Sunday 20 February 2011

Couldn't care less: Growing Old in Broken Barnet update

There are certain blogposts in the Broken Barnet archives which still have a particularly high number of reads, many months after they were published. One of these is 'Growing Old in Broken Barnet', - dealing with the distressing issue of the standard of care in this borough for elderly people who require residential accommodation - and in particular, elderly residents with dementia. It was extremely difficult to write about, as it was based on my own experience of my late father's time in hell - in one of the homes used by Barnet. And I think the reason so many people read this post is because so many of us have elderly relatives who may be in need of residential care and we all worry, and we are right to worry, about their vulnerability should they placed in a home with less than adequate standards of care. I suppose many worry about their own futures too.

I've been intending to write this post for a while now because of the latest developments relating to the home I was writing about. I've put it off, frankly, because I hate thinking about it.

The care home in which my father was treated so appallingly is now owned by a large international company. Although the company had not then taken it over, members of management staff and others present during his time there were taken on with the home, and the prevailing standards continued, throughout several inspections by the body then responsible, the CSCI. The manager who had been so antagonistic to my brother and myself, when we tried to raise concerns about our father's awful care, was promoted within the new company.

The inspection reports, still available online to read, clearly show that despite constant criticism of the same failings in care and the state of the home itself, no real action was taken to protect the well being of the wretched residents, many of whom have severe stage dementia. Even the repeated flouting of statutory requirements was allowed to continue. Why?

Because the councils which use this home for placements, ie Harrow and Barnet, were apparently happy, despite years of such reports, to allow their most vulnerable residents to be left in such conditions, and perhaps were more worried about losing the ability to find placements than pursuing a more rigorous scrutiny of conditions within such places - until such time as Harrow was obliged to launch their investigation.

A couple of years ago we raised concerns with MPs John Mc Donnell and Andrew Dismore, in relation to the continuing poor standards in this home. Mr Mc Donnell was already involved in the issue, and had raised in parliament the concerns his own constituents had brought to his attention, and Dismore was then the local MP. I have to say that this was an example of Andrew Dismore's virtue as a constituency representative: he certainly took our concerns seriously and followed through by trying to do something about it.

I have discovered that after such concerns were raised, Harrow Social Services launched a Safeguarding Adults investigation into this home. The home then offered a voluntary embargo on further placements, for a limited period, anyway.

I consequently made enquiries about the investigation, and was told that local councils were about to resume placements in the home following an inspection by the new body, the CSQ, last year, which had rather surprisingly, resulted in a two star rating. This is despite the fact that the report is full of criticisms and still with outstanding statutory requirements, and as the inspectors themselves point out, the home had such a low rate of occupancy at the time of their visit, the assessment was made in articial circumstances and is therefore arguably misleading.

The inspection was based on visits which although unannounced, were expected, and on feedback from a pitifully few number of residents and relatives. Obviously due to the nature of the residents' dementia, they are largely unable to contribute, and only four questionnaires from relatives were obtained. From their comments there was evident disatisfaction with the state of the home, still not redecorated despite agreement to do so, and criticisms also about interaction from staff. The report highlights problems with the poor maintenance and decoration of the home and grounds, administration of medicines, the management of pressure care, gaps in training of staff, including first aid, the management of laundry, the cleanliness of carpets, the impersonal state of bedrooms, the lack of suitable tvs for residents etcetera etcetera: all issues which were raised by us years ago, and still recurring.

Private Eye magazine, incidentally, has featured a number of articles on this very issue, and suggested that there may well have been pressures on the new inspecting board which might explain the haste to award a rating which would enable further placements.

Last summer, however, our shiny new Coalition government decided to stop awarding quality ratings. There will apparently be, eventually, a different way of monitoring the standards of care in these homes. If you look, you will see there is no report on the home where my father was incarcerated published after April of last year, despite the recent history of concerns. That is nearly a year ago. What has happened in the meanwhile? Well, the home is open once more to new residents. That's all I can tell you.

I would like to think that a new inspection system might mean a far more rigorous set of minimum standards and, more importantly, a truly effective system for enforcing compliance. I wish I didn't think that the companies who run the largest number of homes will use their influence to minimise the impact on their profits. I truly hope that no elderly person will ever again have to undergo the horrific experience that my father had to suffer, but I don't believe that is true.

A few days ago I had to walk past the home where my father spent the last, worst, year and a half of his life. I could hardly bear to look up at the windows. I still feel so distressed at the thought of what he had to endure. I can't bear to think that there are still people in there living in more or less the same conditions that he did, but I fear that there are. And when I sit in council meetings and listen to Sachin Rajput and his Tory Cabinet colleagues pontificating about the need to make savings from the services that are meant to protect our elderly relatives from such indignities, I feel nauseated, and wonder how they will feel if ever their own parents have to suffer in this way.

Last week, the subject of our borough's use of residential homes was in the news again.

Traces of the potentially lethal Legionella bacteria has been detected in the water supplies for two care homes in Barnet, prompting calls for a full inquiry from local trade unions. The elderly are particularly vulnerable to the effects of legionella, and of course many members of staff have been put at risk as well.

Staff and residents in Apthorpe Lodge in Nurserymans Road, New Southgate, and Dell Field Court in Etchingham Park Road, Finchley, were sent letters last week explaining the situation. Both facilities are run by Freemantle Trust, who were subcontracted by Catalyst Homes, whom Barnet Council are due to pay an enormous sum of around £6m following arbitration after a dispute about their care contract.

You might wonder how legionella has managed to get into the water supply in any council used facility: there should, you might think, be a system in place to prevent any such contamination, and it must be established as a matter of urgency how any such system failed in these two cases, and if there are any more cases waiting to be detected.

This issue raises serious questions, yet again, about the ability of the borough to maintain control over the management of care when it is transferred into the private sector. When our most vulnerable citizens are handed over to the care of contracted services, who is going to make sure their best interests are being served? Who is going to ensure that the standard of care comes before the profit margin, and the need to cut costs?

The current Tory administration in Barnet likes to claim that the present agenda of savage cuts in spending is necessary in order to target resources at those who need it most. The placement and monitoring of the standards of care given to a large number of elderly citizens in residential homes might be expected to qualify as a priority of concern, in the list of those who need it most. If you believe this is the case in Broken Barnet, I think that you are mistaken, and probably living in the wrong borough.

Because this is how we do things now, in Broken Barnet. And if you don't like it: get out now, while you can.

1 comment:

Jaybird said...

I am sorry this has brought up such painful memories for you. Thank you for posting on this important issue.