It ain’t necessarily so – Should we ever hear call bells in care homes?
with JOHN BURTON
What’s the purpose of a call bell system? Is it for summoning help or is it only for emergencies? Years ago “nurse call” systems were “hard wired”; in other words they had to be installed and wired-in with fixed call points and an indicator board that showed where the alarm had been sounded. Most systems required staff to go to the room where it was sounded in order to cancel it. Some of these old systems survive but it’s a long time since such were the only ones available.
Modern systems are wireless and can be endlessly ingenious and adaptable, and the audible alarm can be switched off just like a mobile phone. It’s no longer essential to have a big board and loud bells, buzzers or screeching noises, so why are they still an unpleasantly institutional feature of so many care homes?
As with many other aspects of institutional life, we get used to it and stop noticing how intrusive it is, but imagine what it’s like for residents. Imagine if you had to live with that noise all the time. I suggest that one reason why we still hear call bells in some homes is that they are being used as a tool of management. A very blunt, clumsy and destructive tool, but a way of keeping tabs on the staff none the less.
It’s important to recognise that some sort of call system is essential in most care homes. Residents need a way of getting help in what they feel to be an emergency or at least an urgent situation. If you feel ill in the night; if someone has had a fall; if you urgently need to get to the toilet and can’t get there on your own. But then there are other less urgent situations in which call bells are used routinely: to ask for help to get up or go to bed, to ask for a drink or some food or “I need my pills”.
In most of these circumstances we should think why whoever is assigned to care for that resident, and knows his or her needs and habits, isn’t already there. Care “summoned by bells” is neither homely nor truly caring, no matter how quickly the call is answered. When I first started in this work there used to be a horrible phrase – “bell happy” – for those residents who persistently rang the bell. Somehow everyone – the residents, the staff and the management – had entered into a common collusion of bad practice. The resident rang the bell; the staff grumbled and either ignored the bell or abruptly cancelled it without giving the resident the attention they were asking for, and the management tut-tutted and never got to the root of the problem.
Even today I hear call bells ignored or used instead of giving personal attention based on a precise and intimate knowledge of residents’ needs and lifestyles. A call system is essential but it doesn’t have to be heard throughout the home, and it can be individually tailored to each resident’s needs and communicate directly to individual staff. And, of course, there can be a record which can be checked if there are any doubts about who called when and what response they received.
We found a different way – Caring Times readers tell their stories
Home manager, South East: If you have an individual plan with each resident, people wouldn’t have to rely on the call bell to get help. You’ve got to have an emergency system for residents but running ordinary care on the basis of call bells is ridiculous. People use call bells for fear of being forgotten.
Some homes feel it’s got to be there to be “compliant” – that inspectors want to hear the bell and see how quickly it’s answered – but constantly sounding call bells are a sign of a failure of care. You should hardly ever hear one. Senior care worker, Lancashire We had some complaints about calls not being answered for ages (which was true) and we had a new system put in.
The company that runs the home didn’t ask us or the residents what would be suitable, and we ended up with a system that did the same as the old one, and probably the same system that they put in all their other homes. The noise was even worse than before – a screech instead of a bell. It was so horrible that we did rush to cancel it but the residents hated it, and I think some visitors were quite shocked. The regional manager was pleased with it and seemed to think it would put an end to the complaints. But what she didn’t realise was that it didn’t improve the care, it just got the call bells answered quicker. The residents started ringing even more than before because they could get a quick answer but the overall result was mayhem. We rushed around from one resident to another just to stop the noise.
It wasn’t until our manager called in the supplier to ask if the volume and tone of the alarm could be reduced, that we learned that the system could be silent and each member of staff could have a little pager which vibrated and the room number or call point comes up. We are now reorganising how we allocate work and those residents who are assigned to each of us can get through to us individually. This means we plan our work much more carefully and the residents hardly ever use the buzzers. They don’t need to because they know that we’ll be there.