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CQC issues guide on use of cameras to record abuse in care homes


Guidance for the public on the use of cameras to record instances of poor care or abuse in care homes has been published by the Care quality Commission.

The regulator today published information to help people make “appropriate decisions” on the use of hidden cameras, or any type of recording equipment, to monitor care.

The CQC guide neither recommends nor rejects the use of cameras, covertly or in public, but notes that it is a “hugely controversial subject”.

Over the last year, the regulator has been seeking views about the topic and was told that information from the regulator would be helpful.

It follows examples of poor care and abuse being exposed in the media after relatives or staff covertly recorded incidents, such as those which took place at Winterbourne View.

“For some, cameras or other forms of surveillance, whether openly used by services or hidden by families, are the answer”

Andrea Sutcliffe

The CQC published information for providers in December, setting out steps they needed to take into account when using open or hidden surveillance and has followed it up today with information for the public.

“Installing a hidden camera or other recording equipment is a big step, and a decision for people and families to make,” the CQC’s guide states.

“On the one hand, it might set your mind at ease about any concerns you may have. Or it might help you to identify poor care or abuse. However, you should think about how it may intrude on other people’s privacy, including other people who use the service, staff, families and visiting professionals,” it adds.

Andrea Sutcliffe, the CQC’s chief inspector of adult social care, said: “We all want people using health and social care services to receive safe, effective, high quality and compassionate care.

“Sadly, we know that does not always happen and the anxiety and distress this causes people, either for themselves or a loved one, is simply awful,” she said.

“For some, cameras or other forms of surveillance, whether openly used by services or hidden by families, are the answer. Others feel this is an invasion of people’s privacy and dignity. Many don’t know what to do if they are concerned,” she added.

In November, a survey of care home staff found the majority would support the use of cameras to help stamp out abuse and bad practice.

“Cameras have helped to expose terrible cruelty and neglectful care and I welcome this new advice”

Norman Lamb

Care home provider HC-One gathered the views of 7,330 members of staff, 3,300 relatives and 1,535 residents. It found 63% of staff said they were in favour. Meanwhile,87% of relatives would like one in their loved one’s room, but just 47% of residents wanted the same, citing privacy as a key concern.

Gavin Terry, policy manager at Alzheimer’s Society, noted that the use of hidden cameras was a “complex matter” and “should only be a last resort”

“If the person with dementia is unable to consent, any surveillance must be made with their best interests at heart, and be carried out in the least restrictive way possible as it is could compromise their privacy, dignity and basic human rights,” he said.

Care and support minister Norman Lamb said: “Cameras have helped to expose terrible cruelty and neglectful care and I welcome this new advice.”


Readers' comments (15)

  • michael stone

    The advice about installing recording equipment in the room of a mentally-incapable loved-one (i.e. the room of someone who 'cannot give consent') is - unsurprisingly - less than totally clear:

    'If the person does not have the capacity to give their consent (for example, if they are unable to make decisions because they have dementia), it is important that you feel sure that you are doing the right thing – in other words, acting in their best interests. '

    However, interestingly this does connect the defensibility of 'best-interests decision making' with the decision-maker: here, the person who decides to install the camera, as opposed to the people running the care home.

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  • This looks like a pragmatic assessment of reality.

    I may have missed it, but there are safeguarding staff who should be looking at the interests of those who cannot consent. What is their input here?

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  • didn't the woman from the cqc say that cameras could be installed without relatives telling anyone, is this legal? how about when the grandchildren come to visit with their friends, will the person installing the camera ask permission from the parents of friends, will they be uploaded to face book? will the snstaller use it to send to peadophiles? how wever it could have the benefit of protecting care workers against false accusations

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  • HCSW

    I really like the idea, and I am absolutely sure that before I retire, we will carry the recording devices similar to those used by the police. Cameras are great to support our 'evidence based care' and in eliminating any sort of abuse. Only questions are: who is going to monitor/review of these clips, and where the video files should be kept. That is the most difficult issue. I don't think that the hidden cameras installed and operated only by the family is a good idea, as content might be very private, might be stolen from unsecured computer and used on some weird websites.

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  • i don't like the idea of the patient/resident being filmed as I think it compromises privacy and dignity. However, I think it should be absolutely mandatory for all institutions to have this equipment installed and used. The elderly have no advocate, no voice- they need all the help they can get. And, as for privacy/dignity being compromised, there are ways (all nurses will be able to tell you just how) that you can bathe, shower, toilet people without actually compromising their dignity...........simply by using the same methods used by the operating theatre nursing staff when preparing patients for surgery.

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  • I just feel it's sad that it's come to this to be honest.

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  • michael stone

    carrie-ann | 12-Feb-2015 4:37 pm

    Anonymous | 12-Feb-2015 8:18 pm

    In terms of legality, this one is even more complicated than most decisions when people are mentally incapable - but the CQC guidance seems to be almost 'quoting' section 4(9) of the Mental Capacity Act. And section 4(9) of the MCA is a description of a legal 'duty' imposed on anybody who makes a decision - it doesn't [as so many clinical authors 'imply or apparently beleive'] limit who can make a decision [re an incapable person]. This fundamental point about the MCA's 'best interests requirements' is frequently ignored or misrepresented.

    There also seems to be some 'pragmatism' in the CQC's position (hidden filming exposed bad practice in the past - very difficult to therefore forbid it).

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    says the fruit and nutcase expert!

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  • I would have welcomed a hidden camera
    in my mother's room. The home used the "privacy" excuse to hide the presence of numerous injuries including a pressure sore which required the prescription, (eventually after my intervention) of a deep cavity wound dressing despite the fact that before dementing, when she had the mental capacity, she demanded that I attend to her toileting needs and observe her skin conditions. She was demented and despite my complaints, the home routinely breached DoLS standard authorisation form 12 with impunity.

    The safeguarding and supervisory bodies endorsed and even inspired the home's maltreatment of her and others suffering from dementia, instead sucking up to relatives in a truly repulsive and time + effort wasting manner.
    Only the CQC took action on the service users behalf. That home is now being assessed using their new system. I await the results with interest.

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  • I absolutely support the CQC guidance.

    I am now a nurse at the end of my career and I am still traumatised by the fact that I could not do anything to stop 3 particular dreadful episodes of elder abuse as a Junior Nurse despite going reporting it to my seniors.

    1. As a student Nurse I walked into the patient Day room of an Elderly Mental Health Vila and witness the Nurse in charge dragging a lady the lengh of the room and shouting at her, whilst two care assistants looked on laughing (albeit uncomfortably).

    As a newly qualified nurse I witnessed a staff nurse target an elderly man for some unknown reason. She was in charge of his care regularly and would not let anyone else feed him, but a nursing assistant told me that she was starving him. I went to check on her during a lunch period and found the curtains drawn, behind the curtains, she appeared to be on top of him in some sort of tussle.

    On the same ward it was genral practice that the qualified staff gave the medications to senior care assistants to administer if the client needed extra time and support to take oral medication. A junior nursing assistant told me that the nursing assistant was giving the man double medication each time by saying that he vomited the first dose of medication. I talked to the nursing assistant and her rationale was that the patient had cancer and she believed he should not suffer.

    I tried to raise concerns via the Nursing Office but to know avail. Against a background of lesser daily elder neglect, staff and resource shortages i.e both sisters were off sick, I felt I had to check everything and I eventually 'burnt out'. I loved working with the elderly as I had been lucky enough to be brought up in a community highly populated with elderly people.

    The abuse and lack of dignity was so prolific and was obvious to to any nurse who had completed nurse training. This included my Nurse Lecturers who did not prepare me for this, Nurse managers who were not proactive in dealing with it, relatives who were too afraid to complain, Drs, Occupational Therapists, Physiotherapist, volunteers.... I decided that they had developed a strategy to cope by ignoring it. I could not ignor it and it made me unwell so that I was of no use to anyone. I swore I would never work in the area of elderly care again.

    I feel guilty thirty years on, and it still can make me cry. I am delighted that this cancerous problem is finally coming out into the public domain in a way that true advocates of patients can make a positive difference to the care of the older person.

    The CQC guidance may have its limitations but its got to be better than what has gone on for the last 30 years.

    Kind Regards

    Please prepare our nursing students to deal with elder abuse and give them support were they can feel safe and remain anonymous if they need to tell. Their support should not be linked the the Hospital or University. Only the tip of he iceberg has been touch.

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