Did you see the ITV drama, Scott and Bailey, this week? It focused on a care home at which several deaths had been reported in a short space of time. Although they didn’t always get their facts right, for example assuming that a member of staff who had completed NVQ level 3 was qualified to give injections, which they are not (thus confusing health and social care for viewers who already get the two mixed up) some useful issues around elder abuse emerged from the programme that we can learn from.
I thought a definition of abuse would be helpful to ensure we are all on the same wavelength. The charity, 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’
Six important ways to lessen the likelihood of elder abuse
Report concerns straight away
Despite being concerned about her father being subjected to physical abuse and neglect, the relative did nothing beyond reporting her concerns to the Manager, until after her father had died.
Any concerns remaining after being reported to the manager should always be reported to the Safeguarding Team at Social Services straight away.
Expect your concerns to be taken seriously
The Manager was complacent and did not carry out an investigation after a relative had reported incidents or when the Care Quality Commission (CQC) raised concerns.
Relatives are often perceived as ‘difficult’ and while this may occasionally be true, all reports of bad practice should be taken seriously.
Good practice comes from the top
The relative was correct in saying bad practice comes from the top. Any care home is as good or bad as the person/people in charge.The manager’s view that the relative’s standards were unreasonably high is not uncommon.It is important to be able to trust the manager and senior staff in a care home.
Good practice would be for the manager to develop and foster good relationships with residents and relatives and hold regular meetings with them. Also monitor things like incident forms and sickness levels to flag up potential problems. With the right managers and supervisors in place, neglect and abuse in any form should not be possible to go unnoticed.
Staffing levels must be consistently adequate
Low staffing levels were used as an excuse. This is a common problem in homes struggling to provide high standards with inadequate funding from Social Services.
It is important to recruit and train the right staff.
The importance of staff support
There was clearly a lack of staff support and monitoring at the care home in the programme.
Working with vulnerable people can be draining especially when low paid staff have to work long hours in order to receive enough money to live on. Good role modelling is important and regular one to one meetings to discuss challenges, identify training needs and give praise, encouragement and support.
People living with dementia need more intensive support
Dementia was targeted in the programme
People living with dementia are even more vulnerable and therefore need additional monitoring. Staff need to be recruited who are patient and have the right attitude and values. These ‘softer’ issues are harder to measure and require different and more creative interviewing techniques. There also needs to be more staff and on going training in relationship centred dementia care
Of course elder abuse doesn’t just occur in care homes, it can happen in a person’s own home, at a day centre or when they are in hospital. Surprisingly, the perpetrators of abuse are very often the older person’s relative friend or neighbour or someone who provides support to them such as a home care worker.
I would like to leave you with a final thought. If you saw something happening to a child that was unacceptable, why would it be any different for an older person?
You can watch this episode of Scott & Bailey on ITV Player until 6th June 2013 in which “the duo investigate the death of a care home resident whose daughter complains about the level of care he was receiving. Will they find evidence of foul play?”