Former inspectors Linda Goldsmith and John Burton reveal the plight of family members in residential care

Two former inspectors talk to Natalie Valios about being on the other side of residential care, as relatives rather than inspectors, and the distressing experiences that ensued

John Burton is a social care consultant and a former care worker, manager, inspector, trainer and writer
“Just before last Christmas my father died. He lived his last three years in a care home, and he died in hospital in pain and without dignity, emaciated and dehydrated, and suffering from deep pressure sores. My sister and I spent five days and nights with him at his bedside as he died.

My father had chosen the care home. There were some excellent staff and there were some who were abusive, neglectful and rude. In his first two years there, two matrons came and went, having tried to tackle the problems. A new matron was appointed but left before checks were made on her past. In the months before my father died, a nurse who had applied for the job previously was hastily installed as manager so that the owners could sell the home.

This woman was unsuited to the post and was one of my father’s main tormentors. According to the latest inspection report, she is still running the home.

In July 2004, in response to a Commission for Social Care Inspection questionnaire to relatives, I told the inspector that the home was short-staffed; some staff were unresponsive and insensitive; the dining room was cold and dark; the food was poor; medication was not handled properly; my father didn’t seem to have a care plan and there were no reviews; and he was worried that if he voiced his criticisms it would only get worse. In the subsequent inspection report none of this was mentioned.

On several occasions I went to the manager about incidents of mistreatment and my worries that he was developing pressure sores. In March 2005, after a particularly worrying incident, I wrote to the manager telling her about the continuing abuse and neglect that my father was enduring at the hands of a few staff. I got an immediate response from the manager and a late night phone call from the proprietors. Again my father’s care improved but only temporarily because then the manager left and the owners sold the home. In the final few months of my father’s stay the care deteriorated further.

The home was inspected just before he went into hospital to die. The report gave no indication that the home was poorly run: the standards for care were ‘fully met’. Indeed, the report stated there had been no complaints and the residents were protected from abuse by the procedures ‘in place’.

I was incensed by its inaccuracy. I wrote to CSCI listing 45 complaints against the home and CSCI itself. I received an  immediate reply from the inspector saying that she too was concerned about the home and would inspect it again soon.

Another inspector was assigned to investigate my complaints. But the inspectors appear to have made little progress since, although they claim that they have made my complaints a priority. More than eight months later I haven’t received the results.

After their first investigation of the home, one of the inspectors wrote to me saying that they had found ‘nothing untoward with  regard to abuse of vulnerable adults’. It’s at such moments that most complainants give up. When I protested that if they had read my father’s file they would have surely found my letter detailing abuse, they took 14 weeks to retract the statement,  implying that they were doing so only because I had misunderstood what they meant.

But it’s easy to misunderstand CSCI.

Their letters are badly written, they are rarely signed by the author and are hostile, impersonal and authoritarian. It is unaware of how to relate to an upset and frustrated complainant. One of the inspectors has made an effort to let me know what’s going on and I’m grateful to her.

I still haven’t seen the report of their investigation into my complaints about the home, and I don’t think they’ve even begun to investigate the complaints that I have made about CSCI. However, I have just read CSCI’s latest inspection report on the home. Apparently everything is just fine.

They say that there has been one complaint in the past six months – I assume it’s mine – and it is being investigated.

CSCI is soon to provide star ratings for care homes so that the public will be able to know whether a home is poor, adequate, good or excellent. From my experience as a relative, CSCI needs to get the basics right first. I remain unconvinced that CSCI can tell the difference between poor and excellent, let alone between adequate and good.”

Linda Goldsmith won a local government ombudsman ruling after a long dispute with a local authority.She was a Social Services Inspectorate inspector for seven years until she retired in 1998
“We decided to find a care home for my 89-year-old mother, Louisa, when she could no longer live with my sister – where she’d been for 10 years – because of health problems in my sister’s family. I found a wonderful care home, Mary Court in Battersea, south London, run by Servite Houses. It was more like sheltered housing than a residential care home as every resident had their own flat and front door.

She loved it, but two years later Servite announced it was closing Mary Court. This ended up being settled with a court order ruling that my mum could stay there for the rest of her life unless she needed nursing care to a level that the home could not provide.

She lived happily there until she was 95, when in May 2003 she fell and fractured her right hip and clavicle. She had an operation and was declared medically fit for discharge within two weeks. But we were told that Wandsworth Council wouldn’t allow her to be discharged and five months later she was still in hospital.

Wandsworth said she needed nursing care and Mary Court wasn’t a registered nursing home, even though I had written evidence that her needs hadn’t changed. I sought advice from a solicitor and demanded an assessment. A team manager from Wandsworth carried it out and found my mum to be fit for residential care.

Meanwhile, a continuing care panel had deemed my mum to need nursing care, even though they hadn’t assessed, or even met, her. We went to the High Court which said my mother could go home to Mary Court if I paid for nursing care. I agreed because I thought I could demonstrate within a week that she didn’t need it. And that’s what happened: the nurses said they had nothing to do. But Wandsworth wouldn’t let me withdraw the nursing care and I paid until I ran out of money. It cost £27,000.

We went to the Court of Appeal and my mum was awarded costs but Wandsworth refused to give me the money back. I had to go through the ombudsman and that took two years to find in my favour. Last month he said that on the evidence it was unlikely that my mum had needed nursing care. She stayed at Mary Court happily without it until she died in her own chair last December.

Wandsworth knew that I knew what my mum’s rights were but they thought I would give up. I found myself fighting two legal battles for my mum’s interests, lasting four years. The system is so opaque. With all my knowledge it was so hard and I can imagine that most people finding themselves in this situation would give up.”

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Contact the author
 Natalie Valios

This article appeared in the 7 December issue, under the headline “An inspector in the family”

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