Forum Topic

Panorama last night on Care Homes

http://www.bbc.co.uk/iplayer/episode/b0844wq3/panorama-nursing-homes-undercoverI watched it this morning.  Something everybody should watch as so many people don't ever get the chance to visit a care home or nursing home to have any idea at all what everybody else is talking about - so feel unable to comment.And if we all visited them more often then there would be a reduced possibility of any of them deteriorating in the way that some do. 

Philippa Bond ● 3445d6 Comments

I can't comment on the staffing of LBE's care homes because AFAIK I don't know anyone in one and have never visited but I can say that you don't want to have a constant turnover of staff when you are dealing with ill and elderly people.  Lack of continuity makes teamwork harder or impossible.The more experienced are often training/supervising the less experienced so you don't want to lose them.  You don't want them overworked so that they are frazzled and make less good or poorer decisions than they would otherwise. If there are fewer staff then despite there being lovely ensuite showers in each room (I don't know about LBE's care homes) they may never be used because there aren't enough staff to supervise a resident.  The complaint of "I haven't had a shower for weeks" may well be true.  It is easy to think or believe "Oh, they've forgotten" when you weren't yourself there.  Residents who would normally be able to walk to the dining room with aid/supervision may suddenly be pushed in a wheelchair because it is quicker and it takes a lot of staff to get everyone there for meals at the same time.  They then lose their mobility faster which causes further uncomfortable and distressing problems.  You always have to think further of the consequences of an action which may at face value seem a simple solution to one problem but which may have a ripple effect.The staff won't have time for a casual chat with residents.  Please visit your friends and relations in care homes!  Please also consider being a visitor.  The CQC likes to see a programme of activities and although it can be difficult to involve residents sometimes (and difficult for pressed for time staff to remind and persuade them) this gives them something else to talk and think about or complain about (hopefully not too loudly) and is a change from sitting in front of a TV (often in their own room by themselves).  If they are lucky enough to have someone who will come in to play the piano maybe you could offer to get them to the room and maybe join them... if it isn't used an an excuse not to go!

Philippa Bond ● 3432d

Sorry my fault for not being clear.  As you say there don't have to be two trained NURSES but there should be TWO STAFF and many Health Care Assistants have very little training.  The problem is that there are often so few staff there especially at night that it is difficult to get them together to move people.  Hence all the management of comfort calls using incontinence mats and pads.  I reckon it might put a few kids off mucking around with ketamine if they realised what misery it can lead to.

Philippa Bond ● 3441d

You don't need two nurses to turn a patient - a nurse and an HCA or two HCAs can usually do that. Very few nursing homes have more than one nurse on a ward/floor overnight.I agree, lots of nursing homes are woefully under-staffed by nurses, with the shortfall made up by HCAs.And even those nurses there, are less likely to be tip-top in my experience and more likely to be agency. But I only see the bad ones...

Sara Nathan ● 3442d

The use of bed-rails is very controversial - when we asked about these we were told that we could not have them to stop  someone who couldn't see falling out of a new bed in a new location.  There appear to have been a lot of accidents with them in place.http://www.hse.gov.uk/healthservices/bed-rails.htm

Philippa Bond ● 3442d

There were so many story-lines that could be followed up here.Employing registered nurses is more expensive than employing the often untrained carers.  Employing under 25s is cheaper than employing over 25s.  How many registered nurses do they HAVE to have on duty to take all major decisions and who HAS to deal with the drugs with all the rules eg they should make sure that they have SEEN them being taken?  ONE for how many residents?If someone needs to go to hospital - WHO is going to go with them?  Which member of staff will be nominated - or none at all?  When I dared to ask about the ratio of nursing staff:patient overnight in hospital ward a couple of years ago I was told "enough".  That seemed to be ONE:a wardful of patients. Yet TWO are needed for a lot of things - eg turning a patient/moving them up the bed (and I've heard of an obese patient needing SIX) or giving and checking some medication/blood.  No wonder everybody hopes for a quiet night. Stretched and under-resourced.

Philippa Bond ● 3442d

I thought this rather good - though not up there with the Winterbourne programme.At least two nurses I imagine are wending their way towards my tribunal room...

Sara Nathan ● 3443d