Saturday, 7 October 2017

Grief or Gruff

Grief
This week I was talking to a member of the public who was still reeling from having been barred from visiting their mother who was now living in a care home.

Their mother had recently been diagnosed as having dementia and had been relocated from hospital to a local care home.

The care home on the CQC website is rated as requiring improvement and the CQC’s own report (published July 2017) had concerns regarding the safety of the service.

Mr B (who I was speaking to) had raised a number of concerns in the 8 weeks his mother had been living at the home, regarding his mother’s care and had asked a few questions of the staff involved in her care.

Last week he received a notice (not a letter) from the Manager of the home stating that he was no longer welcome on the premises or to speak to staff working in the home.  They had essentially prevented him from visiting his own mother.

Mr B is allowed to collect his mother on a Sunday so they can attend church together but he must be escorted to her room and escorted of the premises, all whilst not being able to even enter into common curtesy conversation…

Firstly, given that many homes are understaffed this doesn’t appear to be a good use of resources.

I honestly cannot believe nor understand how in 2017 we are still hearing about Relatives being banned from visiting their loved ones in care homes across the UK, despite an increase in awareness not just of how wrong this truly is but of how the standard of care could improve across the care industry.

In 2016 the CQC (regulators of Care Services) published Visiting Rights for Relatives to somehow prevent these care providers banning loved ones yet somehow a tear later we are still learning of loved ones being prevent from visiting.

So, you’re thinking how then with guidelines by the regulators of Care Services that states Care Homes are people homes and their family and friends should not live in fear of being penalised for raising concerns (as quoted from Andrea Sutcliffe Chief Inspector of Adult Social Care) are relatives still being barred from Care Homes across the country?

Our Chief Inspector of Adult Social Care, Andrea Sutcliffe, said:
“Care homes are people’s homes. They, their family and friends should not live in fear of being penalised for raising concerns.”

In the letter received by Mr B it stated that the home and the manager was invoking their Habitual and Vexatious Complainants Policy*.  This apparently enabled the Manager to barred Mr B from the premises.

They were kind enough to enclose a copy of their policy in their notice, from the moment you start reading it raises concerns

*Extract from Policy
1.    INTRODUCTION
Habitually demanding or vexatious complainants, and/or people who exhibit habitually demanding or vexatious behaviour, are an increasing problem for [name of Service] staff.  Handling such people or complainants could place a strain on time and resources and cause unacceptable stress for staff, who may need support in difficult situations.  The following procedures set out the [Providers Names] policy in dealing with such people or complainants.  It must be stressed that the vast majority of people who do come into contact with staff employed by [name of service] do not display such behaviour.  This procedure is for the small minority who do.  Execution of these procedures would only take place in exceptional circumstances.

Having spoken to Mr B and taking the time to actually listen I felt that this was an important point to make

Was Mr B being Gruff or was he experiencing Grief?

The Facts of the matter:
Mr B’s mother was diagnosed with dementia 11 weeks ago, 3 weeks later she was transferred from hospital to a care home where she has now been living for 8 weeks.

His mother is living in a service rated as Requires Improvement by the CQC in their published report dated July 2017.

The CQC Inspector also had concerns regarding the Service regarding its ability to provide Safe and Effective Care.

I spoke to Mr B about his complaints and concerns they did not appear to be out of the ordinary nor did I think that they were unrealistic or unreasonable:
      i.        Mr B’s mother’s movement sensor mat was in front of the TV in the room, whilst she was sat on the opposite side of the room in a lazy chair – Mr B asked whether or not it should be placed in front of her chair.
    ii.        Mr B’s water jug and cup was on a cabinet near the door – not in easy reach for Mr B’s mother to easily hydrate herself – Mr B asked for it to placed on the table next to his mother.
   iii.        Mr B’s mother’s teeth were in a glass in the en-suite not in her mother at 10am – Mr B asked how his mother had managed to eat breakfast and the biscuits the carer had apparently given her when she had no teeth in.
   iv.        In relation to iii. Mr B raised concerns over when his mother had last been fed or able to eat.

My take on the situation:
When I was talking to Mr B, I found he was still quite tearful when discussing his mother.  He spoke so fondly of her and of his wishes for her.

In my experience I found Mr B still to be in the throughs of grief.  Grief does not begin at death.  Grief is a natural response to losing someone or something that's important to you. You may feel a variety of emotions, like sadness or loneliness. And you might experience it for a number of different reasons.

There are 5 stages to grief
o   denial,
o   anger,
o   bargaining,
o   depression and acceptance are a part of the framework that makes up our learning to live with the one we lost

Mr B I felt was still in the initial stages denial and anger.  So, when dealing with the Care Home he was being blunt in his discussion and it is important to remember that in truth anger has no limits. It can extend not only to your friends, the doctors, care professionals, your family, yourself and your loved.

However, instead of the Care Home supporting Mr B deal with these emotions and providing him with time and comfort they impacted his grief by barring him from visiting his mother.

Care Providers have a responsibility to both their service users and to their families yet they appear ill-equipped and lack training in the basics of grief.

Yes, we need to treat staff and the service with as much dignity and respect as we can, but in turn respect is earnt and not a given.

None of Mr B’s concerns appeared to be Habitual and Vexatious but the manager was still able to instigate the policy and prevent him from visiting his mother.

If the staff or the manager had been better equipped to recognise the signs of grief and deal with grief this banning and many others like it may never have occurred.  The failing here is quite clearly the Home, the Service Provider and the Manager for not better training their staff to be able to manager and deal with this natural set of emotions.

I also personally feel that Mr B was well within his right to question the safety of the home and to question its staff in their “care” of his mother.  An open relationship with staff is best for your loved one.

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