Residents at a care home are "at risk of abuse" after unexplained injuries were not investigated by staff the health watchdog has found.
Inspectors from the Care Quality Commission (CQC) said Charnwood Oaks Nursing Home in Shepshed, Leicestershire, requires improvement.
A report added Covid-19 measures at the home were leaving people "at risk" of catching the virus.
Operator Prime Life Ltd said an action plan to improve the home was in place.
According to the Local Democracy Reporting Service (LDRS), before the inspection in August the CQC had received a number of concerns about the 79-bed care home.
Inspectors found Prime Life Ltd, which operates the home, was not consistently protecting its residents.
The report read: "Unexplained injuries had not consistently been investigated to find a cause.
"For example, one person who had a visible bruise, had no records that evidenced these bruises had been noticed by staff or if any follow up care was required.
"This put people at risk of abuse."
'Not enough staff'
Inspectors noted while residents "had never felt unsafe" in the care home, there were not enough staff to ensure all areas of the home were monitored properly.
The report said the measures in place in Charnwood Oaks were leaving people 'at risk' of catching the virus.
This included protective equipment not being used for certain tasks.
Inspectors also said risk assessments had not been carried out to protect patients and colleagues when staff had refused Covid-testing.
A spokesperson for Prime Life Ltd said: "A change in management and a thorough action plan has been put in place, bringing about an immediate improvement to the quality of care.
"We are confident that their continued efforts will bring a sustained high quality of care for all of those who live, work and visit the home and we look forward to the CQC returning."
Staffing issues are behind a lack of available beds in Guernsey's care homes, a provider says.
CI Healthcare said the industry was "doing everything" to recruit more people, but staff shortages and island housing rules were causing problems.
It said some homes were considering reducing beds due to the shortages.
The problem has caused a bed shortage at the Princess Elizabeth Hospital, with about 30 people in hospital who should be cared for in the community.
Nick Trott, from CI Healthcare, explained the issue was not unique to Guernsey, with the industry struggling to find staff across the UK and Europe.
He said his group would be willing to build and invest to expand their homes if they had the staff.
image captionThe issues have had a knock-on effect causing bed shortages at the Princess Elizabeth Hospital
However, Mr Trott argued they had the "additional hoop to jump through" of the island's housing licensing system, which also created problems in recruitment.
He said: "We're doing everything we can to encourage staff, but they're just not there.
"Some of the homes... are even considering reducing their bed stock in line with the amount of staff they can find."
'Gold dust carers'
Issues with recruitment have been exacerbated by Brexit and the coronavirus pandemic, President of the Committee for Employment and Social Security Peter Roffey said.
He explained the committee had previously invested in expanding care capacity, but it was "only one part of the picture".
Deputy Roffey said: "You can invest all you like, if you can't attract the staff... that is a problem.
"We need to be treating carers like gold dust, because I don't think we have given them the status or priority that we should have done over the last 20 years."
A NEW study has revealed that care home workers felt “helpless” and that the lives of dementia patients suffered during the Covid-19 pandemic.
The research, by the University of Bradford, laid bare the situation in care homes during the pandemic, and found care was inhibited by a “lack of clear guidance” from Government.
The headline findings of the research were: fear, confusion and a lack of guidance; detrimental impact on quality of life and relationships; staff feeling unseen or under-valued by society; and that staff found creative solutions amidst uncertainty and finding the positives in a challenging environment.
It found that “fear, uncertainty and a lack of clear guidelines were the most vivid memories of the early weeks of the pandemic and the first lockdown” and moving forward frequently changing advice made making the right decisions on care difficult.
It also found that “staff had to deal with unprecedented circumstances whilst also coping with their own fear and grief and, increasingly, with feelings of guilt and helplessness”.
Even in homes where there were not Covid outbreaks, implementing social isolation brought up “ethical dilemmas” around the human rights of patients.
One participant in the study said: “We felt just very overwhelmed that there was no clear direction.
“There was a lot of questions being raised by family members that staff didn’t have answers for. Questions were also being raised by staff around their safety and wellbeing that we didn’t have answers for.
The study was started after many in the care sector felt the issue of Covid and dementia in care homes was not acknowledged by Government at the start of the pandemic, with more focus on hospitals.
Dr Andrea Capstick, the study’s lead author, said: “We invited participants to share their experiences of caring for people living with dementia during the Covid-19 pandemic through interviews, discussion groups or written accounts.
“It is now clear that when the coronavirus pandemic hit in March 2020, there was an unprecedented impact on care homes for people living with dementia.
“Care homes were being ‘left to fend for themselves against coronavirus’. During the first wave around half of all coronavirus–related deaths in England are believed to have been care home residents, 75 per cent of them died in the care home where they had been living.
“Care home staff have experienced heightened stress and burnout and their mental health suffered during the pandemic.
“People with dementia often do not retain information and are not able to understand the reasons for measures such as social distancing, removal of family visits and Covid testing.
“They may repeatedly ask for such measures to be explained or become upset because they think relatives don’t want to see them anymore.
“These measures were, then, extremely difficult to implement and often had a profoundly negative effect on the well-being of the people with dementia concerned.”
Providers say lenders have ‘no appetite’ for industry battered by Covid and staff crisis
Care homes are facing a credit crunch with banks refusing to lend money or provide new services for fear that the care sector is about to crumble, senior care leaders have warned.
A survey of care providers in Hampshire found that 20% had been told their bank was concerned about their long-term viability. Several reported that their bank said they had “no appetite for the care industry” and had refused basic services such as additional accounts.
Nadra Ahmed, the chair of the National Care Association, said providers elsewhere were under similar pressure. “We haven’t seen surveys but I know these conversations are beginning to be held across the country with all banks. Some a bit more aggressive than others. Definitely we are hearing that providers are beginning to feel the pressure.”
Care providers are reluctant to reveal any problems to their local authority clients or the Care Quality Commission for fear of being put into special measures or losing care contracts. Almost half of the care homes that responded to the survey by the Hampshire Care Association (HCA) said they were concerned the current crisis could put them in a high-risk position with their bank or lender.
A fifth reported their bank or lender had been in touch to raise these concerns directly. While some banks were supportive, others had put them under pressure including sending “threatening letters”, one provider said, expressing concerns about care providers’ long term viability.
The report quoted providers saying banks did not want to work with adult social care organisations. “[We were] told the bank does not have an appetite for the care industry,” one provider said. “[They raised] concerns re longevity of care homes as a viable business,” another said.
Andrea Pattison, the HCA executive board member who led the survey, said: “This isn’t just an issue for one or two banks or one or two providers. The majority of the sector is made up of small- and medium-sized businesses, and the government needs to step in to stop banks from foreclosing viable businesses, imposing adverse conditions or withdrawing funding.
“A failure to do that would be a threat to the adult social care sector overall and by extension the NHS, who rely on us to deliver great care.
“It was a shock to hear providers saying their banks weren’t interested in social care as a sector. That was intensely concerning.”
Ahmed said the crisis in social care was becoming ever more acute. “Any resilience that providers had, pre-Covid, was eroded because of the fiasco around PPE and everything we’ve been through before funding was made available,” she said.
On 30 September, the Infection Control Fund, a pot of £600m to pay for PPE for social care firms, will end. “We don’t yet know if that is going to continue,” the industry body Care England said.
The gas price crisis and labour shortages are also putting social care under pressure, Ahmed said. “Heating does not go off in a care setting,” she said. “This is a time of reckoning. As a matter of urgency, the health secretary needs to look at creating a sustainable social care market and bridging the gap between resources and demand – not just money but the workforce too. They are exhausted and anxious and being offered better paid jobs as Amazon delivery drivers.”
The survey comes after months of concern in the sector that insufficient financial help during the Covid pandemic will see care homes and home care providers going out of business, leaving vulnerable people without care.
Analysis by the Liberal Democrats shows social care services face a £1.7bn Covid black hole. Local authorities in England spent £3.2bn on adult social care during the first year of the pandemic, with money going on PPE, extra workers and dealing with extra demand. Yet they received only £1.49bn of extra Covid-19 funding from Westminster, according to Lib Dem figures based on research by the House of Commons library.
“More than 1.5 million people are now missing out on the care they need and many are stranded in hospital, unable to leave because the follow-up care just isn’t there,” the Lib Dem health spokesperson, Munira Wilson MP, said.
UK Finance, which represents banking, said the survey did not reflect its conversations with people in the sector. A spokesperson said: “Lenders understand the current pressures on the social care sector and are actively providing support for viable businesses. As responsible lenders, finance providers will regularly be in touch with their customers to check on their status and see if any assistance may be required.”
The government said it would encourage banks and lenders to take a flexible approach to their customers. Local authorities would have access to sustainable funding for core budgets at the spending review.
A government spokesperson said: “We are committed to the delivery of world-class social care, and the new £5.4bn funding for the sector will put in place comprehensive reforms that are sustainable and fit for the future.”
Michael Gove, the new Secretary of State for Levelling Up, Housing and Communities has praised care workers at a care home for “tirelessly” working throughout the pandemic, after a resident's relative wrote to him about her husband’s excellent care.
The Surrey Heath MP visited Lakeview Care Home in Lightwater, Surrey and thanked its staff for their efforts during his visit which was prompted by a letter from Mary Kearney who highlighted the great care her husband Kevin Kearney received.
Michael Gove said: “Lakeview is a brilliant, passionately run care home, and I was delighted to see first-hand the dedication shown by all the staff who have worked tirelessly throughout the pandemic to make sure that residents are safe and healthy.
“I am so grateful to Inder Hanzra, the general manager, for taking the time to show me the home’s exemplary facilities, and I look forward to returning soon.”
Inderpreet Hanzra, general manager at Lakeview Care Home, which is run by Hallmark Care Homes said: “It means a lot to myself and the team that Mary is happy with the care that we provide to her husband and wrote to Michael Gove personally to acknowledge us.
“The team has worked so hard throughout the pandemic to keep everyone safe, happy and engaged and I am immensely proud of them all.”
During his visit, Mr Gove asked staff and residents about the government’s latest policies including the government's introduction of mandatory Covid vaccination for all care home workers.
Health secretary Sajid Javid: 'Pandemic changed everything'
Michael Gove's visit comes days before Health Secretary Sajid Javid brought together health and social care leaders for a summit to help shape reform and told them "we can't carry on with business as usual".
Mr Javid invited senior and local leaders to seek their views on how reforms can be delivered.
After the summit, Mr Javid said: “We can’t carry on with business as usual, that’s why today I’ve brought together vital leaders and experts from across the health and social care world to hear their views on how we deliver necessary reforms to meet and overcome the challenges we face, and I thank all those who joined.
“The pandemic changed everything and left us with large backlogs. It’s a huge challenge, but the last eighteen months has shown what we are capable of achieving when we work together towards a common goal.
“I’m confident we can tackle waiting lists and deliver the ambitious reforms needed to help our health and social care system recover and move forwards for the better from this wretched pandemic.”
Improving the understanding of how pain affects and changes the behaviour of people living with dementia must form part of the education available to healthcare professionals and family members, says the CEO of medtech company, PainChek®, Philip Daffas.
“Pain tops the list of physical reasons for behavioural changes in people living with dementia*, but it is often poorly recognised and undertreated because of cognitive and communication challenges,” says Philip Daffas of PainChek®, which is the world’s first intelligent pain assessment tool – a hybrid model that uses both artificial intelligence and smart automation, and analyses facial micro-expressions indicative of pain.
“This leads to behavioural and psychological issues, unnecessary prescribing of antipsychotics, and decreased quality of life. Effective assessment and management of pain is crucial to better support high-quality care. With the global population of people living with dementia set to triple by 2050**, everyone, especially the social care workforce, urgently needs support and information about the signs and impact of pain. This also includes how to identify and manage it, to enhance quality of life for people living with dementia and improve the understanding of their carers and loved ones.”
Speaking on World Alzheimer’s Day (21 September 2021), which this year is talking about the ‘power of knowledge’ surrounding dementia and how it affects behaviour and memory, Philip says more needs to be done to educate the thousands of people touched by Alzheimer’s Disease and other forms of dementia.
“Pain causes significant distress and discomfort for everyone, and for people living with dementia, untreated pain is a significant problem that affects their quality of life and behaviour as they are very often unable to communicate their pain,” Philip says. “It is a daily challenge for carers and healthcare professionals to assess pain in non-communicative individuals.
“Knowledge is power when it comes to pain assessment; and the use of technology to generate and collect meaningful data holds the key to addressing the shortfalls in pain assessment, and helps stakeholders to better understand the individual needs of each person living with dementia.”
Philip believes ensuring those living with dementia and potentially in pain are effectively assessed is critical: “This has been the main driver of PainChek®’s latest research, published in our whitepaper: ‘Pain & dementia: common challenges for care managers’.
“For this, we investigated the complex relationship between pain and dementia, examined how pain affects the behaviour of people living with dementia, and the main issues with assessing pain and how these can be overcome.”
PainChek® uses artificial intelligence to detect the presence of a face and landmark facial features, and then applies in real-time a series of algorithms to detect pain-related action units in images captured through a three-second video. This data is combined with observed non-facial indicators of pain imputed using a series of digital checklists by the user, to enable automatic calculation of a pain score and the assignment of a pain intensity level.
“PainChek® provides real-time data through a medical device in their pocket, and a unique colour-coded pain chart output for each care home resident,” explains Philip. “The system also generates monthly management reports for users, which provide care facilities with data on key statistics including tool utilisation, pain assessment frequencies, and distribution of pain. Other key assessment indicators such as follow-up times and outcomes can be accessed as part of the suite of PainChek Analytics.
“Whilst artificial intelligence is sometimes seen as taking away the human touch,” he adds, “PainChek®’s use of the technology has the opposite effect, by empowering care providers to make informed decisions about pain management and treatment and use the data to plan person-centred, long-term care, as well as giving a voice to those unable to verbalise their pain.”
Research highlights challenges faced by social care workers during COVID first wave
New research from Keele University has highlighted the key challenges that workers in the social care sector faced during the first wave of Covid-19.
Social care workers shared concerns that early responses to the pandemic, driven by short-term solutions, did not meet the needs of service users, and also expressed concern about the long-term impact of such changes.
The research, led by Dr Tom Kingstone, with Professors Lisa Dikomitis and Christian Mallen, from Keele University’s School of Medicine, found stories of resilience and rapid adaptation among social care workers. However, there was a deep concern about how new ways of working would impact on service users, particularly the most vulnerable, and what the social work profession would look like post-pandemic. Read more
MPs ignore public consultation and vote for compulsory vaccinations for care home staff
MPs have approved regulations for all care home staff in England to be vaccinated against Covid, despite the government holding a public consultation which found 57 per cent did not support mandatory vaccination.
The government carried out a public consultation earlier this year. Eleven per cent of responses were from care providers, with 28 per cent from care home staff, 23 per cent from the general public and 23 per cent from care service users and their friends and family.
Forty-one per cent were supportive of compulsory vaccination and 57 per cent did not support the proposal. Two per cent were neither supportive or unsupportive. Read more