Looking for Advice - Major Problems with Care Agency

All about caring
1

Good evening all,
I am hoping that someone will be able to provide advice or a friendly ear in relation to the problems that I am going through with the Care Agency that attends to my father.
My father is terminally ill and had undiagnosed mild memory problems. He is totally immobile. To protect his safety when I am in work (I am his full time evening and weekend carer), I have CCTV in every room that he is likely to use, simply to ensure he is safe.
We are with a new Care Agency, roughly six weeks into the package of care.
I have significant concerns, which I have reported to Social Services, the Care Agency and Care Inspectorate Wales.
My question is, where else can I go in terms of reporting the concerns?
I outline the concerns below.

  1. Carers are arriving late or early, never to time. This means my father is sitting undressed waiting for his personal care and clothes to be put on. At night time, he is asked to go to bed too early, or I have to get him into bed myself if the call is late, which defeats the purpose of the carers assessment based package. As he is terminally ill, I can fully understand he wishes to stay up as much of the day as possible and enjoy the simple things in life like the television.
  2. Carers do not log in or log out by telephone as they are supposed to, which means ‘the office’ have no record of their arrival or departure times. I state this, as the time spent in the property is usually much shorter than the allocated 30 minutes twice daily. The actual time on personal care spent with my father must be only just out of single figures.
  3. Carers are not recording the correct times of arrival or departure on the record file which I look at on a daily basis.
  4. Carers are writing minimal information in the file, mainly in relation to what they did, but nothing about how Dad is feeling, his health, any issues etc.
  5. Manual handling is ‘sloppy’. Brakes are not being applied consistency to his bed, steddy etc, and the carers do not seem to know how to use certain types of bed slide sheets - which shocked me. One was using YouTube to view a video during his 30 minute call for 10 minutes on how to use a Banana Slide Sheet. I was aghast, especially when the carer told me I should view the video too and train myself up.
  6. None of the carers are registered with Social Care Wales. I know this is a new scheme, but so many are already registered, it worries me why these carers are not. Is it simply administrative, or is it due to lack of experience or qualifications?
  7. The most worrying thing, given that an OT has assessed my father as double handling and have kindly provided us with a huge amount of manual handling equipment, a CCTV recording has shown that they ‘ordered’ my father to stand-up and hold onto the base of the bed, and use the Carers shoulder for stability when he was receiving some personal care yesterday, even though this particular carer must have attended tens of times before.
    I am so worried about my fathers safety now, that I cancelled last night’s call.
    I am going to ‘supervise’ each and every call I am able to now, to ensure (a) the care plan is being followed in full and (b) my father’s safety is not put at risk. In relation to the latter, please forgive me as I am not qualified in this area, but when does this become a “Safeguarding” issue? One occasion where he was put at risk, or does it have to be several occasions? Thank goodness the CCTV captured it, as my father does not remember this ‘incident’.
    In (potentially) the last months of my father’s life, I want him to be cared for as gently and as dignified as possible. He has a form of aggressive cancer which is non-treatable.
    I know, I am able to provide all of his care needs myself if I were to resign from work, but I have a good career, and my father would not want me to do this. I have even studied towards competency standards of a professional carer to enable me to do a competent job with my father.
    I am so disappointed at the lack of care by this care agency.
    They have failed to respond to my concerns on several occasions. In a period of 6 weeks, there have been 34 email exchanges between myself and the agency, with only four of those being replies from them.
    What can I do please? I am concerned that there are an apparent lack of care agencies in our part of Wales, and so I am reluctant to pull out, but some ‘shaking up’ needs to be done swiftly.
    Thanks for reading a long message - and I hope someone is able to advise.
2

Hi Paul

Where do we start …

Sorry to hear of your fathers illness.

Could you temporarily take time off. Leaving you employment is not a good idea in the long term. Would this also effect your pension etc.

Have you thought of applying for funding to select your fathers care package.

Have you thought about with own funding employing one/two full time carers.

You could contact …

https://www.cqc.org.uk/

3

Is CHC / NHS Continuing Healthcare a factor here ?

https://www.carersuk.org/forum/support-and-advice/all-about-caring/chc-coughlan-grogan-judgements-nhs-contuing-healthcare-nhs-fnc-hospital-discharges-all-under-this-one-thread-35998

Alternatively , Palliative Care ?

What is palliative care?

Worth exploring ?

4

Thanks for the reply Sunnydisposition, appreciate the opportunity to talk on the forum. Yes, my employers are great, and I have been given some time off work previously. I don’t think the CQC applies in Wales. We have Care Inspectorate Wales (CIW) and I suppose they are the equivalent. However, I am advised they will not consider individual complaints/issues. I am not getting anywhere with this care agency, although I am hoping to meet with them next week. There are multiple issues that need to be solved, and the care agency appear to just be getting away with it at the moment. I dread to think what might be going on in other peoples homes where they do not have a son/daughter/spouse/friend/relative who can keep an eye out for them frequently too. I am always the first to compliment any sort of good service, but this is way off the mark.

I am going to explore Direct Payments but it sounds very complicated. The big issue with not living in a major town or city is the lack of alternative care providers so I am not hopeful even then, with Direct Payments, that a service could be provided.

I am keeping my fingers crossed that there will be a significant (with a capital S) improvement with this care agency, and some form of detailed investigation into the issues I have described.

5

Hi Chris
Thanks also for the reply.
We did have support from Marie Curie, but they have pulled out, which is good in a way, as Dad did not go downhill as fast as originally predicted. They will be my first port of call when the time comes.
CHC application was a bit of a nonsense. The DN who did the original assessment did it without even seeing Dad and meant we did not get off to a good start. I insisted she visited and did the assessment in my presence. I was told of all complications in relation to CHC (day)/Social Care (night) combinations that I was put off.
It all sounds so easy, but in reality, it is always a fight.
On top of this, I am spending £1000/month on private care as well, but the difference is here, the carers are excellent, and I could not recommend them enough. Compassionate, dignified, just all round lovely people. Shame I have two extremes. on my hands.
Cheers,
Paul

6

So be it.

If I were you , I would check out these sections in that thread :

FAST TRACK NHS CONTINUING HEALTHCARE ( NOT JUST FOR END OF LIFE ! )

CHC : APPLIED FOR BUT REFUSED ?

Make your own judgement … as opposed to relying on a district nurse … who is not , exactly , impartial … wearing her NHS cap ?

7

Thank you Chris.

8

Your welcome.

It may come as no surprise that such 5 star care is rationed … by design ?

https://www.carersuk.org/forum/support-and-advice/all-about-caring/chc-rationed-high-time-to-ask-some-obvious-questions-33311?hilit=chc%20rationing

Paid care workers … indicative of " Social " care … as opposed to trained nurses ???

9

Hello and welcome!

Can you complain or not?

Make a list of issues or use a logbook to record details of issues. This is like a bad film. If they are failing him, you need to be willing to quickly intervene on his behalf.

10

Hello Thara_1910
Yes, I have complained 30 times! There is no action from the care agency to date.
I have been prepared to take action since the problems were noticed - almost on day 1.
There has been continual communication from my end for almost six weeks.
I have had one letter from the care agency saying they are looking into the issues, but I believe they are not taking me seriously enough to put any remedial action in place, hence why I am looking to take this higher - i.e. solicitors etc, especially with my father being put at risk with manual handling yesterday.
Paul.

11

Sorry you’re in this position. I had similar stuff with my mother.

If your dad needs double handed care, has the OT given the carers a sit to stand electric hoist? The carers shouldn’t be using lift belts or asking dad to grab hold of them or the unstable bed, in my opinion.

In terms of care plan records, they need be current, accurate, complete and timely. Is your dad self funding, or is the local authority paying for his care? If you have good records and evidence of the apparent falsifications, and of his poor handling and 'near misses" you could initiate a safeguarding case, if you have communicated your concerns to the agency and things haven’t improved over time.

I initiated two safeguarding cases that ended change of provider and in compensation for paying for two carers but only one showing and a whole host of falsifications. The other resulted in better care.

You need strong evidence before filing and it sounds like you’ve got that.

Has your dad had a recent needs assessment through social services?

Have you considered hospice care, at home or in a hospice?

12

Hi Paul

I’m sorry to read what you are going through with your Dad. I’m in a very similar situation.

Could you use direct payments to employ some of the private carers that you currently use? If they are too expensive could you buy some of their time and do some other hours yourself (if work will let you and it’s only temporarily?).
Alternatively I do wonder whether if you used direct payments to employ the current agency they might be more responsive to your concerns? I’m thinking of doing something similar myself. I think the care agency just don’t listen to me but wonder whether if I was paying and could go elsewhere they might be more responsive? Worth a try??

My father has part of his care funded through direct payments - we also employ a charity (PeoplePlus - not sure if they operate in Wales) to do all the admin so once it’s set up it’s not actually that much work. The council may have a list of charities who do something similar near you or you might be able to google it.

Good luck with everything!

13

Sorry I meant to add my fathers MP was very good at raising concerns about his care when I felt I was getting nowhere. She wrote to the Director at Social services and got a helpful response. Not sure if all MPs are as good but worth a try?

14

Thank you to all who responded.

I am considering taking out a safeguarding case against the care company.

Has anyone ever done this, and how difficult was it? Was it worthwhile? What was the outcome? I am not interested in any financial gain - I will make that very clear. I am only interested in improving standards, and getting the best of care for my father.

15

Hi Paul.

A good starting point for the basics would be the CAB :

Get advice about health costs and services - Citizens Advice

__

Social services complaints - who can use the complaints procedure.

This advice applies to > Wales

Are you are unhappy about the service you have had from your local authority social services department ?

This page tells you who can use the local authority’s (LA) complaints procedure.

I take it that CHC / NHS Continuing Healthcare as a possible route has been considered and … dismissed ?

16

Hi Chris

Thank you for the very helpful link! Funnily enough, I was thinking about CAB today.

I shall read intensely!

Thank you,
Paul

17

Your welcome.

Even remembered it would be for Welsh citizens.

18

Great! Diolch yn Fawr!

19

Peidiwch â gadael i’r bastardiaid eich malu i lawr?

20

Well I find myself returning to this post first and foremost to vent my fury in relation to the way this care company are treating my father, and secondly to seek advice - I am sorry if that is the wrong order but that’s the way I am feeling today!

Prior to Christmas, I received a written apology from the company where four issues in my complaint were upheld. There have since been two further incidents. One of a manual handling nature again, and a second in relation to a derogatory comment made against my father which none of us heard but was captured on our outdoor CCTV.

I have made further complaints in relation to these two, only to find out that the care company are terminating their contract with the local authority in 28 days in relation to my father’s package of care.

Rather than working to solve these issues and develop the partnership between us and them, they have pulled out.

I am absolutely disgusted by the way my father has been treated physically, and the way we as a family of two carers have been treated with complete disregard. I feel we have been sidelined and trodden on simply because I have raised serious issues.

I work in a quality and standards environment, and I am always the first to pick up on areas that could be improved, and especially when it comes to my father, if I see issues, I will raise them!

I could never recommend this company, and would hope that others do not go through the same eight weeks of hell that we have been through. I do have to say, one or two carers are good, and I hope they are able to find another job with a more caring company - that would be my advice - but do I tell them?

My question though, is where next?

That is quite an open question - a new care agency, direct payments, CIW, whistleblowing through the media?