All posts in Hospital Care

What Good Care Looks Like

Every older person has the right to live safely, in a warm, clean environment and be treated with kindness and respect for their individuality.

Unfortunately despite some good care practice carried out by dedicated staff, the media has frequently highlighted the poor care and shocking treatment given to some of the most vulnerable people living in our communities.

Someone you know may need or be receiving care and support. They may be either living in their own home, a care home or somewhere else and you need to know what good person- centred care looks like, to root it out if you are looking for it or ensure they are receiving it already.

It is important that everyone feels able to say if they are concerned about someone else’s safety or the care they are receiving (or lack of it) who perhaps is unable to speak up. Some things to look out for that demonstrate good care are: iStock_000004809750Medium

  • People are treated with privacy, kindness, dignity and respect and seen as individuals before their disability, illness or needs. (“We cannot care for people unless we care about them and we cannot care about them, if we don’t know who they are”)
  • Care records are kept and include what is important to the person, what is important for the person and how they like to be supported
  • Needs and expectations are reviewed regularly with the individual and/or the people who know them well
  • Eating and drinking well and maintaining a healthy weight. (People’s likes and dislikes for food and drink are investigated. Drinks put within reach and people with a memory impairment reminded to drink)
  • The right medication is given at the right time and taking it observed
  • Well trained staff are available and training includes dementia care (80 per cent of people living in care homes have a form of dementia or severe memory problems)
  • The right sort of equipment is available
  • Meaningful and age appropriate social activities are available and informed by choice.
  • Relatives are made to feel welcome and included
  • Financial security is investigated
  • Care home is integrated with the local community (e.g. joint gardening or history
  • Leadership is strong and supportive. (Senior staff set a good example)

If you have a concern about someone else’s care and the danger is immediate dial 999. If the danger is not immediate, contact their Local Authority and ask to speak to the Adult Safeguarding Team.

If you are concerned about the quality of care provided by a care or nursing home or domiciliary provider, contact the Care Quality Commission on 0300 061 6161 or www.cqc.org.uk

Keeping Older People Safe from Elder Abuse – Neglect

We all have the right to feel and be safe, regardless of our age or circumstances, so you may be surprised to know that incident reports of abuse towards older people are increasing and many are not reported. It is therefore important that you are vigilant to ensure older people are safe and treated with the dignity and respect they have a right to and deserve.

Unfortunately I come across abuse all too often and typically nothing has been done about it until I ask the following question ” Would you report the matter if your concerns related to a child? Why should it be different for older people?” 91 years of life

A definition of elder abuse

Action on Elder Abuse, defines abuse as: “A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to another person”

Elder abuse is a complex issue

Elder abuse is a complex issue and often involves more than one type of abuse. For example financial abuse may also involve emotional abuse if someone is being threatened as well as complying with inappropriate demands for money.

Over the next few weeks we will look at the different categories of elder abuse that you are likely to come across in relation to older people in a bit more detail so that you know what you are looking for.

Lets begin with neglect.

What is neglect?

Neglect is a form of abuse whereby people responsible for providing care for someone who is unable to look after themselves, fail to meet their needs. Neglect can be intentional or can occur as a result of not understanding what the person’s needs are. Under the Mental Capacity Act 2005, wilful neglect and ill treatment became a criminal offence.

Neglect occurs when there is failure to provide food, shelter, clothing, heating, medical care, hygiene or personal care, and the inappropriate use of medication. Examples could include not giving someone proper assistance with eating and drinking, or failure to provide a warm, safe and comfortable environment, failing to provide adequate personal care or ignoring someone’s health needs. Repeated calls for assistance may be ignored or someone’s care plan may not be read or followed.

Possible signs of neglect are:

•​Urine smell in a person’s environment

•​Pressure sores

•​Depression

•​Lack of stimulation or prolonged isolation

•​Person has unkempt appearance or is dressed inappropriately

•​Signs of malnourishment or dehydration

•​Person has untreated medical condition

•​Not being helped to the toilet when assistance is requested.

•​Home has insufficient or no heating

•​Under or over medication.

Paula’s Story

Rose has Alzheimer’s and lives in a specialist care home for people with dementia. Her only relative, Paula, is unable to visit very often as she lives more than a hundred miles away and works long hours. When Paula visits her aunt she is concerned to find that Rose does not have her own dress on and it is too big for her. Her hair had been cut badly and not been styled and her lower dentures were missing. Paula is aware of a strong smell of urine in the home and observed that her aunt was wearing an incontinence pad that needed changing. The most worrying thing for Paula was that her aunt appeared depressed and withdrawn.

Rose’s care was clearly being neglected and her niece was advised to report the matter to the Safeguarding Team at Social Services

 What to do if you are concerned about elder abuse

If you are concerned or have a concern about someone else about harm or abuse and think the danger is immediate phone the police now on 999!

If it is less urgent, you can phone the local police or contact the Local Authority Adult Safeguarding Team. You will find these numbers on-line or in a  telephone directory.

Top Tips For Putting Care of Older People in Hospital On The Road to Recovery Post the Francis Report

In my previous post I started to look at the scandalous situation surrounding elderly care in hospital and the report published by Howard Francis following a lengthy investigation.

The Francis report makes 290 recommendations and while I don’t disagree with any of them, I am horrified that no-one has been held to account for the premature death of hundreds of older  people and that Francis makes no direct allegations. Here is what I would like to happen to turn the situation around. bigstock-Closeup-Of-An-Old-Woman-s-Hand-6224883

  • Identify the people responsible for the deaths (I believe this has already been done) investigate them thoroughly and take appropriate, decisive and public action.
  • Identify and fund minimum staffing levels for hospital wards to include at least one staff member and volunteers recruited with sole responsible for supporting patients well-being. This must include making sure elderly patients are eating and drinking. This will need to be monitored by the Quality Commission (CQC) in the same way they monitor staffing levels in care and nursing homes.
  • Introduce basic care standards elderly patients can expect and ensure the CQC monitor them rigorously.
  • Make corporate neglect a criminal offence.
  • Involve patients and relatives in the design and production of basic care standards, policies and procedures.
  • Identify a person centred patient care champion for each hospital rather than a Chief Inspector of Hospitals.
  • Provide training for Trust and Board Members so they can provide strong person centred leadership. We are entitled to see the people who are ultimately responsible for the service held to account.
  • Introduce lay assessors (ordinary people who have used a hospital) to inspect hospitals on a regular basis and report to the Care Quality Commission (CQC)
  • Increase duration of the annual budget cycle to three years in order to introduce longer term improvement strategies.
  • Identify hospitals that provide person centred care to older patients (use patient and relative surveys to find them) and use them as pathfinders for excellence in elder patient care.
  • Introduce an independent ‘hospital neglect line’ on the lines of Child Line for three years to allow time for the above changes to take place.

Making the much needed changes will take concentrated effort over many years and I believe the NHS will feature highly in the next election. However we have no time to lose if we want to regain our pride and confidence in the NHS for older people and we all have a vested interest in making that happen!