Getting it right – all the time

Posted on August 29th, by geoff in Caring Times, CT blog. 2 comments

By guest blogger JEF SMITH

It is a truism that the sort of care residents receive varies very substantially between homes; on this point Care Quality Commission reports no more than put detail onto simple observation. The rather more subtle finding of a recent report from the consumer organisation Healthwatch – or ‘healthwatch’ as they sometimes annoyingly write it – is that ‘The quality of care varies . . . also within the same home’.

What it’s like to live in a care home, the findings from a study which draws on visits to 197 homes carried out between January and April 2017, is not simply saying that places which do good work on, say, involving volunteers or bringing in members of the local community may be less successful at providing general healthcare for their residents or ensuring pain control for people close to death. Again, CQC reports, go some way to separating out such different elements of a home’s performance.

The Healthwatch point is different again. It is that a home which can turn in an excellent show on a Monday morning may have deteriorated disastrously by Tuesday afternoon or even sooner.

Despite the wealth of evidence Healthwatch’s visitors must have gathered, the report is rather weak on actual examples of widely varying standards, but any honest manager knows that one of the hardest tasks for even a good or outstanding home is achieving consistency. Homes which meet their residents’ needs pretty effectively during the day time, for example, can easily fall short at night, since the pool of staff they draw on for both hands-on care workers and their supervisors is quite different after dark. Regular shift and holiday changes can also bring a weakening of the level of service, a deficiency of which senior managers may or may not be aware.

Improving consistency requires eternal vigilance, sound communications and an attitude not only open to but also actively promoting consumer feedback. Walk the floor, keep your eyes open, listen to what people say – or don’t say!

Inspections, it has often been admitted, present by and large only a snapshot of what goes on in a home. The hard lesson for prospective residents – at least those enjoying the luxury of being able to make a genuine choice – is to spend a good deal of time in a home under consideration. If possible spend a night there, and try calling for help in the early hours of the morning. Watch how the day shift come on duty and how the change-over takes place. Does breakfast look and taste as good as last night’s supper? Are your first impressions of caring attention sustained, or does sympathy wilt under the pressure of multiple demands on care staff time?

It pays to take your time; if you move in, you could be there for quite a while.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

2 responses to “Getting it right – all the time”

  1. Bob Ferguson says:

    It certainly does pay to take your time – in particular, taking care not to be seduced by the industry’s annual schmooze-fest, the carefully edited snapshot that is the Care Home Open Day. The sad reality, however, is that, for the majority of those concerned, time will have already run out once the decision on residential care has been taken.

    Caveat emptor could prove an empty warning.

  2. John Burton says:

    What a mess we’re in! You can’t get it right all the time. Nobody gets it right all the time. We’re encouraged to believe that there is one right way of being – living, caring, cooking, cleaning, managing – in a care home. Regulation and inspection is based on one universally agreed definition of good or outstanding. Big brother is watching but misses the signs of abuse and neglect, and even ignores them when warned.
    A good care home is a community or large family where people are living together with loss and illness. And, yes, in a good place they find love, comfort, company, community, friendship and happiness. Nobody’s perfect.

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