What is going wrong?
It is impossible for the CQC in its existing form to cope with the level of poor care and abuse that is being reported. For example, care assistants are carrying out a great deal of the hands on care. Qualified staff are involved with care planning, dealing with relatives, doctors and general overseeing.
Before continuing I think we must look at the role of the care assistant and how its designation has been perceived over the past thirty years. It is here that I must bring in my personal experience: i have no doubt that to most people outside the caring profession this will come across as unbelievable. However, I give that view knowing that I risk being accused of hyperbole. But it is the truth – it must be told.
*Back in the late seventies I worked in a large Psychiatric hospital that also dealt with care of the elderly. The care of the elderly was split into two divisions, one was wards that went under the term of, ‘pre senile dementia’ which dealt with patients that were mostly able to walk, and the other was wards for full-blown dementia where patients sat in geriatric chairs, or chairs in the ‘Day room ‘ area all day, a dreadful thing to witness I assure you! Back then the role of the care / nursing assistant was very much hands on. A culture had developed among the, ‘Trained Staff’’ that Care/Nursing assistants were there not to support the trained staff but, to be delegated to carry out all the hands on work. This meant in practice that The Charge nurse sat in his office and did the ‘Paper work’. The deputy Charge nurse would help him, the Staff nurse would occasionally come out of the office to delegate to two Nursing assistants (Of which I was one) the task of caring for 35 doubly incontinent patients, and among the stench and utter confusion we tried but, we failed miserably. I live with that failure on my conscience daily.
I retired in 2008. However, I am still getting reports of totally inadequate staffing levels and Care/Nursing assistants treated in a similar way. There is clearly a deficiency in the way that some Care/Nursing homes are being monitored. It is my belief that a culture of secrecy has developed in homes that offend. It works this way, Staff feel afraid to speak out for fear of losing their jobs or being ‘marked known and watched’. Sounds paranoid yes, but nevertheless it happens.
What, for an example, can a care worker who is witnessing neglect and abuse and is told by corrupt managers, “If you speak out we will engineer an allegation against you?” do? Here we have total disempowerment. That Carer knows that none of the whistle-blowers have been re-employed, they are silenced by fear.