone doing a vital job can never expect to afford to buy their own property. In effect property prices have created a new underclass of people and that gap is ever widening. If you think it all through logically, we will sooner or later reach a point where there simply won't be any staff to run institutions such as that which my brother in law's mum saw her days out in. Our society needs to seriously look at the fairness of such a situation. If you look at the estate agents windows in Mill Hill, they are full of glorious properties. Isn't it a scandal that not one of these can be afforded by anyone earning what the government has declared as the legal minimum. Barnet Council has recently declared that it aims to set rents in the social housing sector, where many people in low paid and caring professions live, at 80% of the market value. You don't have to be a genius to work out that this will in effect cause a flight of people from the area who simply cannot afford to live in Barnet. However you look at it, this can only undermine society and make those who are vulnerable less safe.

At a recent meeting one of our Conservative  Councllors suggested that this was simply a question of supply and demand and if those on low pay don't like it, they should move to a cheaper area. To me this abhorrent. If we price the less well off out of areas such as Barnet, we end up creating ghettos of poverty. Ultimately this will cause all manner of social problems. Forcing people to move away from friends, family and their caring support networks is perhaps the biggest false economy of all. When my children were young, I benefitted from having both my mother and my wifes parents locally. My mother would cook meals for my wife after the children were born, her mum would babysit. When our parents became ill, we repayed the favour and cared for them. This saved the state a fortune, as if we'd been foced out of the area, the state would have had to pick up the bill.  The government and locla authorities must seek to stop this process of destroying society by social exclusion. They must take urgent action to address the unfairness of low pay and high housing costs. They must build a society where the workers at care homes such as that where my brother in law's mum lived can have a decent standard of living. I don't think there is any excuse for the type of care home scandal I talked about at the top of this article. I also don't believe that there is any excuse for any of us to turn a blind eye to the social injustice that those in the caring professions are suffering either. I happen to believe that if staff are well rewarded and made to feel valued by their employers and by society at large, they are far more likely to take pride in their work and go the extra mile to ensure that the people they care for are happy and well looked after.

I started this article by talking about wisdom and thinking things through before speaking about them. My brother in law gave a very thought provoking eulogy. The only conclusion I can draw from his words is that ultimately we need to build a fairer society. If we dont want "care home scandals" ultimately we need to build a society where we all buy into the idea of fairness and dignity. We don't at the moment and that is the biggest scandal of all.

Updated *** Guest Blog - Linda Edwards Family Carer - A Barnet Council Care Horror Story

**** Updated Sunday 13/11/2011 ****

Guest Blog by Linda Edwards (Family Carer),

As a family carer in Barnet, I should like to thank the Learning Disability Social Work Review Team Manager for re-investigating a Complaint I made about an abusive incident towards my daughter, who has learning disabilities and autism, and myself.

On 19^th April 2011 at 4.30pm, my daughter and her Support Worker arrived at my office whilst I was in a meeting.  They were both distressed and her Support Worker explained that the Senior Care Manager from the Supported Living Service Provider supporting my daughter, which had been commissioned by London Borough of Barnet (LBB) Adult Social Care and Health, had refused to provide the train fare for my daughter and her support staff to visit her father.  It was 4.30pm and my daughter was due to leave at 8.30am the following morning.   The Support Worker explained that she didn’t know what to do as for the past three years; they had been providing the train fare for my daughter’s visits.

I too, didn’t know what to do and telephoned the Senior Care Manager to find out why he had changed this policy with no notice.  He began screaming and shouting and instructing me to stop my work and sort out the mess (that he had created).  His screaming at me caused further distress to my daughter, her Support Worker and to myself.  I felt upset that my work colleagues had to hear this man shouting at me, and that my daughter was by now extremely distressed. 

The following morning I was still shocked and described this unprofessional incident to my daughter’s Social Worker who advised that she would inform the Learning Disability Social Work Review Team Manager.  After I submitted a complaint he met with the Service Provider’s CEO and with their Senior Care Manager who had been abusive.  They responded by telling lie upon lie about the incident and about me.  So, not only did the incident occur, but also the outcome of my complaint was based on lies.  I therefore was forced to challenge this outcome causing further distress to me, and which cost even more expense to the London Borough of Barnet. 

The Learning Disability Social Work Review Team Manager offered to reinvestigate my complaint with the additional issue of the lies that had been told to him by the Service Provider Management.  He met with me together with my ‘support friend’ and then he met with the witness from my office who had witnessed the incident.  He then met with the CEO and Senior Care Manager again. 

The outcome of his reinvestigation is that he is satisfied that the whole of my complaint should be substantiated.  I have asked for reassurance that no other vulnerable person in Barnet will receive the service from such a ‘bullying’ Service Provider, but so far this request has been refused with the comment “It is important to be proportionate with the comment in our response to complainants and to providers!"

My first experience of the Complaints process in Barnet was very different.  In March 2008 I made a formal complaint to Barnet Social Care and Health which included issues by the same Service Provider who had demonstrated that they had no specialist understanding of working with people on the Autistic Spectrum or working towards goals and outcomes.  After six months, I asked them for information about their goals for my daughter, and the same Senior Care Manager who screamed at me on 19^th April 2011 became rude and abusive screaming “We are still getting to know her.  We can’t perform miracles.  You must be patient”.  In spite of three senior LBB Adult Service Managers at the meeting, including the Manager of the Adult Social Work Team who was in the chair, no action was taken.  Had the Chairperson not accepted this intimidating behaviour from a Senior Care Manager commissioned by LBB, or had the Director of Adult Social Care and Health removed them when I first reported such behaviour in October 2007, two weeks into commencement of their contract, they wouldn’t have been around to repeat the same behaviour four years later.   Them “Getting to know her” with no goals or outcomes lasted over four years, until August 2011!  By this time my daughter had become deskilled from their lack of autism expertise, inability to put into practise a person centred plan, work towards any goals and refusal to work with me in partnership.

On 4^th July 2008, in response to my complaint, on behalf of LBB Adult Social Services, the Director of Adult Social Care and Health refused to remove the ‘bullying’ Service Provider, basing her report on their lies and assumptions from the Manager of the Adult Social Work Team who had chaired the meeting when they had screamed “We are still getting to know her!”  With further intimidation, she then suspended the complaint and I could only get the complaint reconvened after many months, having met with Andrew Dismore (then MP) and securing the services of a specialist solicitor. 

Intimidation, lies, incompetence, bad practice and exclusion by Senior LBB Managers have been cause for me to make other complaints and resulted in me becoming unwell, being supported by my doctor and often unable to work.  This culture is totally in contrast to the Governments Carers Strategy, from which LBB have created the Barnet Carers Strategy 2009-2012.  It is very clear what this and the previous Government has wanted for carers:  “Staff that work in health and social care should respect carers.  Staff should work together with carers in looking after their family member.”

Early in 2011, I wrote to the Director of Adult Social Care and Health at the LBB a few times to ask her to meet with me so that I can describe the effects on my daughter and on myself as a carer, of her decision in July 2008 to keep the ‘bullying’ Service Provider based on lies, assumptions, incompetence, lack of experience and a lack of monitoring, but so far she has ignored my request. 

I sincerely thank the Learning Disability Social Work Review Team Manger who has reinvestigated my complaint 19^th April 2011.  Whilst my daughter cannot regain the wasted past four years, I only wish that this Manager had responded to my complaint in 2008 rather than the Director of Adult Social Care and Health who insisted that the London Borough of Barnet would continue to pay for such an inappropriate and shoddy service for my vulnerable daughter.

In his first response to my complaint 19^th April 2011 the Learning Disability Social Work Review Team Manager said “I can only point out that this seems to be part of the poor communication between you and Hillgreen Care Ltd and that the sooner this situation is resolved, then the better it will be for (my daughter) and for you.”  Why then, did the Director of Adult Social Care and Health continue commissioning this bullying Service Provider and poor value contract since October 2007?

Her decision was nothing to do with the current funding issues for vulnerable people but based on listening to and representing unfounded lies and disregarding me as a carer. The London Borough of Barnet could have commissioned a good value for money service for my daughter, as there are some excellent Service Providers in Barnet who strive to offer the quality of service that our vulnerable family members need and deserve.  Instead, she chose to have the final word!

What other profession would tolerate such abusive, lying behaviour and still retain the same Service Provider to repeat such behaviour?  Only the “Care Industry!”

Wouldn’t it be reassuring for all vulnerable people, their family carers and the caring rate-paying Barnet residents, if the London Borough of Barnet refused to continue commissioning such inappropriate Service Providers?
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Update - 13/11/2011 Linda added the following
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I do hope that LBBarnet are monitoring my guest blog and all related contributions.

On behalf of family carers, I only wish that I had shared my stories earlier.  The fear of 'coming out' was that my vulnerable daughter would have been victimised.  I and others are monitoring this very, very closely and I promise that any whiff of victimisation will be disclosed.

It is a pity the LBBarnet did not monitor the shoddy service they provided and the cowboy organisation they commissioned since February 2007.

They would have saved considerable money for the rate payers of Barnet. 
Linda edwards

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Linda Edwards is a family carer.  Guest blogs are always welcome at the Barnet Eye. Please email me via the link in my profile