ANALYSIS
Undercover TV filming captured distressing scenes in two residential nursing homes. But is surveillance the best way to stamp out abuse? Kat Keogh reports
Debate rages over how to improve the quality of care for older people Alone and upset, 98-year-old Yvonne Grant calls out for help from staff at Oban House nursing home in Croydon, south London. The great-grandmother’s calls go unanswered for an hour, by which time she has asked for help more than 300 times. The distressing footage, taken from a camera placed inside her room by her worried family, was screened as part of BBC Panorama’s Behind Closed Doors: Elderly Care Exposed, which aired two weeks ago. The provider HC-One, which owns 227 nursing and care homes across the UK including Oban House, has apologised unreservedly for the failings of care for Ms Grant, who died in 2012. Ms Grant was forced to walk to the toilet and staff were seen dropping her roughly on her bed. Two staff members have since been convicted of common assault. Ms Grant’s case has prompted the care provider to consider installing surveillance cameras in residents’ rooms to ‘root out’ instances of abuse or neglect.
It is consulting staff, residents and their families on an ‘opt-in’ scheme where residents and their relatives would be able to ask for cameras in rooms. HC-One’s chair Chai Patel says surveillance cameras would be a key move to protect those in its care. ‘As an organisation, and as a sector, we need to move forward and tackle the problem once and for all,’ Dr Patel says.
‘THERE IS A PRIVACY ISSUE, BUT I KNOW THAT IF IT WAS MY FAMILY, THEIR SAFETY WOULD COME FIRST’ ‘Unannounced inspections by the Care Quality Commission, local authorities and our own service quality teams are important, but alone they do not always uncover the actions of a small number of individuals.’ Not everyone is convinced CCTV would help eradicate abuse, however. Many Nursing Standard readers took to our Facebook page to give their views on the issue of cameras (see box).
While some say the idea would help expose neglect or mistreatment, others believe having more staff to care for patients is the urgent matter. The GMB union will consult its 6,000 members who work in HC-One’s nursing and care homes on whether CCTV is the right step. GMB national care sector officer Justin Bowden said the issue was a highly emotive one, requiring ‘careful consideration’. Nurse Margaret Haywood, who helped expose poor care at Royal Sussex Hospital in Brighton by secretly fliming for Panorama in 2004, says she was ‘heartbroken’ by the latest programme. But she adds that she is not sure if surveillance is the answer. ‘There is a privacy issue,’ she says, ‘but I know that if it was my family, their safety would come first. ‘We also need to recruit the right type of people to work in care homes. Caring for someone is the hardest job in the world.’ The latest Panorama programme also included allegations of abuse at the Old Deanery care home in Braintree, Essex. Seven staff have been
Yvonne Grant’s care, as exposed by a Panorama documentary, sparked a national outcry
14 may 14 :: vol 28 no 37 :: 2014
NURSING STANDARD
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ANALYSIS
sacked from the home, which is run by Anglia Retirement Homes, after scenes that appeared to show a resident with dementia being hit. A woman arrested by Essex police on suspicion of assault has been bailed pending further enquiries. In response to an emergency question in Parliament the morning after the show was screened, care minister Norman Lamb insisted the government is working to ensure vulnerable people are protected.
Certification
Measures include an inspection regime introduced in 2013 by regulator the Care Quality Commission (CQC), with new fundamental standards of care, which will allow the CQC to prosecute providers – and their directors – who fail them. A new ‘care certificate’ for healthcare assistants (HCAs) is also being piloted by education and training provider Health Education England this summer and will by rolled out nationwide be March 2015. Every new HCA will have to complete the certificate within their first 12 weeks of work, and will not be able to work unsupervised without it. ‘The images we saw on our screens [on Panorama] were truly disgusting,’ Mr Lamb said. ‘The family and loved ones of care home residents should not have to endure that. Everyone should receive the highest standards of care delivered by well-trained and compassionate staff. We are committed to making that a reality and preventing abuse and neglect’ NS
NURSING STANDARD
‘CCTV OR NO CCTV, YOU CANNOT TEACH HOW TO CARE’ What you told us on Nursing Standard’s Facebook page ‘If people are not being treated with respect and dignity and there are concerns being raised then YES put cameras in. Let’s get the rot out of care homes.’ ‘CCTV or no CCTV you cannot teach how to care for someone. Some homes employ people with hardly any experience to make numbers up on the floor. I was a carer for six years and am now a qualified nurse. I would never go back to work in a home, there are many risks.’ ‘It is hard to say what the right thing to do is. CCTV is a debatable issue, in this case yes it is probably needed, but then individuals in care need their own privacy and dignity.’ ‘Make CCTV mandatory!’ ‘CCTV scares me, not because I have anything to hide, but because it is destroying one of the principles we are working towards... that of privacy and dignity.’ ‘It is a real shame that the option of CCTV even has to be considered in the first place.’ ‘I am sick of being hit by patients. Trying to get help for an aggressive patient or someone with challenging behaviour is like asking for a miracle. Maybe it would also catch the nurses and carers who are hurting patients.’ ‘It disgusts me that people get minimum wage or just above to work with elderly people. Our older generation are worth far more than minimum wage.’ ‘Our residents have buzzers. When they are pressed they light up in the corridors and also make a noise. They are timed so can be monitored for response time. Failure to place a buzzer within reach of a resident constitutes abuse.’ ‘If CCTV was to be installed, who would have access to it? You would need resident or family permission for consent for those without capacity to be filmed. Proper staff vetting and training as well as decent pay is what is required first.’
may 14 :: vol 28 no 37 :: 2014 15
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Undercover TV filming captured distressing scenes in two residential nursing homes. But is surveillance the best way to stamp out abuse? Kat Keogh reports
Debate rages over how to improve the quality of care for older people Alone and upset, 98-year-old Yvonne Grant calls out for help from staff at Oban House nursing home in Croydon, south London. The great-grandmother’s calls go unanswered for an hour, by which time she has asked for help more than 300 times. The distressing footage, taken from a camera placed inside her room by her worried family, was screened as part of BBC Panorama’s Behind Closed Doors: Elderly Care Exposed, which aired two weeks ago. The provider HC-One, which owns 227 nursing and care homes across the UK including Oban House, has apologised unreservedly for the failings of care for Ms Grant, who died in 2012. Ms Grant was forced to walk to the toilet and staff were seen dropping her roughly on her bed. Two staff members have since been convicted of common assault. Ms Grant’s case has prompted the care provider to consider installing surveillance cameras in residents’ rooms to ‘root out’ instances of abuse or neglect.
It is consulting staff, residents and their families on an ‘opt-in’ scheme where residents and their relatives would be able to ask for cameras in rooms. HC-One’s chair Chai Patel says surveillance cameras would be a key move to protect those in its care. ‘As an organisation, and as a sector, we need to move forward and tackle the problem once and for all,’ Dr Patel says.
‘THERE IS A PRIVACY ISSUE, BUT I KNOW THAT IF IT WAS MY FAMILY, THEIR SAFETY WOULD COME FIRST’ ‘Unannounced inspections by the Care Quality Commission, local authorities and our own service quality teams are important, but alone they do not always uncover the actions of a small number of individuals.’ Not everyone is convinced CCTV would help eradicate abuse, however. Many Nursing Standard readers took to our Facebook page to give their views on the issue of cameras (see box).
While some say the idea would help expose neglect or mistreatment, others believe having more staff to care for patients is the urgent matter. The GMB union will consult its 6,000 members who work in HC-One’s nursing and care homes on whether CCTV is the right step. GMB national care sector officer Justin Bowden said the issue was a highly emotive one, requiring ‘careful consideration’. Nurse Margaret Haywood, who helped expose poor care at Royal Sussex Hospital in Brighton by secretly fliming for Panorama in 2004, says she was ‘heartbroken’ by the latest programme. But she adds that she is not sure if surveillance is the answer. ‘There is a privacy issue,’ she says, ‘but I know that if it was my family, their safety would come first. ‘We also need to recruit the right type of people to work in care homes. Caring for someone is the hardest job in the world.’ The latest Panorama programme also included allegations of abuse at the Old Deanery care home in Braintree, Essex. Seven staff have been
Yvonne Grant’s care, as exposed by a Panorama documentary, sparked a national outcry
14 may 14 :: vol 28 no 37 :: 2014
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 22, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
ANALYSIS
sacked from the home, which is run by Anglia Retirement Homes, after scenes that appeared to show a resident with dementia being hit. A woman arrested by Essex police on suspicion of assault has been bailed pending further enquiries. In response to an emergency question in Parliament the morning after the show was screened, care minister Norman Lamb insisted the government is working to ensure vulnerable people are protected.
Certification
Measures include an inspection regime introduced in 2013 by regulator the Care Quality Commission (CQC), with new fundamental standards of care, which will allow the CQC to prosecute providers – and their directors – who fail them. A new ‘care certificate’ for healthcare assistants (HCAs) is also being piloted by education and training provider Health Education England this summer and will by rolled out nationwide be March 2015. Every new HCA will have to complete the certificate within their first 12 weeks of work, and will not be able to work unsupervised without it. ‘The images we saw on our screens [on Panorama] were truly disgusting,’ Mr Lamb said. ‘The family and loved ones of care home residents should not have to endure that. Everyone should receive the highest standards of care delivered by well-trained and compassionate staff. We are committed to making that a reality and preventing abuse and neglect’ NS
NURSING STANDARD
‘CCTV OR NO CCTV, YOU CANNOT TEACH HOW TO CARE’ What you told us on Nursing Standard’s Facebook page ‘If people are not being treated with respect and dignity and there are concerns being raised then YES put cameras in. Let’s get the rot out of care homes.’ ‘CCTV or no CCTV you cannot teach how to care for someone. Some homes employ people with hardly any experience to make numbers up on the floor. I was a carer for six years and am now a qualified nurse. I would never go back to work in a home, there are many risks.’ ‘It is hard to say what the right thing to do is. CCTV is a debatable issue, in this case yes it is probably needed, but then individuals in care need their own privacy and dignity.’ ‘Make CCTV mandatory!’ ‘CCTV scares me, not because I have anything to hide, but because it is destroying one of the principles we are working towards... that of privacy and dignity.’ ‘It is a real shame that the option of CCTV even has to be considered in the first place.’ ‘I am sick of being hit by patients. Trying to get help for an aggressive patient or someone with challenging behaviour is like asking for a miracle. Maybe it would also catch the nurses and carers who are hurting patients.’ ‘It disgusts me that people get minimum wage or just above to work with elderly people. Our older generation are worth far more than minimum wage.’ ‘Our residents have buzzers. When they are pressed they light up in the corridors and also make a noise. They are timed so can be monitored for response time. Failure to place a buzzer within reach of a resident constitutes abuse.’ ‘If CCTV was to be installed, who would have access to it? You would need resident or family permission for consent for those without capacity to be filmed. Proper staff vetting and training as well as decent pay is what is required first.’
may 14 :: vol 28 no 37 :: 2014 15
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