Hospital admissions from care homes

Hospital admissions from care homes.

Some strong words and sobering facts in this article from the British Geriatric Society blog.

Residents of care homes have complex healthcare needs, reflecting multiple long-term conditions, significant disability and advanced frailty. Care provided to this complex cohort of people is often fragmented. Day to day care services are delivered to a variable standard often with high staff turnover and limited support from the wider health system.

I would like to know about the figures for admission compared to the general population. I think they need unpicking more to allow for the possible increased vigilance and potential risk aversion of care home staff. Both of which could contribute to the higher rates of admission.

What’s going on at BUPA?

February was a busy month for me, and I didn’t get to the keyboard often. So I’m having an office day catching up with this blog.

Fist thing first check on the bad care reports for February

It may take a while, because it looks like there are a lot. Yes CQC are rolling out their new inspection model, yes they have raised the bar, but I don’t see that as an excuse for any responsible provider. Clearly those that are good and outstanding have been rated as such.

So first week in Feb, two BUPA homes in trouble.

What’s that about, when BUPA clearly have resources, don’t they?

I can guess at the answers, having experience of working for large organisations, but I wouldn’t like to post them here without a lot more evidence to back up any claims and avoid a libel case.

So in general my experience in large organisations would suggest that maybe these areas need looking into-

1-Priorities of the organisation. What is the balance between providing good care and making money?

2-Central focus. Does the centre know whats happening on the floor and vice versa?

3-Branding. Are these BUPA homes or homes that BUPA run?

Dementia Friends in The Walled Gardens of Cannington Tea rooms

It was lovely to hear from Hayleigh at the Walled Gardens tea rooms today, about how attending a Dementia Friends Information session that I had run had changed her families approach to visiting granddad who has Dementia.

Hayleigh attended the walled gardens staff session and had taken on board one of the messages in the Bookcase analogy. Her family had been in two minds about visiting. However after Hayleigh explained to them what she had learnt about the different parts of the brain, and seeing the person as more than their Dementia, they have started to visit more often.

Job Done! Nice one Hayleigh.

For those who haven’t attended a session, see the video below.

To find out more:

Happy New Year!

I hope that everyone has had a happy and restful break. I certainly did, but have had to cram a couple of weeks work into five days in order to catch up!

Hence the lateness of the greeting.

One of the things that makes Christmas for me is the BBC.

It all starts with the Christmas Radio Times, and then Carols From Kings, The Reith lectures, The Royal Society Christmas Lectures and delightfully this year Terry Pratchett and Neil Gaiman’s Good Omens!

The Reith Lectures by Professor Atul Gawande were a huge pleasure this year and I can highly recommend them.

Click here to go the BBC website to listen to them

The first lecture explores the topic of why doctors fail, and explores the factors which affect medicine, Ignorance (lack of knowledge) and Ineptitude (failure to use existing knowledge).

The second lecture is titled the century of the system,  and interestingly describes some simple systems that care and nursing homes would do well to copy.

Lecture three is about the problem of hubris and looks at the issues of aging and death and how society has a problem recognising the limits of what professionals can do.

The final lecture the idea of wellbeing is for me the highlight, and explores ideas around end of life care and assisted dying.

If nothing else, for me, the whole series re enforces the importance of the fact that people providing care need to care. A simple concept,but one that’s often overlooked.

CQC State of Care report Video!

Sorry for those reading offline, but I will be covering this in print next week.

For now though here’s the video from CQC.

Elderly woman died after suffering burns in nursing home bath

This is a very sad story, and my heart goes out to this ladie’s family.

However I can’t help feeling it further shows up the defficiencies in care and nursing home regulation.

The story has been reported by the Health and Safety Executive, after a now dissolved company was found to be negligent.

The worrying element is that highlighted by the magistrate. The directors of the company have walked away from this with a £5,000 fine. Which may or may not be paid by the company, as its now dissolved.

So what is to stop these clearly unsuitable people starting up a new home, if they haven’t already done so?


My Care Service Report and Select-a-Home service will always look into the Directors of care companies and their past.




The Living Later Life Conference

AgeUK Somerset are holding a free one day conference on 26th October at Taunton Racecourse.

Their website says:

This conference will tackle the issues that matter most when it comes to ensuring  a good quality of later life: housing, mutually-supportive relationships, retaining independence and control, enjoying an active lifestyle, health and social care services, living well with long-term conditions and much more.  It will encourage us all to envisage and plan for how we want to live our later life.


Listen to a number of high-profile speakers, including:


  • Sir Andrew Dillon, CEO, National Institute for Health and Care Excellence
  • Professor Ann Bowling, Professor of Health Sciences, University of Southampton
  • Dr Chrystalina Antoniades, Department of Clinical Neurology, University of Oxford
  • Tony Watts, OBE, Chair of South West Forum on Ageing and Founding Editor of Mature Times
  • Conference Chair – Clinton Rogers, Somerset Correspondent for BBC Points West

To book online and for more details visit their website:–events/north-somerset1/

I look forward to seeing you there 🙂

The Smell Test

I always tell people not to rely on the smell of a home as an indicator of quality. Yes an overall odor is unpleasant and a sign of something not being as it should be. However it may be passing odor, and quality of care may still be good.

That said, I visited a home in Southport on Merseyside for a client recently, and the smell at the door was in fact an indication that all was not well when one dug deeper.

Clearly the owners of the establishment hadn’t invested in the business for some time. Sadly a symptom of the financial, political and regulatory system in which care for the elderly is provided.

That’s not to exonerate the owners, who are making a profit, at the expense of the care and comfort of the residents. It’s just a hobby horse of mine about how care is provided in the private sector. Whilst there are standards in law below which the standard of care should not fall, there are no standards which cover how the care should be financed. This allows unscrupulous providers to put profit before care. The decor is an example of how excess funds available after what are seen as unavoidable costs (staffing, food) are seen as fair profit for the owners. Allowing corners to be cut.

The smell and decor alone, still did not provide the full picture of poor care though. Talking to the staff on duty, residents and relatives. It was clear that care was poor, with not enough staff for residents needs, poor nutritional care, and signs of corporate incompetence.

What do CQC think of this home? They list it as compliant, sad but true.

I have made my findings available and reported concerns to the local authority safeguarding team.

Remember that free advice is available to help you find the best care for you and your loved ones.





It’s not rocket science to provide safe warm housing in the 21st Century

Fellow South West Age Action Alliance member Tony Watts OBE contributes this article on the health and well being benefits of good housing for the elderly.

It seems sad to me that government need this spelling out to them in the 21st century. Maybe in the 50s and 60s of the last century, but now!?


Click here for the article

No Kidding Sherlock!

This is a great article, but does state the what’s been obvious to those of us in the business for many years.

Reduced funding from whatever source, has brought margins crashing down. Managers and shareholders aren’t going to let their earnings fall, so its the people who actually provide the care who bare the brunt.

Training in particular has been hit. Yes e-learning has its uses, but as a trained educationalist and nurse mentor, I can only recommend thorough training, with professional trainers in a classroom as the best way to ensure a skilled and motivated workforce.

With regards to pay and other rewards, it’s been clear for some time that the standard of candidates applying for care work has changed. When the terms and conditions working on supermarket tills are better than providing care, what can we expect?

What’s the solution?

If I was commissioning care services, I would ensure the contract contained terms that limited profits for the company and pay for staff who do not provide direct care.

And of course make sure more money went into the system.

You pay peanuts you get monkeys.