Wednesday 15 February 2012

Care Homes: Take Note

"Care homes of various standards acting like muppets"

Care homes. The word 'care' isn't meant in any way to be ironic however we have all been to 'that care home'. As sad as that is the standard in care homes is generally poor. That's not to say there are not good ones, there are, however normally where I say the good outweigh the bad, I don't think this is the case. Good care homes seem few and far between and to say you get what you pay for isn't exactly true. It's more pot luck. The care given ranges from excellent to sheer negligent and for the latter we end up having to alert social services through vulnerable adult forms. It's horrible to see the elderly who have spent a lifetime serving the country and paying taxes left in squalor because the care staff don't give a crap. Invariably there are two sides to every care home. The side that the relatives see during visiting hours and the graveyard shift. During the day, patients are paraded in social areas, full of Amitriptyline and polite, English speaking nurses tend to their needs in full view of anyone who pops by. At shift change they are replaced by a bunch of miserable mis-fits who don't care one iota about the people they are supposed to be looking after. OK, I'm generalising massively and tarring the good ones with a bad brush but in all honesty the good homes rarely call us so I we don't see them. They care for their patients as they should and as a result their patient rarely go to hospital. When they do, they are clean, we get a handover, a full history with matching paperwork, an escort and a smile. Sadly we are more likely to get a seriously ill patient, be greeted with a grunt, no handover, no paperwork, no history and no escort. Our patient is likely to have soiled themselves and been left to suffer. These are the homes I want to Take Note. These are the ones that need investigating. These are these are the homes that should face the strictest sanctions. So, with that in mind to avoid a confrontation with us and avoid an inspection from the local council, social services and the police the following should be noted and followed:

  • Don't leave your patient lying in their own faeces.
  • Don't tell us they were fine an hour ago when they've been dead for 6.
  • Don't put your patient to bed after they have gone into cardiac arrest.
  • Don't negate to start CPR because "We are short staffed"
  • Don't negate to start CPR because "I forgot"
  • Don't call yourself a 'care home' if you're not going to care
  • Don't put coded doors on every corridor and look annoyed when we knock.
  • Don't call 999 just because your patient fell over. Check them first.
  • Don't allow a catheter bag to fill to bursting point.
  • Don't allow a colostomy bag to fill to bursting point. 
  • Don't put tea in the mouth of someone who is dead to cover your arse.
  • Don't call yourself a 'care home' if you're not going to care
  • Don't wait until your patient is septic before calling us. 
  • Don't leave your patient uncleaned for days on end. We can tell. We can smell.
  • Don't look at me blankly when I ask what room we need to go to.
  • Don't look at me blankly when I ask what is wrong with the patient.
  • Don't look at me blankly when I ask for a medical history. 
  • Don't call yourself a 'care home' if you're not going to care
  • Don't look at me blankly when I ask for a medication list.
  • Don't look at me blankly when I tell you the patient has been dead for a long time.
  • Don't hide from me. I will find you. 
  • Don't call us because you want less patients on your night shift.
  • Don't leave your care home staffed by all non-english speaking nurses. 
  • Don't call yourself a 'care home' if you're not going to care
  • Don't refuse an escort to hospital when they have paid for an escort to hospital.
  • Don't forget to feed your patients.
  • Don't wait 15 minutes to call us for someone who has gone into cardiac arrest.
  • Don't lock the patient who is in cardiac arrest in their room and wander off.
  • Don't kiss your teeth at me. 
  • Don't call yourself a 'care home' if you're not going to care
  • Don't refuse to give me your name. 
  • Don't tell me it wasn't your job for whatever question I ask you.
  • Don't lie to me. 
  • Don't let relatives come in and watch us doing a resus.
  • Don't let other residents stand and watch us do a resus. 
  • Don't call yourself a 'care home' if you're not going to care
  • Don't leave your residents sat in the same chair for 15 hours a day. 
  • Don't tell me you're a "residential home, not a care home" as an excuse.
  • Don't take me to the wrong patient.
  • Don't give me the paperwork and medication of the wrong patient. 
  • Don't call us and then wait 15 minutes to let us in the building.
  • Don't call yourself a 'care home' if you're not going to care
  • Don't tell me a patient who is hypo had a BM of 10, 20 minutes ago. 
  • Don't drop your patients.
  • Don't blame your patients. They are in your care.
  • Don't be rude or dismissive to us.
  • Don't blame everything on dementia.
  • Don't call yourself a 'care home' if you're not going to care
  • Don't wait a month to change your patients bed sheets. 
  • Don't forget humans need water. We can tell if you forget.
  • Don't be a carer if you don't care.
This are not me or ambulance crews being pedantic, these are basic human rights. Treat others as you'd like to be treated. Some of the places we visit are verging on inhumane and the sooner something is done to prevent this third world squalor the better. Every single one of the above I have witnessed and can only comment on what I see. Like I said, I don't see enough of the good homes because the patients are well cared for and rarely need an ambulance!

Click the Take Note photo at the top to see the other posts in the series!


  1. Sadly, it's all true! Keep up the good work, maybe someday someone will take notice. Maybe. Someday...

  2. I work in a 'residential' home! I think 'care' isn't in the name deliberately! There are some great care assistants there but also some not so great! Not helped by crap management! It's not the worst place I've seen but also not the best, unfortunately!

  3. Ah yes, the patient who is so sick they must have an emergency ambulance *right now* but then when you arrive it takes them 10 minutes to answer the door, and then nobody knows which patient it is or what room they are in.
    I've not been doing this very long and yet I've already lost count of the number of times this has happened to me.

  4. I now work in social care commissioning, we're the ones going out to investigate when you guys do the Safeguarding referrals. These things shouldn't happen in this day and age, but they do, all too often. And I fear with the financial climate the way it is, fees being squeezed etc, things will only get worse.

    I'm lucky, I work with learning disability providers, things are much better than in older peoples services. That's not to say things don't still happen, but when they do, we bounce on them from a very great height. Life gets very uncomfortable for a while, we make a freeze on placements and serious repeat offenders find themselves with contracts that come to an end. The world of older people's care is unfortunately very different!

  5. you forgot one, don't call an ambulance if a DNR is in place, call the GP! This causes lots of unneeded work for Ambulance and Police and Coroner's Officers.

  6. Safe guarding alerts whilst time consuming are very necessary. There are also many different "care home" types these days from sheltered accommodation right through to palliative care, each is different with different rules and regulations.

    For the crew attending the first response from the establishment is crucial if only to ensure they understand which they are in.

  7. Also don't tell me that there is no DNR in place, let me successfully resus your patient and then tell the doctors at the hospital that the pt has a DNR so that I have to apologise to the family for doing my job properly due to your incompetence


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