Panorama.S2014E18.Behind.Closed.Doors.Elderly.Care.Exposed
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00:00A care home for the elderly, but where's the care here? And where are the words of comfort?
00:19How often is this the experience of those who are older and vulnerable?
00:24Everybody neglects me, because I'm not their child. I don't want to be like them.
00:35We go undercover to discover what can take place when relatives aren't there.
00:40I'll come in a minute, I just need to help here first.
00:42The challenges for care workers.
00:46I've lost count of the times I've found people lying in urine-soaked sheets.
00:52And what happens when things go wrong?
00:55No! No!
00:57When the caring stops.
01:00She just slapped her. She did. I mean, that's assault.
01:04She's just assaulted that lady.
01:06At this care home, eight staff suspended.
01:10At another, grieving families whose relatives died after neglect.
01:15As a society, we need to say this has got to stop. We can't have this going on.
01:23At a third home, secret filming by a family that captured their grandmother's hours of distress.
01:32As she called for the toilet more than 300 times.
01:37I'd go in there, she'd start crying. She said, I just don't want to be here anymore.
01:42We're living longer and our needs in old age are getting greater.
01:46This is a problem no-one should ignore.
01:49This is a challenge for the whole of society.
01:52There should be no hiding place for poor care.
02:05Night deepens across the capital and at this nursing home in South Croydon,
02:10residents are settling in their rooms.
02:13It's December 2012. The X Factor is on the TV.
02:18Tonight, it's the X Factor final!
02:2298-year-old Yvonne Grant is finishing a cup of tea.
02:33Just before 9.30, Yvonne needs the toilet.
02:36She can no longer walk, but getting to the toilet is really important to her.
02:40It's a matter of dignity. She needs help.
02:44I need the toilet.
02:46Oh, God, please help me.
02:56Oh, God, help me.
02:58Oh, please, God, help.
03:00I need the toilet, please.
03:04Yvonne started calling almost half an hour ago.
03:08She doesn't know her family has left a secret camera in her room
03:12to check on her care.
03:14She is now desperate.
03:19Yvonne is just a short distance from the nurses' station.
03:23Staff should know she doesn't use her call bell.
03:26She calls out instead.
03:32But no-one is answering her.
03:34Can I use the toilet, please?
03:38Another 18 minutes tick by.
03:41Still no help.
03:43I need the toilet, please.
03:46Can you help me, please?
03:49Nurse!
03:58Yvonne Grant lived her whole life in South London.
04:01She grew up not far from the care home.
04:05She always used to talk fondly of when she was living at home
04:08with Mum and Dad when she was younger, of her sisters.
04:11It's the area where she raised her family and worked,
04:14eventually becoming head of dressmaking at one of Croydon's large stores.
04:20Always put her lip-heat on.
04:22She used to love looking smart.
04:24We used to say she looked like the Queen Mum,
04:26the way she used to have her hair.
04:28She was as young on her 90th as she was on her 80th.
04:32She just never seemed to age.
04:38Her granddaughter Vanessa and her family lived nearby.
04:43But when Yvonne required more medical help,
04:45doctors said they needed to find a nursing home.
04:49She was increasingly unable to walk.
04:53So she moved to the 61-bed Oban house,
04:56owned since 2011 by one of the country's biggest providers, HC1.
05:04Soon, Vanessa began to feel things weren't quite right.
05:09Almost every visit, she pointed out problems,
05:12but felt things weren't changing.
05:15On the surface, it did look smart,
05:17but when you're in it for a while, you start to see the cracks.
05:21I'd go in and she'd start crying,
05:23and she'd say, I just don't want to be here any more.
05:25I knew that something wasn't right, but exactly what, I don't know.
05:30Or I didn't know until I put in the camera.
05:33In Yvonne's room, the unattended camera counts the minutes as she waits.
05:46On that Saturday night, Yvonne calls out nurse 321 times.
05:53She pleads for the toilet 45 times and bangs her cup on 26 occasions.
06:08Finally, after more than an hour, a care worker appears.
06:13Her name is Sokovia.
06:16Despite Yvonne's long wait,
06:18Sokovia doesn't seem interested in helping her to the en-suite toilet.
06:35Sokovia and a colleague are telling her to defecate in her incontinence pad,
06:39the last thing Yvonne wants.
06:41She hated the fact that she couldn't walk to the toilet.
06:44She used to say it was so undignified.
06:47She would always make sure that she used the toilet.
06:51She wouldn't, as she'd say, degrade herself of using a pad.
06:57Again, Yvonne has to wait.
06:59Would you give us five minutes?
07:02You will, won't you?
07:03Yeah, we will.
07:04Five minutes?
07:05What's the problem?
07:08With that promise, Sokovia leaves.
07:1215 minutes later, there's no help.
07:15And now, the light's switched off.
07:37Consultant nurse Lynne Fair is an expert on elderly care.
07:41She's advised the government on protecting vulnerable older people.
07:46This lady, she probably, like most of us,
07:49haven't had an accident since we were two or three years old.
07:53So you've got the dehumanisation, the emotional trauma,
07:57the physical pain.
07:59This is a type of assault,
08:01but not the type of assault people understand.
08:08After more than 20 minutes in the dark,
08:11an hour and three-quarters after Yvonne started calling out,
08:15Sokovia returns with another care assistant.
08:18You're going to go to the toilet, aren't you?
08:21You're going to have to help us.
08:23No, I want the toilet.
08:25In the darkness, they try to make a desperate Yvonne,
08:29who hasn't walked for years, walk to the toilet.
08:32I want the toilet.
08:34I want the toilet.
08:37Are you going to help us?
08:39Yes, I want to.
08:41They should be using a hoist.
08:43When they realise she can't walk, they sound disgusted.
08:49You can't even walk to the toilet.
08:52Listen, Yvonne, we've got other people, yeah,
08:56they're waiting for us to do.
08:58So now, whatever you want to do to the toilet, do it in the pad.
09:02They drop her back on the bed and complain they're short-staffed.
09:08I want to use the proper toilet.
09:11Just do it in the pad.
09:14When you finish, press the bell, we'll come and change you.
09:17That's not what Yvonne wants, and she still hasn't been to the toilet.
09:22Oh, this is terrible.
09:24She's upset, and again she's alone.
09:27Don't shut me in.
09:29Please shut me in. Don't shut me in.
09:32Please.
09:34Please don't shut me in.
09:37Two and a half hours after Yvonne first called out,
09:41a different member of staff, a nurse, finally takes her to the toilet.
09:47The care worker that you see there, the one who does all the talking,
09:52she was prosecuted for common assault.
09:55And was she found guilty? She was found guilty.
09:59Last July, Sokovia was given a suspended sentence and community service.
10:04She's currently appealing against the conviction.
10:09The secret camera was in Yvonne's room on three occasions over two weeks.
10:14That night was by far the longest wait that she had for the toilet.
10:18Some care workers are also seen being kind.
10:22I'm going to get you up, put you in the toilet.
10:27But there is other poor treatment.
10:30There is nothing gentle about the way she's being handled here.
10:36This care assistant was also convicted of common assault.
10:43Lynne Fair is regularly called in to investigate concerns over care.
10:48She says too often action isn't taken.
10:51I am very relieved to hear the police took that so seriously
10:56and the CPS took it seriously in that place
10:59because it doesn't get taken seriously everywhere.
11:01Sometimes in society we have to say enough is enough.
11:05Things only change because society finally says
11:09we will not tolerate this any more.
11:14Croydon Council's safeguarding team concluded Yvonne's treatment
11:18amounted to neglect and institutional abuse.
11:23What was the reaction of the management when you showed them the footage?
11:27Horrified. Absolutely horrified.
11:34HC1, the company that owns Open House, has told Panorama...
11:39The failings in care from that period were totally unacceptable.
11:43We apologise unreservedly to Mrs Grant and her family.
11:46And... We always seek to deliver the kindest possible care.
11:53The home now meets all necessary standards.
11:58When Vanessa told her grandmother she'd put the camera in
12:01and knew what had been happening, Yvonne was pleased.
12:05She said, thank God for that. It's going to stop now.
12:08It's not going to happen to others.
12:10The next afternoon was when her last days began.
12:15It's like she was holding on for it to be found out.
12:21Yvonne died in January 2013, aged 98,
12:26surrounded by the family she loved.
12:30Vanessa remains angry that the earlier complaints she'd made
12:33weren't listened to.
12:35It left her grandmother vulnerable to poor care.
12:38And she believes the secret camera was vital in getting heard.
12:43I wish they were actually in every room in every care home.
12:46That way, maybe care would just be given automatically
12:50because people are aware that they're being watched.
12:54She is part of a quiet revolution
12:56where worried families are putting in their own cameras.
12:59Many experts discourage the use of secret cameras,
13:03but accept that's what happens when families lose trust.
13:08Putting in a secret camera does not sit comfortably
13:11with me. Things are being filmed that are very intimate,
13:15but I absolutely understand why the families are doing it,
13:18because no-one is listening.
13:23But how do you build trust so people don't put in cameras?
13:27Here at the University of Worcester,
13:29they believe better training for care staff is part of the answer.
13:35Those fundamental aspects of care,
13:37like the ability to maintain somebody's dignity...
13:40The aim is to teach the skill and understanding staff need
13:44when they move on to real people.
13:47You've got to have very highly skilled care
13:50but delivered in a kind and compassionate way
13:52to have to go hand in hand.
13:54Professor Dawn Brooker is a leading expert on dementia.
13:58She says there are many good care workers,
14:01and in the best homes, the culture reinforces the right way to do things.
14:07Everybody knows what good looks like.
14:10Everybody in that home matters.
14:14Most of the 17,300 residential and nursing homes in England
14:19meet the regulators' basic standards.
14:22Professor Brooker, who is against secret filming,
14:25has done groundbreaking research
14:27into the care of challenging residents with dementia.
14:31She says far too many have limited quality of life.
14:3630 years ago, it was relatively rare
14:39to see anybody with dementia in a care home.
14:42They were full of people who were pretty self-caring, really.
14:46And yet we've continued that model.
14:49Care homes now have become the home
14:52of people with really, really very complex needs.
14:55We are coping with some of the most challenging
14:59and vulnerable people within our society.
15:03But across the country,
15:05even basic standards of care for older people
15:08are not being met by a hardcore of homes.
15:11Exclusive figures released to Panorama by the regulator
15:15show since 2011,
15:181,260 homes have been given warning notices.
15:23This is serious.
15:25It means here, at the Care Quality Commission,
15:28they've started legal action because of failings in areas
15:31such as care, welfare and staffing.
15:35More than a third of the 1,100 homes that remain open
15:39still don't meet all standards.
15:42That's 406 homes with more than 15,500 beds.
15:49The new chief inspector of social care wants change.
15:54There are organisations who are running care homes.
15:57They're getting paid to provide care and to provide support.
16:00We are expecting people who are running services,
16:03who are managing these services, to deliver.
16:06People shouldn't be getting into this business if they don't care.
16:12In the UK, more and more of us are living longer.
16:16A third of the babies born last year will reach 100.
16:21That is going to put care homes under even more pressure.
16:25We're only as good in a society
16:28as the poorest quality of care that we tolerate.
16:31We have to admit that we do have a lot of shortfall in quality of care
16:36and that it causes people a lot of misery.
16:39So unless we get care homes right, unless we really raise the bar,
16:44actually all our futures are going to be really grim.
16:49Frequently it's staff with poor or minimal training providing the care
16:53and when that goes wrong, the consequences couldn't be more serious.
16:57Next, elderly care home residents were left lying for hours on painful bedsores.
17:01Her family say she was treated worse than an animal in the care home she stayed in.
17:06A cleaner says she saw one staff member slap a patient whose wife...
17:11Each of these cases, which were investigated or reached court in the past year,
17:16represented a failure to care for someone vulnerable,
17:20a failure to change, even when there are warnings.
17:32Leslie Lincoln is an experienced nurse who made numerous complaints
17:36about the nursing home where her mother lived.
17:40Enid Trodden was denied even the most basic care.
17:45She'd still be in bed, soaking wet, freezing cold.
17:49She wouldn't have had her breakfast, they would be lying on the table in her room.
17:53Her 86-year-old mother endured months of appalling care before she died.
18:00I probably wrote about six letters, possibly a dozen phone calls.
18:06I was desperate, really, because I just thought,
18:09I'm making all these complaints, nobody seems to be taking any notice.
18:14That home was Orchard View in West Sussex.
18:17A coroner has ruled that neglect contributed to the deaths
18:20of five elderly people at a residential home in Sussex.
18:23Some residents were left dirty, distressed and unattended.
18:28Leslie's mother, Enid Trodden, was one of the five whose death was hastened by neglect.
18:34Last October, a coroner ruled that 19 Orchard View residents who died
18:38had suffered poor care.
18:40In a home riddled with institutional abuse.
18:46It just made me feel more guilty, that how could I have left her there?
18:52And amongst that, how did I not know that this was more serious than what it was?
18:59Of course, the place looked fantastic, looked marvellous, but...
19:02You had no idea what was going on, did you?
19:04None of us knew what was going on in there.
19:07And all the families who had relatives there
19:09now live with the distress of what happened.
19:12Behind that façade of the new building,
19:15it was that there was hell on earth going on.
19:18You're just thinking about your relative
19:20and you're literally living on a day-by-day basis, particularly there,
19:24because every day there seemed to be some new catastrophe
19:27or something that had happened.
19:29Southern Cross, the company that owned Orchard View, collapsed in 2008.
19:34My mother was the last person to go into that care home
19:37and I felt I was hoodwinked into going into that place.
19:41They knew they were in dire straits.
19:44They just told you what you wanted to hear.
19:47And take their money.
19:50People died at Orchard View for lack of care.
19:54We can put men on the moon, rockets in space, reach Mars,
19:58but we can't do that.
20:00We can put men on the moon, rockets in space, reach Mars,
20:04but we can't look after the elderly.
20:08That's what I feel.
20:13Lynne Fair was one of the investigators sent in.
20:18Despite our best efforts,
20:20we were unable to get the managers of that company
20:25to see the neglect that their staff were administering.
20:30It took an admin assistant turned whistleblower
20:33to expose the full extent of what was going on in Orchard View.
20:38Morally, I know that I did the right thing,
20:41but personally, I have not worked for two years
20:43and the case has had a huge impact on my life.
20:49Eileen Chubb has first-hand experience
20:52of just how difficult it can be to blow the whistle.
20:55She was a care assistant at a different private sector home.
20:59She spoke out and lost her job as a result.
21:03I've been a whistleblower.
21:05I've been there and I know the fear and, you know,
21:08the distress that people are put through.
21:11I saw horrific abuse.
21:13I reported it from that moment on.
21:16We were basically driven out of our jobs.
21:18Yeah, I got a copy of it, yeah.
21:20Her experience led her to start a charity called Compassion in Care.
21:25In the past 14 years,
21:27she's had more than 1,600 calls from whistleblowers working in care.
21:31Across the country, she finds some homes are complained about over and over.
21:37Every day, cases are coming in where there's been, you know,
21:41sometimes up to 15 staff, 20 staff raising concerns.
21:45Six years later, more staff raising the same concerns
21:50One call she received in March 2013 was from a woman called Karis.
21:57She was really nervous, just said that she was a care worker
22:01and there was a number of others as well, and that she'd blown the whistle.
22:06Karis was upset by how she'd seen elderly and vulnerable residents treated.
22:12When people beg to go to the toilet
22:14and then they're sitting in their OVCs and people think it's hard.
22:19This is the care home where she used to work.
22:22The old deanery overlooks the Essex countryside.
22:26It's a residential home which sits alongside St Mary's Court nursing home.
22:32Together they make a 183-bed care village set in beautiful gardens.
22:38The brochure says,
22:39care is at the heart of everything we do.
22:43But during more than two years as a housewife,
22:46Karis says she saw care workers shout at, goad
22:49and even pull some elderly residents about.
22:53You get the people mocking them, winding them up,
22:57to being downright abusive, some of the shouting.
23:01What went through your mind when you saw that happening?
23:04It's shocking and really upsetting.
23:07What makes you say those kind of things to people?
23:10Karis and ten other staff put a long list of complaints
23:13about pay, staffing levels and poor care
23:16to their then bosses in August 2012.
23:22Amy, a care assistant, was one of them.
23:26Like the others, she was concerned about not having enough time
23:29to do all that was needed
23:31and people being left soaked in urine.
23:34There were so many residents there.
23:36How was she supposed to do all of them?
23:39And with the amount of carers there were,
23:41it was just physically impossible.
23:43It was horrible.
23:44There was one resident and there'd be a massive puddle on the floor
23:47and the amount of times that people just used to walk past
23:50and just shrug it off.
23:51You wouldn't want to be treated like that,
23:53so why do you treat them like that?
23:57They also complained about the lack of care.
24:01They also complained to the local authority
24:03and the national regulator.
24:05That September, the Care Quality Commission
24:07made an unannounced inspection.
24:10Staff levels at the old deanery that day
24:12were described as woefully inadequate by an inspector
24:16and some residents were waiting too long
24:18for call bells to be answered.
24:20Essex Council's safeguarding team also stopped new residents
24:24moving into the home for three months.
24:27It should have been a clear marker that things needed to change.
24:31So did they.
24:36Alex Lee is about to find out.
24:39She will see what the inspectors don't see.
24:44She's going undercover as a care assistant at the old deanery.
24:50I am worried and I feel really daunted by it.
24:53I just hope I can get out of here.
24:55I feel really daunted by it.
24:57I just hope I can do a good job. I really, really do.
25:11Alex, an experienced journalist, has never worked in care before,
25:15but Panorama arranged training in addition to the three days
25:19mandatory training the home provided before she started work.
25:23We soon discover the pressures that care assistants face
25:26for £7.16 an hour.
25:34Well, this is my first day wearing the cameras at the old deanery.
25:38I'm just going up to the first floor of the care station
25:40to start my shift.
25:44Pasta, tuna and cheese. It's like a bake.
25:47Like a maze.
25:49This 93-bed residential home is one of the largest in the country.
25:55Alex finds she's pitched straight into the job, with limited guidance.
25:59At first, it's a struggle.
26:02You say through the middle?
26:04She wants to go for a wee?
26:06Whereabouts do I need to take her?
26:19Yeah, I'm just finding it slightly chaotic.
26:21Nobody really tells you anything.
26:23Nobody explains what's going on, you know.
26:25It's frustrating, to say the least, because the problem is
26:28you can make a mistake, you can probably end up hurting someone.
26:33The home says employees are well supported.
26:36It has told Panorama there are...
26:38..a large number of staff on duty at any time who can provide guidance.
26:43Detailed care plans exist for every resident.
26:50WHISTLING
26:52CHILDREN SING
27:00Which song was the theme song from The Wizard Of Oz?
27:05At the old deanery, Alex finds many good things,
27:08like comfortable rooms, a cinema...
27:12..hairdressing and these daily activities.
27:15Would you like a cup of tea?
27:17Most residents fund themselves.
27:19Some pay roughly £700 a week.
27:23Who's this chap down here?
27:25This is you.
27:27Oh, is it? Yeah.
27:29I really enjoy spending my time with the resident,
27:33experiences they've had, what they've done with their lives.
27:36They've all had such a rich history
27:38and they've got so many stories to tell.
27:40Very good.
27:42But there just never seems to be any time to sit down
27:46and just listen to them.
27:48Can you get me ready or not?
27:50Yes, I've come to help you.
27:53Alex's job is to help many residents to eat, drink, dress...
27:58Let's get you to the toilet first.
28:00..to clean them and help them wash.
28:03It's also about being sensitive to their needs.
28:06Let me just tuck that down for you. That's brilliant.
28:09Many residents only need a little support.
28:12Others need a lot.
28:15The residents there that are there just for residential needs
28:18have no problem.
28:20They've got a social life there, they're food-provided,
28:22they can get around.
28:24But there are also a lot of residents there
28:26that have much more complex needs.
28:29Those residents need a lot of skilled help.
28:32All right, just stop.
28:34And Alex does meet many care workers,
28:37who are trying their best.
28:39We've got this snazzy number.
28:41Got that one, right.
28:44The lady has spoken.
28:54But from day one, Alex hears call bells ringing for a long time.
29:00When a resident presses a button or pressure pad,
29:03their room number flashes.
29:05If no-one answers within six minutes, the system goes into emergency mode.
29:09The bells sound so everyone can hear.
29:14I'm just with somebody. I can't come at the moment, I'm afraid.
29:17Sometimes delays are because care assistants are busy
29:20looking after other people.
29:22The alarm's going quite often,
29:24because the problem is there's just so much to do
29:27that you physically do not have the time
29:29to go and get to all the buzzers
29:32to go and get to all the buzzers that are sounding.
29:36Sometimes staff are doing handovers or writing care notes.
29:44Whatever the reason, there are several hours in most shifts
29:48when Alex notices call bells sounding almost constantly.
29:53Are you OK?
29:55And some residents are clearly distressed by how long they have to wait.
30:00This woman was sadly in the final months of her life.
30:03She rang her call bell a lot.
30:05On this day, she called ten times, twice the home's average.
30:12Do you need the toilet? Let me turn your buzzer off.
30:17But without help, she couldn't go to the toilet safely.
30:20She fell twice trying to get there on her own.
30:24Nobody answers.
30:26I ring and I ring and I ring
30:30and nobody comes near me.
30:34Everybody neglects me.
30:43Until a call bell is answered,
30:45there's no way of knowing if the resident is wet, dirty
30:48or, more worryingly, has had a fall.
30:52Even so, this care worker called Lorna
30:55is saying she put a call bell behind the back
30:58of a man whose movement is so limited
31:00he has the button hung around his neck.
31:10We can't know if she really moved the bell,
31:13but three times she says she did.
31:21Lorna could be joking, but he can't do anything for himself
31:25and that call bell is his lifeline.
31:30The company which runs the home says while a bell does ring audibly
31:34once a resident has waited six minutes...
31:37It does not at all follow that if a call is answered after six minutes,
31:41there is a failure of care.
31:43The vast majority of calls are answered within minutes.
31:51Alex also sees the consequences of people not getting help
31:55when they need it.
31:57She regularly sees people sitting in their own mess for lengthy periods.
32:01Often it's the same three or four people.
32:06He's absolutely saturated.
32:09And number two as well.
32:11Has he been changed today?
32:13I don't think he does.
32:15Him and another one, they're always drenched when they go to bed.
32:22I've lost count of the times I've gone in
32:25and found people lying in urine-soaked sheets
32:29that have got pads with poo in that, you know, they've been sitting in.
32:35It's stuff like that that I find really frustrating.
32:40Alex is heading to a resident's room
32:43to move his possessions to a new room.
32:46His serious medical condition means he relies on staff completely
32:50to take care for the rest of his life.
32:52To respect his privacy, we're not using his voice.
32:56Hello. You all right?
32:58He says he needs someone to clean him.
33:01He's already rung his call bell twice.
33:04So what's happened? You've opened your bell, as you say?
33:07Two care workers have been in.
33:09Both cancelled the bell.
33:11Somebody's already just been to you, is it?
33:13They went without helping him.
33:15It seems that was being left to someone else.
33:18How long ago did you go?
33:20He tells Alex he's been lying in his own faeces for more than an hour.
33:24She cleans him.
33:26So, basically, you've had to wait here for an hour?
33:29Even so, he says it doesn't matter.
33:32He's not complaining.
33:36Are you going down?
33:42This is one of the care workers who left without helping him.
33:46She was in the room just minutes before Alex.
33:49Her name is Anita, and a year earlier,
33:52the whistleblowers complained she had a bad attitude.
33:55She was later promoted and supervises some staff.
34:01There were a number of care workers
34:03the whistleblowers complained about in 2012,
34:06but they only made their written complaints
34:09after weekend pay and hours were cut.
34:12Anita said that was to bring it in line with other local care providers.
34:17There was no morale left.
34:20You'd been pushed so far,
34:22pushed to the point where you break or you have to fight back.
34:26And what did fighting back mean in your terms?
34:30It was to stand up and say,
34:32look, things are going on, this is not acceptable,
34:35and we can't deal with this.
34:38In 2012, Anglia Retirement Homes Limited,
34:42the company that runs the old deanery,
34:44was owned by a local property developer.
34:47He insists it was properly run, delivering good care,
34:50and the behaviour of the complainants during negotiations
34:54showed the dispute was about money, not care.
34:59After a messy argument, six of the care workers were suspended,
35:03including Carys, partly for not raising concerns earlier.
35:07Amy was among three who left.
35:10Just two continued to work at the old deanery.
35:13The Home says the complaints were investigated, but...
35:17The allegations were, in the vast majority of cases,
35:20denied by the accused.
35:22The incidents were old and no verifying evidence could be obtained.
35:27Whatever the motivations behind the dispute,
35:30investigations by the CQC and the local authority that followed
35:34identified problems around staffing, answering calls,
35:38training and the treatment of some residents.
35:45A year later, when Alex is working at the Home,
35:48there is change of a different kind.
35:51Anglia Retirement Homes Limited,
35:53which runs the old deanery and St Mary's Court next door,
35:56is sold to a private equity firm, August Equity, and it's noticed.
36:17Providing care for the UK's ageing population,
36:20is an expanding business,
36:22and it's attracting private investment companies like August Equity.
36:27In the last financial report,
36:29the two homes made more than £1 million in trading profits pre-tax.
36:40At the old deanery, the new owners and new chief executive
36:43seem to be trying to deal with call bells not being answered.
36:48Care workers are given pagers, which tell them who's ringing for help.
36:54I've got the pager for help.
36:56So what, like, if someone presses a button up there,
36:59it goes straight to your pop-up?
37:01It goes to your pager and beeps. It's really annoying.
37:07But Alex doesn't notice much change.
37:11And now she finds some call bells unplugged.
37:14The call button's being pulled out.
37:17She finds the bells of three different residents unplugged
37:21on five occasions.
37:23The three are known for asking for help a lot.
37:26Your buzzer's not plugged in.
37:28It should have been.
37:29I know, it should have been, but it's not.
37:31I've just plugged it back in.
37:33I wonder who pulled it out.
37:35I don't know.
37:37They hate me, you know.
37:39Who?
37:41Sam Murphy.
37:44Alex can't know who left it unplugged,
37:47but she hadn't noticed it happening before.
37:50Call bells for residents are a lifeline.
37:53Without those call bells, they're imprisoned.
37:56They have no way of communicating with the outside world.
37:59It could be that there's not enough staff.
38:02It could be that there's not enough staff.
38:04It could be that the staff do not appreciate
38:07the importance of the call bell to that resident.
38:10Anglia Retirement Homes say they take allegations of call bells
38:14left unplugged or not answered extremely seriously.
38:18They continue...
38:20Frequent audits of the call bell log are carried out
38:23and any such incidents are examined and investigated.
38:29But Alex doesn't notice much change.
38:33But Alex is also seeing the sort of rough treatment
38:36of some residents the whistleblowers complained about
38:39more than a year before.
38:41Here, Lorna, the care worker we saw earlier,
38:44has showered this elderly lady.
38:46She appears to be rushing to dress her,
38:48pulling on her nightie while she's still wet.
38:51I'll tell you what.
38:53Put that in.
38:55What is it?
38:57It's a fake shoe.
38:59No, no, no, not that one.
39:01No, don't wear it.
39:03Give me time.
39:04Yeah, it is a minute.
39:06The resident's not impressed.
39:12Is it normally like that with that?
39:14Rough.
39:23And another lady is clearly upset
39:25by how she's treated by a different care worker.
39:32SHE SPEAKS INDISTINCTLY
39:47She's already made it clear who she's talking about.
39:51What, a man or a woman?
39:55What colour hair?
40:01It's cool.
40:03She's talking about Anita,
40:05the care worker who earlier walked away from a man
40:08who needed to be cleaned.
40:11Separately, Alex sees some residents like this woman
40:15with large bruises.
40:17God, that is one big bruise.
40:19How do you say it was? Did it just appear?
40:21Apparently, that's what I got told anyway.
40:23It's a bit strange, isn't it?
40:25Older people can bruise easily,
40:28so it doesn't necessarily mean anything sinister.
40:31But this should be recorded on a body map
40:33to keep a check on what may be happening.
40:36It isn't.
40:38Another lady is clear in her own mind how she got her bruises.
40:42You've got bruises all over your arm.
40:44How did you get them?
40:48The carers?
40:50What did they do?
40:54Pulling you?
40:57We can't know how they were caused or why they weren't documented.
41:02But with an incomplete record,
41:04there's no way to keep a check on what's going on.
41:07Over 36 shifts with cameras,
41:10Alex saw at least seven large bruises.
41:13Only two were recorded.
41:15What I've been shown in the training that I've been given
41:18is that you roll people, you do it like that.
41:21Pause, not claws.
41:23Almost like a grab mark.
41:32During her time at the home,
41:34as well as worries over how people are handled,
41:37Alex sees some care workers who mock and goad residents.
41:41The sort of behaviour the whistleblowers warned about a year before.
41:47Remember Lorna, who gestured she'd taken a call bell away from one resident
41:52and was rough with another.
42:00The man she's lifting in a hoist swears at some staff,
42:03usually when he's agitated.
42:05He seems better when people explain what's happening.
42:09Here, his private parts are being washed,
42:11but Lorna gives him no warning.
42:14You absolute bitch.
42:20This is really intimate care,
42:22and the way it's done here clearly upsets him.
42:27Then Lorna has her say.
42:44Are you ready for this?
42:48Morning, Jo. Morning.
42:50The test of any home and its staff
42:52is how they look after residents with the most complex needs.
42:56People like Jo Madison.
42:58All right, I'm going to get you up, Jo.
43:01I know.
43:03Alex is told she's one of the old deanery's more challenging residents.
43:09I didn't quite know what to make out,
43:11the tones and the personality and how they treat this woman.
43:15Because I see this lady, you know, and she's very quiet,
43:18sort of going round the care home in her electric wheelchair.
43:25I think he's very naughty, don't you?
43:27No, I'm not. Don't you?
43:29That makes it worse!
43:32Jane's brought in a new staff member,
43:34and she's going to help her.
43:36That makes it worse!
43:39Jane's brought up five children, including her daughter, Jill.
43:45That's Mum at about 15.
43:47That's Mum at about 17.
43:49Beautiful. She is, isn't she stunning?
43:51Young woman, yeah.
43:52They're how I think of my mum.
43:54I'm very aware of how different she is these days.
43:57She also looked after others as a social worker,
44:02and is paralysed down her right side from a stroke in her 50s.
44:08She's got this fierce independence.
44:11She thinks she still gets herself up and gets herself washed
44:14and gets herself dressed.
44:16She cannot do any of those things,
44:18though in her mind she thinks she still can.
44:22In the behaviour notes written by staff,
44:25Jane is often described as aggressive.
44:28She can lash out if frustrated,
44:30and Jill has been increasingly worried.
44:32Yeah, no, that's fine. That's fine.
44:34But there are definitely ways of dealing with her.
44:37Well, she's a pussycat. Yeah.
44:39Ways of doing it wrong, and all hell breaks loose.
44:42I've had the home ring me to say
44:44they've been experiencing problems with Mum,
44:46being very difficult, quite obstructive with her care,
44:51and kicking out and hurting staff.
44:55And I said, well, that's very unlike my mum.
44:59She can kick off, but it's usually when she's been hurt.
45:02And I'm saying, you need to look at the reasons why.
45:06It was Lorna who first took Alex in to help with Joan's morning care.
45:12It's aggressive. It's behaviour...
45:15..behaviourally kind.
45:17Oh, OK. Yeah, so it's just going to hurt you.
45:20Hello, Joan!
45:22Good morning, my love.
45:24Joan needs to be washed and dressed.
45:27Just hold here, otherwise she's going to hurt me.
45:32Lorna is physically restraining Joan and asks Alex to help.
45:37Hold him. Hold him.
45:39I don't want that black thing on me.
45:41I'm going to dry you.
45:43Well, I'm going to dry it.
45:45Thank you. I'm going to dry it.
45:49Help!
45:51Lorna should be defusing the situation.
45:53Instead, she's winding Joan up.
45:55Do it! Do it! Shout it!
45:57How are you? A bit louder.
46:01Try and...
46:02I wish you'd tell me!
46:04Is that like a tiger?
46:07I thought you were a bloody idiot.
46:09You were not me.
46:11Why are you getting so angry?
46:13Alex doesn't know what to think.
46:17Lorna asked me to hold her arms or her hands to stop her from hurting her.
46:21I didn't feel very comfortable doing it.
46:24I think because Lorna was taunting her almost,
46:26reciprocating the insults that she was throwing at her,
46:29it was just escalating things.
46:31We asked consultant nurse Lynne Fair to review Joan's care.
46:37They didn't talk to this lady, they didn't tell her what was going on,
46:41they didn't anticipate what her problems were,
46:44and all that lady's got is to resist what they're doing to her.
46:49The Home told Panorama...
46:51These incidents involved a small number of staff
46:54and are not reflective of the high standards of care
46:57which we expect and demand from all of our team.
47:03But increasingly, staff need the skills to cope with residents
47:07who can no longer explain what's wrong.
47:11Good morning, Joan!
47:13Where are you going?
47:15On 28 mornings, our unattended camera in Joan's room
47:19shows how care assistants start her day.
47:24Joan's paralysed right side is painful.
47:28But on too many days, she's pulled roughly and she reacts.
47:32Get out!
47:34Get out!
47:36Calm your head.
47:38I'm not going to calm my head, don't worry.
47:40Joan's addiction has led her to a state of panic.
47:43I'm not going to calm my head, don't worry.
47:45Joan's a determined woman who's overcome disability,
47:48but she's treated like a child.
47:52Treated spitefully.
47:55I'd be embarrassed if you were my mum.
47:57Her knuckles wrapped.
48:01She's told she smells.
48:03Come on, Alex, you stink.
48:07I know I do, it's because I'm working here, it makes you stink.
48:10Joan can be difficult, but this shouldn't be happening.
48:15Hello, nice to meet you. Nice to meet you, thank you.
48:18After reviewing Joan's care,
48:20consultant nurse Lynne Fair is meeting her daughter, Jill.
48:24She says the home should have been asking questions
48:27about the reactions different care workers get.
48:31The organisation have not been looking at the evidence
48:34that they've actually got.
48:36The evidence would be there,
48:38so there's obviously something going on
48:40because of when she expresses her dissatisfaction through aggression,
48:44at what times and who are the care staff that were involved.
48:48And there is a clear difference in the way Joan behaves
48:51when she's with care assistants who show more understanding.
48:55Joan, can you just wash your hands and face for me?
48:59As requested in the family's care plan detailing her needs,
49:02they involve her.
49:04Who is that one, though?
49:06They chat to her and she's much more relaxed.
49:11Why are you doing this?
49:13Why are you doing this?
49:15Get your nightdress off, darling.
49:17But with Lorna and Anita, the battle with Joan is predictable.
49:24Lorna throws the bag strap at Joan's head.
49:29And she's left to struggle on her own.
49:33We needed to show Jill what the secret camera had picked up.
49:37It's an insight into what can happen when she's not there.
49:44I've had inklings, gut feelings.
49:47I'm bitterly disappointed.
49:49I spent two years with my sister
49:51looking for somewhere for Mum to go and I've let her go there.
49:57And I've let that happen to her.
50:02This type of abuse is very insidious.
50:05This is hidden.
50:07This is like psychological domestic abuse.
50:14Panorama hasn't shown the undercover film to the Old Deanery
50:18but has provided it with details.
50:21It says...
50:23We are shocked and saddened by allegations made
50:26by the BBC's Panorama programme of inappropriate behaviour
50:29by some members of staff at the Old Deanery care home
50:32and apologise unreservedly for those failings.
50:36We care passionately about our residents
50:38and will not tolerate this kind of behaviour.
50:44Last November, CQC inspectors gave the Old Deanery residential home
50:49a clean bill of health for the first time in 18 months.
50:54But 11 days later, Alex is on shift.
50:59She sees the senior care worker, Anita,
51:01with another assistant about to get Joan up.
51:05We'll call the police.
51:09I needed the hoist, so I went to look for it in Joan Madison's room.
51:13The hoist was in there and Anita and another care assistant
51:17were trying to get her ready.
51:19I could tell there was a lot of aggression in the room at that stage
51:22and I couldn't stay, so I decided to leave
51:25a secret camera in the room before I left.
51:30We shouldn't have to put up with this, it's ridiculous.
51:34At the moment, I'm dealing with an alley cat.
51:36Right, erm... I need to go that way, Joan.
51:39Anita seems increasingly exasperated by Joan
51:42as they start to dress her.
51:45Joan! Good help!
51:47Joan! Joan!
51:49You are a vicious, nasty old lady.
51:52And Joan appears to have scratched her.
51:55Ouch.
51:59You won't be saying that in any bit of security.
52:01The situation is escalating.
52:03She threatens Joan.
52:05I'm going to make an official complaint.
52:07I don't get paid enough for being assaulted constantly.
52:10Could you please put that under my head properly?
52:13No.
52:14Then Anita does this.
52:17No!
52:18She slaps Joan.
52:20Joan!
52:22Did she just slap her? Can I see that bit again?
52:24Yes, you can.
52:28She did! I mean, that's assault.
52:30She's just assaulted that lady.
52:33But who would believe Joan?
52:35Because Joan is labelled by everybody that I've seen so far
52:39as someone who's aggressive, she's nasty, she's an alley cat.
52:44I feel like I've let her down.
52:46I've let everybody down that trusted me.
52:48I begged, I pleaded, I fought like a tiger
52:51to get the funding to get her in there.
52:55The care home says that Anita...
52:57..has been summarily dismissed
52:59and other disciplinary proceedings will be completed
53:02shortly after the Panorama broadcast.
53:07The home told Panorama as soon as they were informed of our evidence
53:11they took immediate action.
53:13They suspended eight staff and...
53:16..hired an independent law firm to carry out a full investigation.
53:21Our priority remains the health and wellbeing of our residents
53:25and we have more than 200 dedicated members of staff
53:28who remain committed to the highest standards of care.
53:38Jill visits her mother at the old deanery several times a week.
53:44If things aren't going to change,
53:46I will have to look for somewhere else for her.
53:48Where will my mum end up?
53:51But the old deanery is her mother's home.
53:55There's an element of hope because I have to have hope.
53:58I don't want to move her, Alison.
54:00I believe...
54:02..that they could change things.
54:04They've got some amazing staff that need good, strong leadership.
54:08It isn't adjustment needed, it's fundamental change.
54:13The old deanery emphasises the good care it provides.
54:17Its new owners say they've increased the number of senior staff on shift
54:21and introduced an independent whistleblowing service.
54:25The Home told Panorama it's...
54:27..very concerned that any broadcast
54:30of what is likely to be highly emotive material
54:33will give a wholly false view of the home.
54:36..and told us to consider...
54:38..the many positive views that have been expressed about the home.
54:43However, two months ago, after we informed it of our findings,
54:47the CQC carried out an early morning inspection.
54:53This time it found too few staff.
54:57And some residents waiting too long for call bells to be answered.
55:01They discovered one person crying and distressed
55:04because they couldn't find a care worker to help them to the toilet.
55:08In less than two years, the CQC has visited the home six times.
55:14We have inspected the old deanery.
55:16We have identified concerns that we've had,
55:19we've issued a warning notice.
55:21They improve, but then they fall back on other areas
55:24and, particularly because of the issues around staffing,
55:28that's where you get the problems.
55:31The CQC gets eight serious legal challenges a week.
55:35The CQC gets eight serious legal challenges a week
55:38from places unhappy with inspection reports.
55:42It finds some homes seem to resist change.
55:46But it's introducing ratings to make it clear which homes are doing well.
55:51A new legislation will mean company directors
55:54could be prosecuted for failings in care.
56:01But as Alex finishes her time at the old deanery,
56:04she knows inspectors won't see all that happens in homes.
56:10So I've just come off my last night shift, actually, at the old deanery.
56:15I'm absolutely shattered, if I'm honest.
56:18What these residents are getting is just the basic level of care,
56:23you know, and sometimes even that's not happening.
56:27And it's just not good enough.
56:30For too many people like Joan, we aren't getting the basics right.
56:34So what will it take to change that?
56:38At the Department of Health,
56:40the minister with responsibility for care in England
56:43agrees there's a problem.
56:46There's a stubborn minority of care providers
56:49who do not meet acceptable standards,
56:52and those are the ones that we have to tackle.
56:55And we have to send out the message
56:57that there should be no place in our care services
57:01for providers of that sort.
57:04With pressure on funding and growing need,
57:07he accepts change will take more than fine words.
57:11This has to be a big collaboration between government,
57:14the regulators, local authorities and providers.
57:19I think collectively we can drive up standards
57:22and ensure that our loved ones get access
57:25to the best possible care that's available.
57:30The families who've experienced poor care
57:32say that means all homes need to measure up to the best.
57:37For Leslie Lincoln, that's the only way to protect others
57:40from the neglect her mother suffered at Orchid View.
57:46As a society, we need to say this has got to stop.
57:49All the basics are basics.
57:51You shouldn't have to be complaining about that sort of thing.
57:54It should be top-notch.
58:06And each time the cries of someone like Yvonne Grant go unheeded,
58:10the question for us all is do we have the will to stop this happening?
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