As part of a Which? investigation, we asked three actors to spend a week of their lives in four randomly chosen residential and nursing homes. The investigation raised serious worries about some of the care in the homes, including safety concerns, poor nutrition and even one case of potential abuse.
Potential abuse in care home
Experts were so concerned by one member of staff's behaviour, and the care offered in the home, that Which? reported it to the regulator.
Our actor witnessed the staff member dragging a resident to the toilet by one arm while talking on a mobile phone, and another resident being repeatedly pushed by the head and shoulder when trying to stand up.
The regulator ensured that admissions were suspended immediately and the potential abuse is being investigated.
Poor skills of care home staff
Our experts were also worried by poor skills and communication in three of the four homes, and a lack of management. Our actor observed a lady moaning in pain waited 35 minutes for pain relief because staff were busy doing a handover.
Another actor saw one carer shovelling food into a woman’s mouth. When she raised her hand to stop so she could swallow, the carer took the food away and ended the meal. It doesn't have to be this way – the next day our actor saw another carer gently singing and feeding the same woman with dignity.
Lack of activity for care home residents
Our experts were concerned by the lack of activity in all four homes. After posing as a visiting relative, one expert told us: ‘I was shocked to see that residents had tables pushed into their fronts so they couldn't move – it gives me grave concern to think that could possibly carry on and on. In the hour I sat there, not one of them moved.’
None of the daily activities in the timetable on the wall of one home took place. The last available inspection report highlighted an outstanding or ongoing statutory requirement to provide activities and tells the home to do this - one and a half years before our investigation.
Health and safety concerns
Essential standards for health and safety and cleanliness are enshrined in law, but our experts had concerns about hygiene and health and safety in two homes.
In one, a room with a collapsing ceiling was poorly secured and had poor signage, there was damp on the wall by the bed, the toilet seats were stained and the bathroom sinks dirty. This home was rated ‘good’ in its last inspection in August 2010, but the report also required the home to clean up.
In another home there were two exposed wires in the bedroom, two potentially blocked fire escapes, and dirty bathroom equipment. By contrast, two other homes were clean, although one was cramped.
We asked our actors to keep detailed food diaries. The nutritional content was estimated and analysed by our expert dietician, who was concerned by what she found in two care homes.
One served food supplement drinks to all residents, and once before lunch. Our dietician said: ‘These supplements are prescribed by GPs to malnourished people, and are not for general use. Widespread offering of these to residents before a meal suggests the care homes were keen to offset appetites or there’s a lack of appropriate nutritional training. This is unacceptable.’
Our dietician visited another home for lunch, posing as a relative, where she observed two residents not offered the help they clearly needed to eat. She also estimated the portion sizes were too small, with inadequate calories and protein. The sample menu in the glossy brochure was nothing like what was offered. Our actor reported a half-stone weight loss that week.
By contrast, another home had a good range of fresh local food with home-made cakes, and creamy Horlicks in the evening.
A care home should be a real home
A good care home should be just that – a home. We'd like to see a good standard of care for older people in all homes throughout the UK. This includes not just clean, safe living spaces and nutritious food, but activities to ensure that care home residents have a good quality of life.
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