Are caring homes a fallacy?

Are caring homes a fallacy?

The most common job vacancy currently is that of a care assistant or support worker; that are in themselves, separate jobs. However, the use of the two titles are increasingly being merged, perhaps to save money. When I found myself unemployed and in search for a job with meaning, I took the opportunity to take a job that would improve someone’s life. Describing the role as a ‘support worker’, I was to support service users to reach their ‘full potential by empowering them to fulfil their personal, social, educational and emotional needs’. This, coupled with the company’s aim of “supporting opportunity, choice and success” led me to be to believe that the firm had an ethos which closely resembled my own. My experience differed completely from this. The only section that I can whole-heartedly agree with is that the candidate is required to maximise profitability. This point goes on to say that profitability is to be balanced with the quality of service provided, which is where I begin to disagree. In my short stint at this particular residential care facility, I found three things; profit was always put before people; those in management care very little and; those who are vocal are ostracised.

The first issue that I encountered was the lack of staff on shift. Although I was promised two weeks of shadowing to become accustomed to the needs of each resident, I was not granted this. Instead, I was thrown into the deep end; or shall I say shallow end, pushed into cooking and cleaning every shift (roles which were once carried out by designated house keepers, before the cuts). This issue came to the forefront of my attention when I was still in my ‘shadowing period’; as I was cooking, I was asked to supervise three residents with severe epilepsy. Needless to say, this was completely out of my comfort zone, and having as I had no training in administering buccal epilepsy medication, it was dangerous.

Further to this, low staff levels meant that residents were not able to ‘be a part of their local community’, as stated on the company website. For a building with nine residents, staff numbers could range from four to nine. As some of the residents need two members of staff whilst accessing the community, the number of staff left in the building would be unsafe. This was realised when a resident was left to sit in his own urine as there was no member of staff to supervise an epileptic resident if they were helped to change. He was left like that for an hour.

When not sat in their own bodily fluid, residents can look forward to doing nothing all day. I asked every shift if I could support a resident in the community, for the majority of shifts, I was met with the same response; “they don’t have the funding”. Despite this funding excuse, there were three residents who accessed the community daily (without the ‘right level’ of funding), because they were difficult to handle when agitated. The manager of the houses suggested an activity for a resident of tidying his room with staff- he was physically disabled and could not participate in this activity. This manager also asked staff to put the same resident to bed at three in the afternoon, due to lack of staff.  This convenience driven support work thoroughly disregards the company values of ‘Choice & Respect’. Instead they opt for the illusion of choice, displaying pictures of residents out and about from eons ago. These photographs, although charming for visitors, filled me with heartache on every shift, knowing that residents once had a fulfilling and busy life, now sat in front of the TV for hours on end.

This company go on to claim that they “believe everyone can do amazing things and we will work creatively to support this”. Nevertheless, I know this to be untrue, for, despite my persistent pleas to provide a very intelligent resident (who had suffered brain damage) with well-planned and personalised rehabilitation, this was never granted. In its place, he was frequently left to wander the hallway and brood alone. This was the most harrowing resident experience that I encountered, leaving me in tears frequently. Personally, it appeared that he had been left in the home to rot.

According to The Care Quality Commission’s guidelines – based on the Care Act 2014 – “residents must have their nutritional and hydration needs met, including: dietary intolerances, allergies, medication contraindications”. This, to my knowledge, was not met in this home. A resident, who had a suspected gluten intolerance, was repeatedly given gluten. When I took charge of this issue and demanded that they had gluten free alternatives and did not take part in ‘chippy teas’, I was told that I was being sanctimonious and to stop. In turn, this resident was fed gluten again, started to complain of stomach pains and suffered with diarrhoea. Even when I did manage to enforce a gluten free menu for this resident, there was no education about gluten provided, which led to staff ‘accidently’ feeding her gluten containing foods. In addition to this nutritional neglect, residents were consistently fed insalubrious meals of takeaways, canned macaroni cheese and butter-saturated mash potato. When I complained about the lacking nutrition, I was laughed at and told that the residents should be able to eat as the “average person eats”.

What’s more, medication faced neglection. One morning shift, a resident woke with seizure-like symptoms, low level but noticeable. As noted in his personal protocol, after thirty minutes of displaying seizure symptoms, he must be given rescue medication. After four hours (and insistent nagging from myself), management only just agreed to provide him with this medication. Previously they had argued with me that the medication would make him docile, opting rather to leave him in discomfort. It was lucky that he even had rescue medication in the medical cabinet, since, in spite of procedure set in place, the medication was not being checked daily. A colleague once told me how they got home and realised that they had rescue medication on their person and was not able to return it until the morning. Should this particular resident have gone into seizure, they technically could not use another’s medication and the ambulance would have to be called straight away.

While staff who give medication are trained, they still make severe mistakes. For example, the manager of this home left open, measured medication out in the nurses’ office, and left the office door unlocked. When they returned to the office, the medication was no longer there. Thankfully, a resident, who obsessively tidies, had thrown it in the bin and not ingested it. Now this situation has a myriad of misdemeanours, to name a few; leaving medication unattended, leaving the door unlocked, leaving personal information unsecured. However, that is not all, the manager went on to blame a member of staff who was not in the building at the time. This, again, completely disregards the company value of ‘responsibility and accountability’.

In February, this same manager locked the bedroom doors of all residents in the night. One of the bedroom doors lock broke. A resident was stuck, alone, in their bedroom whilst a locksmith was called. This was before my time, so I am, naturally, going from what information I could gather. One source stated that this may have been because one of the more nocturnal residents was trying to enter every bedroom. This is gross misconduct, yet it went ignored. This did not surprise me. This is the same manager who lied to a family about how their son had broken his nose, keeping hidden the fact that another resident had pushed him. This manager also concealed financial abuse. When a resident had money stolen from them, it was not reported to his financial appointee, his mother. Management decided it was best to deal with this in house and cover up any wrongdoings.

Training in this role is extremely poor and never time sensitive. Every member of staff should have training in the ‘Safeguarding of Vulnerable Adults’ (SoVA) before shadowing. I worked there for six weeks before I received any basic training. In this home, there were residents with so called ‘challenging behaviour’, that were occasionally violent. Therefore, it was important that staff knew how to protect themselves and others. Positive Behavioural Management (PBM) was the system of choice here. Although there were two residents who required PBM trained staff to work with them, there were members of the night staff who were untrained in both SoVA and PBM. Further to this, there were numerous nights shifts that were carried out by non-buccal medication trained staff. Management allowed this as there was a trained person stationed next door. In reality, this was inadequate, as when in seizure, every moment counts. Leaving the house to obtain a trained member of staff would drop staff levels to one, meaning that should anything else happen in the home, there would be no way to handle the situation.

The problem is, the management know when people are visiting, be it inspectors or family; therefore, they can present the home in a positive manner. Instead of holding themselves accountable and endeavouring to improve, almost everything was swept under the carpet. This ensured the company retained its reputation, appeared to attain its goals and continued to show a profit. To enhance their profits, they did all they could to lower expenditure, mainly through a low staffing level, budget training, cutting community hours, and above all, shrink salaries. Support workers are paid eight pounds per hour, even on the night shift. Moreover, the treatment of staff did nothing to subsidise this. I was once asked by a manager to climb into the hazardous waste bin to clean up after someone had not sealed a bag properly. Obviously, I declined-much to her disgust- and she went on to suggest that I was not a “team player”, as other members of staff completed their share of this. I congratulated on them on completing their ‘cleaning toxic waste’ badge and suggested that people take more care with tying the bag. Eventually the manager left me alone and, surprisingly, did not ask me to complete any more ridiculous tasks.

It is easy to see why some care workers have become so careless. When profit comes before people, there will always be an environment of resentment and disillusionment. Most people enter this industry because they want to make a difference in someone’s life, then are laughed at by senior members of staff. I left to save my sanity, I cried after most shifts. Whilst this may because I am awfully sensitive; I believe that this is a common trend with support workers. It is hard to stay emotionally neutral towards residents, you spend a large amount of time with them and attend to their needs, you become invested. Personally, all I wanted was for residents to live as they were promised; to reach for their goals with ambition and imagination; to be granted choice and respect in how they want to live; to feel part of a family with inclusivity and support; to feel safe with well trained staff who had honesty and integrity and; be attended to by management who took responsibility and accountability for their actions.