waking up residents in care home
9-Jul-2010 0:43 am
does anyone know if there are any guidlines/standards for how early residents with dementia in care homes should be woken up by care staff (is 5.30am too early) i think that it is but i want evidence to back it up
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14-Jun-2011 11:13 pm
i agree i wouldnt want to be woken up that early and residents need to be woken up slowly give them time to adjust to there surroundings 530 am is far to early i use to work in a residential home and we would never wake our residents till after 8am and if a resident decided she wanted to stay in bed and there was no particular reason for this she or he just decided they wanted a lie in then we would take up breakfast and maybe encourage to get up later residents have rights and also choices residents with dementia need time when woken but they also need good sleep and to wake so early becomes along day for them and prevents orientation so yes if u not sure why ask yr manager after all you are the voice for yr residents
17-Jun-2011 8:47 am
why are you waking people?? If the team ie both nights and days are doing person centred care then your routine should reflect the changing patterns of peoples natural waking ie more residents ready to get up in the summer and less in the winter with corresponding changes for dark nights etc in the winter.
waking anyone with or without a dementia is likely to trigger aggressive responses !!!!
19-Sep-2011 6:14 pm
Look at evidence based practice around waking patients with dementia in care homes, also sleep hygiene. Recruit as many of your colleagues as you can that agree that the current practice is abusive and not patient centered. Have a meeting with your managers and present your findings in a calm and rational way, suggesting changes that are beneficial to the residents. Refer to anything that that the home has written in its mission statements or promotional material and point out that these documented standards are not being met but your proposals could change this. Advise a trial period and evaluation after 2-3 months. If nothing changes then you really do need to seek advice from the NMC and your union to protect yourself and the Care Quality Commission.
19-Sep-2011 7:53 pm
Thank you, that is my intention. However, having spoken with the current members of staff (I have just joined the team) this has been discussed earlier on number of occasions and nothing changed. As I do not agree with this poor practice I feel very uncomfortable to allow the members of my team to carry on with this during my duty. Not sure where I stand with this. I have worked in many elderly care settings and have never faced such an early start.
19-Sep-2011 9:14 pm
Try the approach suggested- you may find that previous conversations and suggestions are not as strong as yours. Also others feel as you do so that makes for a more cohesive approach. If you still come up against a brick wall then the situation really is awful and the only redress is the CQC. You would be are totally within your professional rights to go down this path as you are being obstructed from following the NMC code of conduct to safeguard the rights of your patients. Whistle-blowing is a hard thing to do but there is obviously evidence that this poor practice has been discussed before and needs to be dealt with. The dignity of the patients should be paramount and protected.
19-Oct-2011 3:04 pm
I have been a care giver for many years in nursing homes. I have always disagreed with the practice of pulling residents that are sound asleep from their warm beds. Most of them are not spoken to or explained that it is morning, they are just greeted with bright lights, someone throwing some clothes on them and tossing them in a wheelchair, usually in less than 5 minutes time. It is the practice of every home that I have been in to do this, starting at 5am and sometimes earlier if they are short of staff. It upsets me and makes me feel helpless, as there has been no resolution for it, even after working with senior services and other state agencies.
19-Oct-2011 6:54 pm
It is abuse if you wake anyone up purposely before 0600, it is as simple as that. (There are obvious exceptions for those who wake up naturally or request to be woken.)
Best practice is this, refuse to wake ANYONE before 0600, and those who you do get up, give them enough time to wake up, allow them enough time to do things as they want to and wash/dress themselves if they are able. Always ask if they want to get up and allow people who can decide for themselves to sleep later if they so wish. This is true patient centred care. What is not done, gets handed over. This is 24 hour care.
You WILL come up against a brick wall of management who want a production line mentality, regardless of what they say, and you WILL come up against a lot of whining and bitchiness from day staff, especially HCAs who will start putting little digs and complaints in saying 'night staff aren't doing anything' or 'night staff are supposed to get x amount of people up' etc, which are both crap. (I will say there will be some staff who actually agree with you, Nurses and HCAs, but we seem to be in the minority and many HCAs don't know how to speak up, but that still does not mean we shouldn't do things we know to be right). It may not be a popular thing to say, but it is true, and I think anyone who disagrees knows it too. Stay strong, and fight against this culture.
I would flat refuse to allow anyone on my team to carry on with this practice whilst I am on shift, as I would be responsible. Remember, YOU are the staff Nurse, YOU are in charge, not the HCAs, regardless of what they think.
So start by changing things on your shift, do things the RIGHT way; when the inevitable whingeing starts, go to management and say this is what is happening now, you will not accept any excuses about timetables or breakfasts, and will go to the CQC, UNISON or the RCN and even the NMC with your concerns just to cover your own back if it happens again, because at least then it would be on record.
29-Oct-2011 7:57 am
does anyone have a link with confirmed legislation on this they can send me? i have worked in care for several years but have only recently come into elderly care (EMI) where the start times are such an issue. I also have just started mental health nursing training so wish to bring anything i can to promote patient well being... The main argument thrown back on me is "duty of care", i.e., they argue "well, they've been sleeping all day... they need personal care... it's not like they don't get adequete sleep between the day and the night... they need to get up and stop bedsores... they've been in bed since 6pm!" etc etc... I agree with personal care but feel that is not excuse to get people up AND i feel it is a failure of the day routine that there isn't enough stimulation that they must fall asleep... The avergae support worker is encouraged to start seeing if anyone is ready to get up from 04:30!!! I refuse to do this but will check on personal care needs plus individuals desire to get up or not. Any help would be appreciated!
11-Aug-2012 11:31 pm
CQC standards people can expect from their care home:
1. You should be respected and be
part of deciding your care and
support. You will be told what is
happening all the time.
? you will be part of talks about your
care, treatment and support. You will
get support to help you make
? staff will respect your privacy and
? you will get support to help you live as
independently as you can
? before you have any examination,
care, treatment or support, you will be
asked if you agree to it.
2. You can expect care, treatment
and support that meets your
? your needs will be checked. This
makes sure you get the right care
which is safe and that supports your
? you and your care professional will
agree to the care which will help your
health and well-being
? you will get food and drink that meet
? if you have more than one service, or if
you are moved between services, they
will work well together.
Your service should meet your needs for
? culture and the language you speak9
? sex (whether you are a man or a
? sexuality (whether you are lesbian,
gay, bisexual or straight)
? religion or belief.
The law protects your rights under the Human Rights Act.
3.You can expect to be safe.
? you will be protected from abuse.
Staff will respect your rights
? your care home will be clean.
You will be protected from infection
? you will get the medicines you need,
when you need them, and in a safe
? you will be cared for in a safe and
? you will not be harmed by unsafe or
the wrong equipment
And this isn't all the standards CQC say people can expect
So I think with the examples cited above , then there is no way the care home can evidence for the CQC inspections!
How sad that practices employed in the 70's still endure
11-Aug-2012 11:33 pm
the bullet points changed to question marks when I posted the above.....................very strange :-(
18-Aug-2012 8:33 pm
I have spoken woth the CQC re what time should residents be woken up, unfortunatly there is no guide line time, it is a loophole in the system
Having said that, there should be a time in the persons care plan as to what time he or she is put to bed, so it would make sense to also put what time the residents would like to be woken up
If this was made to all care plans, it would end the problem, once and for all
At the moment, many thousands are being woken up well before 5am because it is convenient for staff at the care homes
And care workers are affraid of losing their jobs if they speak out, even though they are on the minimum wage
For many, it is a wage, better than no wage at all, this also applies to many that are highly skilled in the profession
Come on CQC close that loophole once and for all and stop the abuse of the ones that cannot stand up for themselfs, after all, thats why your there.
18-Aug-2012 8:47 pm
THIS IS TO PUT THE RECORD STRAIGHT
THE CQC STATES, THERE IS NO SET TIME TO WAKE UP RESIDENTS AND GET THEM DRESSED
IT IS A LOOPHOLE
THE CQC GETS LET OFF THE HOOK BY SAYING IT SHOULD BE IN THE CARE PLAN, AS WE ALL KNOW, IT IS NOT
A GOOD CARE PLAN SHOULD STATE WHAT TIME A RESIDENT WISHES TO GO TO BED AND WISHES TO BE GOT UP, HOW EVER I HAVE NEVER SEEN A CARE PLAN THAT STATES WHAT TIME TO GET A PATIENT UP
IT IS THER DUTY MANAGERS JOB TO MAKE SURE THE CARE PLAN IS FULLY UP TO DATE AND COMPLETE, ONCE AGAIN GIVING A LOOPHOLE TO THE CQC AND STAFF AT ALL HOMES
HOW STRANGE IT IS THE ONES WHO CANNOT STAND UP FOR THEMSELFS WHO ARE GOT UP THE EARLIEST, NORMALLY STARTING AROUND 4,30AM
AND BY THE WAY, JUST FOR THE RECORD, IT IS ACTUAL MENTAL ABUSE
SO CQC, WHEN IF EVER WILL YOU PUT A STOP TO THIS COMMON BAD PRACTICE AND PROTECT THE ELDERLY WHICH IS WHAT YOU ARE THERE FOR
10-May-2013 0:56 am
action on elder abuse state that it is abusive to wake residents up early to wash/ bed bath them(other than the necessary pad wash and changes) - even if they don't get up. they are quite happy to pursue these matters with or for you, even if you wish to remain anon. i contacted them after initially contacting cqc who didn't bother to answer - what a joke.
i have faced many years of pressure from the matron (who denies it to my face, but goes behind my back either pressurizing the care staff or making sarky comments).
i refuse to disturb someone unless they are;
: a)needing a complete wash and clothes changes for incontinence reasons
:b)they request to get up/agree to it and are deemed mentally able to make their own decisions
:c) are unsafe in bed
trouble is nobody complains to my face.i wish they would, but they are cowards. i have a great team of night carers, but they are targeted and made to feel bad, for not helping the day staff more. i know we should work as a team and help each other, but not at the expense of these vulnerable people. i`m sure even in the most respected of homes these practices continue (we are such a home) and relatives would be horrified if they knew.
i`m sure managers believe by washing and dressing a resident in bed and not actually getting them up is OK, but they are still being unduly disturbed at an unacceptable early hour. hell of a difference from having a discreet "hygiene" check, to a complete bed bath and being undressed etc.
i didn't know about this loophole and am completely disgusted, may be that's why no one from cqc replied to my email. lack of staff is a problem and i also believe any person who believes it is alright to carry on such practices should not be in the job.
5-Oct-2013 3:54 pm
As a HCA, with staff nurse in charge, how do I go about dealing with this situation without getting trouble myself? I am currently shadowing for the next two shifts as it's a new job then I will be on my own. The earliest patient we woke the other night was 4am!! They didn't complain so I don't know if they wanted to or are just used to it. One woman however made it very clear she did not want to be woken at 5.30 am. She was extremely distressed and angry and carried on crying and shouting for about an hour after we had gotten her up. The hca I was shadowing said she's like this every morning. I don't see why the woman has to be woken if she doesn't want to! And when I'm on my own I am not gong to do that to the poor woman. The hca I was shadowing also called the woman cray, to her face, when she was kicking off. I was really uncomfortable about that. What do I do? As i said this a new job so i haven't been there long and don't know how things are day to day, I don't want to get into trouble or cause friction between me and the other HCA's and I really can't afford to lose my job but I can't justify treating some of the patients this way, it's against their rights.
7-Nov-2013 2:34 pm
I am pretty new to the care service and already I'm at odds with what is regarded as acceptable care policy.
I am paid minimum wage and find myself put in a position of trust that does not reflect that salary.
Even though I have not got a vast amount of experience in the care profession, my natural intelligence and common sense tells me that there is a lot of things going on within the system that are clearly not right....perhaps even verging on abuse.
Where I work I am well aware that there are vulnerable people being woken up as early as 5.00am to be washed and dressed, some are clearly in a distressed state and not in a position to resist or complain.
As mentioned in earlier posts, there is a requirement placed on night staff to wash and dress a certain number of residents every morning, the day staff expects this quota to be met or else there is a complaint levelled against the night staff regarding laziness.
I have made my feelings known on this matter to the management without success.
I came into this profession to hopefully make a difference and help people live a decent and comfortable life.....at this moment in time I only seem to be plugging holes in a wall made up of bureaucratic red tape.
14-May-2014 6:04 am
Please can someone tell me where the guidance/legislation is in regards to waking residents up to do full body washes? As in the home I'm in, it is deemed acceptable after 6am, however, I still find it cruel if they are sleeping and unhappy about it, also I want to know about pad changes during the night when doing checks, If a resident needs continence care for faeces, they are sore, or wet through, I wash them, but, if there pad is a bit wet and there skin is in good condition, I have just been quickly changing the pad as to not disturb the resident from sleep, now some of the nurses and HCA's are in agreement with me, whilst others are not, who is right, and where is the guidance? I am on the verge of quitting my job, as I am sick of day staff complaining, nothing we do on nights is never good enough, I genuinely care about the residents, but am starting to get very fed up.