Case Studies

Care Campaign for the Vulnerable is supporting families coming to us reporting unfair evictions in care homes. We understand the majority of care providers and professionals work hard with families to try and meet loved ones care needs and will only serve notice if it's in their best interest to do so but worryingly, our organisation is seeing a significant increase in ''revenge'' evictions when families say they raise legitamate concerns about care standards as well as lack of communication on the health and well being of loved ones during the Covid lockdown.

''Our Dad is currently a resident in a care home. He has degenerative conditions - Parkinsons with Lewy Body dementia. His family found out on 28th January 2021 that due to a ''breakdown in communication'' between the home and us (his family unit) that the home have decided to terminate Dad’s contract, with no consideration for his wellbeing – this seems to be personal now towards us without considering dad. The care home manager and Regional manager for the provider have both admitted that this is not in Dad's best interest to be moved, however they have gone ahead and served notice anyway. The areas we would like investigated are:

• Communication with families
• Management of the pandemic and supporting individual needs rather than a blanket solution for all
• Documentation of incidents
We are a very close family and before the pandemic Dad had a visitor every day. When the pandemic hit, the home were very reluctant to communicate and offer families proactive support. As we couldn’t see Dad we wanted updates, not just to know he is 'fine', we wanted to know how he had been, how his behaviour and mood was, if his weight had changed, common topics that any loving family would want to know. When we requested this we were told, by management, that they had no duty of care to families and why would we want such detailed information– this in itself shocked us, my question back would be why wouldn’t you want this information, however the shock came when both of the managers said that this level of information wasn’t possible and if we didn’t like it we were free to find another home (I have this on email). The lack of compassion and collaboration is astounding.I raised this further with the care provider and the senior management team member, he admitted his behaviour was inappropriate and we had a meeting and came to an agreement that we would have a regular call with a nurse, using a form that managment would create and have a regular catch up call – this has been hit and miss and the care home have not followed through on their promise.

The communication has broken down further more recently because we have asked questions, which as Power of Attorney for Dad we have a right to ask. Since the pandemic, like many other patients, Dads health has seriously declined, especially his mental health. Just today we have had Dad talking about suicide and wanting to end his own life because he can’t have contact with his family (I have this on video).

''Our Dad's power of speech is now very limited so he has difficulty communicating.'' Daughter.

The care home has a porch facility to enable visiting however the door used has wire in (as per the picture) which for someone with tremors in their eyes due to Parkinson’s this is debilitating. As you can see the glass in the door not only has wire but also appears smeared and dirty. We have struggled with the setup however have accepted it as we were just grateful we can see our Dad in the flesh.

Part of a letter sent to the family from the care provider, "What you are now asking is not sustainable. We can and do meet your father's needs but cannot meet your needs. Clearly we will never meet your ongoing expectations, therefore if this is unacceptable to you then I would suggest to find an alternative placement for your father”. Care Provider

Christmas day was a turning point as Dad actually struck a member of staff out of frustration because he wasn’t allowed to reach out to us, his children, and couldn’t really hear or see us properly. Dad has insight and instantly burst in to tears as he knew what he had done – this is traumatising and continuing with this set up is cruel. We raised this with a staff member and asked if we could investigate a personal visiting plan for Dad to enable him to enjoy the limited time we get (30-45 min visit once a week) again this suggestion got shut down. Every suggestion we have made has been dismissed.

After our request got shut down we noticed on Facebook that a resident has ‘been on a shopping trip’, out in the public, yet we could not see dad with full PPE, even though the current set up is doing more harm than good to him. Questioning this has now led to the situation we are currently in as we had a call with management to discuss this and asked for an explanation as to why there were different rules for different people yet we weren’t able to investigate a personalised plan for Dad – we were told by a executive team member it was ''none of our business.''

We put the case forward for the home to investigate the possibility of assessing Dad for the Essential Visitor approach (as per the NHS website as our Dad falls into at least three of the categories. Again senior managment dismissed this and said – ''I could but I know the result it will be a no….'' this was said straight away and even before it was given any thought. This lack of respect for family’s wishes is distressing in such an emotive situation.

It states on NHS website for 'Essential Visitors' - Essential visitors are any family members or friends visiting a resident in pressing circumstances. These include a need to prevent or respond to a decline in health and wellbeing, in times of distress, or in circumstances approaching end of life. Essential visits should be supported at all stages of the pandemic, including in lockdown. Care homes are asked to generously support these visits. The care home manager should support you to have essential visits if these circumstances apply to your loved one. Or you can ask the manager/senior staff member for essential visits if you are really concerned about the wellbeing of your loved one.

''Our wonderful Dad before he went into care...''

Circumstances that allow for an essential visitor include:

•where there is concern that the resident’s health and wellbeing is getting or will get worse

•?where visiting may help with communication difficulties

•where visiting will ease significant personal stress or distress for the resident and/or their family

•other pressing circumstances – for example, where there is concern that the resident may be approaching end of life.

When it comes to deciding if an essential visitor is needed, distress means that the resident is showing signs of being depressed or withdrawn. It can also mean they are showing signs of anxiety – being anxious or restless. This applies whether or not the resident has a condition like dementia, or a learning difficulty.

The Christmas Day incident is troubling us as we found out by chance that it had not been documented in Dad's notes. We called on Boxing Day to see how he had been and mentioned the incident to the nurse on shift and she advised she had no knowledge and it was not in his notes. I flagged this to another care member team and it has taken approximately three weeks to get confirmation that this is documented – our worry is are there any other incidents which have not been documented?

In October 2020 Dad was found in the car park – he had walked out of the facility – we don’t know how long he had been out, what happened or what the resolution was – he was just moved upstairs so he couldn’t get access to the doors. We have never received any information as to why and what has been done to prevent this happening to someone else. We believe a DoLS was raised but still to this day it is not in place as the manager in our opinion has not done her job properly by not chasing this up. Dad is in her care and it is her responsibility to ensure his safety and what measures can be put in place, are put in place, to protect him, the other residents and staff.

It is very difficult to trust a care provider that is non transparent, un-collaborative and at the sight of any challenge hides their head in the sand or just dismisses families. It is easier to push the problem away and pretend it hasn’t happened rather than deal with it, which is what has happened. We therefore believe this needs to be investigated to ensure things are running properly to protect not just our Dad but other vulnerable residents who may have no advocate or family.

The care home management have defamed our characters, calling us ''nasty and aggressive'' when we are none of those things….we are only passionate about our father's wellbeing and we follow our rights and ask questions to ensure not only his medical and personal needs are taken care of but his mental health is too….if this is ''nasty'' then I am proud of that title. We have always been complimentary to the care staff and never confrontational, however we have asked the management team difficult questions which they have taken as being'' confrontational'', and this has never been the case, we just want to ensure our dad to have a good quality of life, for how long he has left.'' Our father has spoken on video about ''wanting to end it all'' and he ''wants to top himself''.

Prior to Dad moving we had a meeting with the manager of the home, and in this meeting explained how close we were as a family, how we wanted to be involved in dads care and life. Prior to the pandemic Dad received a visitor at least every day, once a day, sometimes twice and we felt like the home was home from home and welcoming. As we visited so much we got to know what was happening with dad on a daily basis as we proactively asked the staff about dad’s mood, sleeping weight etc. We believe up until the pandemic we had a very good and open relationship with the home, the management and the staff. Even during the pandemic we have always been respectful to the staff and complimented them on how they have supported dad and helped him get dressed etc. The management team are trying to say we have made staff cry but this is not true. We have even had staff trying to connect with us personally on social media. We have given the staff treats and many thank you's. Our concerns are with the senior/ management and the running of the home not the individual carers.

Then the pandemic hit.

Everyone was shocked by the pandemic and the home instantly locked down in February. Families were allowed to look at relatives through the window but that was it. At the time we felt this was a very good action to ensure the safety of the residents and staff as no one knew what we were all going to be dealing with.

In April it was Dads' 70th birthday and we sent decorations for his room to be put up so he could at least feel special even though he wouldn’t be able to celebrate. The care home manager assured us the decorations would be put up and used. On the day we visited and sang happy birthday through a window. The home had made him a cake to share with the other residents which was wonderful, however the decorations we sent did not make it up which was very disappointing and the care home manager gave them back – such a small task which would have made such an impact to Dad and the family disregarded. This was very upsetting.

As we could not visit we called on the phone, however the care home phone system in place is not fit for purpose as either no one answers, sometimes it has taken mulitple attempts to get through, or if they do answer the reception on the phone is that bad you can’t have a productive call. We have tried raising this with management and staff to say bring Dad to the phone rather than the phone to Dad due to it losing reception but this seems to fall on deaf ears. We have raised this on multiple occasions to the manager to get this family life line fixed but the phone is still not working correctly (reference recording)

When moving Dad in we gave staff an iphone which we asked them to support Dad in using when he wanted to get in touch and to enable video calling – when the pandemic hit and the home closed we expected this to come in to play. We asked and asked for the team to use the phone to enable us to communicate with dad but again this fell on deaf ears. We both work full time and have families therefore asked for a bit of a routine to be created so we knew what was happening and when and Dad had a bit of consistency and routine – again we were told that this was asking too much and we had to just expect a call when we got one.

Proactive contact as dad has not given permission for Facebook. Dad went into the home with an iphone so we could have contact. The phone never got used and was locked away in the safe. At one point dad wanted the phone and got frustrated and lashed out as he wasn’t given it. It took us complaining we never saw updates of dad for it to start being used.

We were told by managment that the phone would be used to send us updates – photos and videos of Dad at least twice a week (I believe this is what they consider part of the personal care plan)

Log of photos – often these have been prompted by us testing the phone to say ''missing you – not heard from you for a while''.

• September 2020: 26th
• October 2020: 2nd, 7th, 9th, 12th, 13th, 21st
• November 2020: 3rd, 5th, 24th
• December 2020: 4th, 9th, 14th, 17th, 30th
• January 2021: 4th, 6th, 19th, 25th, 27th, 29th
As you can see there is no consistency. There is often a flurry of activity after we have mentioned something to management that contact has slowed down.

Often we are told the phone is out of charge even though this is kept by the nurses and their responsibility to switch off or keep charged

We were told that the home use Facebook to share new stories with families, our Dad decided years ago that if this happened he did not want his personal situation over social media. As we were visiting regular this did not matter to us but as the pandemic hit further this was a life line we did not have. In this situation we hoped that the home would be proactive and share information with us about Dad – photos/videos……this did not happen and we were basically told that it was unfortunate but that was the situation and that was the tool used.

In September 2020 we were called by the home advising us that they had ‘found’ dad in the car park. Dad was based in a lower ground floor room which was meant to be secure. The car park is next to a main road and somehow dad had managed to escape the unit. We asked for detail such as: how long had he been out? How did he get out? What was the resolution to avoid this happening? We never received satisfactory answers or explanations to those questions, thehomes answer to the problem was simply that he was fine andthey would be moving dad to an upper level room so it could not happen again – if dad had taken a few more steps towards the road this could have been a very different story and for us this was a serious incident as the home is meant to be secure on all levels.

There has been limited proactive communication from the home throughout the pandemic and as we felt in the dark and was not receiving information (every time we call we get…''.he is fine'', we then ask more detailed questions like has he slept, eaten etc and then we start to find out the real state of play) so we reached out to the home to ask for some more regular support and structured information. This was advised by the CHC team to try and help us articulate to the care home what we felt we needed to feel connected to Dad, this was meant with a positive sentiment and to try and manage the frustrations we had by not receiving information about our father in light of the fact we could not see for ourselves. The sentiment was collaborative and positive. We did not expect the home to be able to agree to all our requirements however we did expect them to work with us as a family to find the best possible options. Unfortunately, the reply we received back from the care home manager was none of those things."

Care Campaign for the Vulnerable is supporting this family. If you are interested in this case study please contact ccftv.cares@gmail.com. We have seen all the families documentation/emails and recordings regarding their complaints and the reports sent to CQC and health authorities.