Inadequate Care - Action?

As I have posted elsewhere my mother is in a short-term nursing home placement for assessment for NHS continuing healthcare and social care. She previously was in an excellent care home. She has now lost her home and gone from being in a sociable setting where she was mobile (up and down stairs, ate in the dining room with other residents) to having major surgery and no rehabilitation and she is getting worse every week physically and psychologically. The nursing home is awful. Either the staff or not skilled appropriately or the home just has poor practices. I saw the care plan today which basically is fiction, saying she can do things when she can’t.

Apart from the decline since being in this home (two weeks) she is not being helped to eat even though I have consistently said she needs help. She has a fractured right wrist and is right handed.

Anyway, I take food and she is hungry and eats when I help her to and today when I visited was really thirsty too so wasn’t being helped to drink either. I can only go once a week due to bein 300 miles away from the nursing home.

Anyway, care is poor at best and as I say this place is awful and so my question is it appropriate to go to the court of protection with these concerns. Now? Even with a DOLS in the pipeline which the manager of the care home applied for? Something needs to be done to end this awful care but of course I don’t want to interrupt the assessment process (and don’t think I can anyway). Any thoughts anyone as I am desperate to halt this decline in my mother’s wellbeing.

Elizabeth,

This isn’t something I have experience on, so these are just my suggestions. Hopefully others will be able to advise.

In the meantime have you tried ringing Carers Uk or Age Uk helplines? Or CQC for advice?

If your mum isn’t getting adequate support to help her with drinks and nutrition then that is a serious matter. Have you spoken with the manager? If that wasn’t effective then making a complaint or ringing adult safeguarding are options.

What does her care plan say?

Melly1

I would raise an urgent safeguarding concern with Adult services at the local county council social services. They should get the duty social worker to call you back within 24 hours and they can start a safeguarding investigation with the home in question.

Hi Melly and thanks for your response. I have complained to the manager several times but the problem remains and my mum is getting weaker. The care plan in my view is a piece of fiction. I saw it for the first time last weekend - it says she can feed herself and that she can walk a couple of steps with assistance (she can barely sit up in bed). I have pointed that out to the manager but may send another email today. I have also contacted social services to report it. I don’t know what else I can do but am going down there earlier this week (Thursday instead of Saturday) to monitor the situation.

I will try ringing Care Uk and Age UK Helplines too.

Liz

If you feel that your Mum is receiving inadequate care in her care home then that needs reporting to the CQC (Care Quality Commission) highlighting your concerns

Hi Elizabeth,

Did they not change the care plan after you pointed out the inconsistencies between what it says and the reality? No wonder staff aren’t helping her - if the care plan stipulates she doesn’t need help.

Pet66 had issues with her having her husband’s food cut up for him - he was in a care home close enough for family to visit, so that meant they could monitor it better.

The sooner you can move her closer to you the better.

Melly1

Elizabeth
As Melly stated I had issues with carers cutting my husbands food. Well the meat mostly. I put a note in his daily book, a note on his wall, and on the door. A polite note obviously. The manager got the message and had laminated notes in place including one in the kitchen. It took a lot of badgering. Comments about common sense etc.From my daughter’s too.
Whether you a paying, part paying or CHC paying should not make any difference. The home is paid to care,!
Could you insist on reminders being put up in appropriate places? Or do it yourself when you next visit?

Thanks everyone for the fantastic s comments and support.

As it happens, today safeguarding was activated and I received a call from the community assessment team saying that they are sending in a nurse to check on my mum’s welfare as and they will remove mum from the home if they find it is not doing the job they are paying for (this is the CCG). Also, the manager of the nursing home emailed, not responding to my complaints in any detail (son not addressing the issues with the care plan or feeding issues) but just saying mum went to the hospital today and when she came back had lunch in the dining room (some kind of roast) and was smiling and that she (the manager) and the CPN observed this. As I replied, this is very far from the version of my mum that I saw on Saturday so I am sceptical. However, also reassured that safeguarding checks are happening.

Also of concern today was the community assessment person’s statement that mum cannot go from the assessment placement up to Manchester next ‘’because of the way the funding works’’. I was horrified by this as my mum needs regular family contact and I cannot manage these 600-mile trips indefinitely. I called the Ag UK Helpline thought and they have provided advice and guidance so that I can challenge this.

So I am feeling somewhat reassured tonight that my mum will be protected from further harm (lack of food) but there remains a lot to be done to ensure that she is well supported and comfortable.

I am going down again on Thursday and this will be the first time I have been there on a weekday and so hopefully will get to speak to some people involved in the assessment process and get some input about what happens next.

Liz

Liz,
sounds tentatively like progress.

Melly1

Yes thanks Melly. This is my feeling too.

Liz

Liz, it’s actually good that they have told, in writing, you that mum cannot move “because of the way the funding works”.
You also have the name of the person who had decided this.
Have you met him/her?

Now you know this, you can challenge it!

It’s too long ago that I dealt with CHC for mum to remember the exact detail, but I know that what I would call “boundary issues” are discussed in the Framework.
You can challenge this decision quoting mum’s human rights, and also there should be a consideration of your situation too. You cannot keep doing these long tiring journeys.

Can you take videos on your phone? If so, I suggest you do this each time you visit.

Hi Bowlingbun,

Thanks for your comments and suggestions. The person actually made this comment about how funding works and placements needed over the phone. He seems very supportive generally but anyway I got his email address and sent an email explaining that what he had suggested (an intermediate and extra placement) would have a significant impact on mum’s wellbeing (a key term in the Care Act) and would not be in mum’s best interests. I haven’t had a response as yet but yes I also made it clear that I cannot carry on doing these journeys indefinitely but have been doing them in this crisis.

I have a good smartphone and so making videos might be an option if mum doesn’t object. I am writing this at 5.30am as I get ready for the latest trip……

Liz