Abuse of older people is continuing in care homes in England as revealed by a staff survey published this week in Nursing Times
The survey results are alarming and expose cruelty from care home staff including taunting, slapping, pinching and tying elderly people to chairs. If this snapshot of life in care homes is played out across the country then many of our older people are receiving psychological and physical abuse at the hands of those employed to care for them.
The format of this research project encouraged nursing staff to be honest about their experiences. The anonymous survey was completed by 156 staff working at five new nursing homes in four local authority regions in England.
“The survey results make uncomfortable reading”
The newly employed staff were asked to report on their experiences in nursing homes where they had previously worked. This meant that the respondents did not feel held back by anxiety that they would be identified by their employer.
The survey results make uncomfortable reading with some of the free-text examples describing shocking treatment and abuse.
Participants reported the following examples of abuse:
“The senior carer and her cronies took delight in the senior carer cleaning this man’s toenails with a fork, then putting it on the dinner table to watch another resident eat their dinner with it.”
“Just under half of the examples of reported abuse were psychological”
“It wasn’t uncommon for the care staff to lark about and put the wrong dentures in people’s mouths so they looked funny, y’know, like a man’s teeth in a woman’s mouth.”
“It was common practice for the carers to flick Mrs A on the head with a tea towel or duster. She didn’t have dementia like most of the others, but she had no relatives…no one ever came to see her.”
“When Mr B got scared he would scream like a girl…so the carers would sometimes push him along very quickly in his wheelchair just to hear him scream.”
The statistics are alarming with 88% reporting they had witnessed or suspected abuse in their previous jobs with three quarters who reported abuse saying they actually witnessed it.
Just under half of the examples of reported abuse were psychological. Examples from those surveyed included ignoring residents, name calling, withholding affection, threat of eviction, taunting about a disability or about sexual needs and threatening with physical violence.
“The second most common type of abuse was neglect”
The second most common type of abuse was neglect seen by 59 staff members with examples cited as placing the call button out of reach, not giving drinks or food, leaving residents in wet pads or beds, leaving and forgetting patients on toilet, and the falsification of records including fluid intake.
The third most common type identified was physical abuse, 67 incidences witnessed by 37 people. These examples of physical harm to the frail and vulnerable are cowardly and shocking. Examples listed include pinching, slapping on arms or legs, pulling hair, punching arms and legs, slapping on the face and physical restraint such as tying an older person to a chair using tights.
Research author Steve Moore, commissioner of care and nursing home services at Dudley Metropolitan Borough Council argues that until we acknowledge that the current safeguarding and regulatory processes are ineffective then abuse will continue. Mr Moore calls for more effective ways of assessing the suitability of staff to their caring roles.
“It is hard to police care that takes place 24 hours a day”
The abuse revealed in this study is disturbing as is the fact that it appears that so many staff, 10% of who were nurses failed to report this abuse. What does this say about those workers? In our news story on this research Professor Martin Green, chief executive of Care England raises an important point, namely how will the new employers ensure that these workers do not continue to turn a blind eye to abuse in their new jobs?
It is hard to police care that takes place 24 hours a day, often intimate and behind closed doors. It requires a culture change that makes this kind of treatment unacceptable. While the Francis report focused on care in the acute setting it is clear that a similar high level investigation is needed for the care home setting. This would hopefully lead to the appropriate structures and mechanisms to be put in place to work to eradicate this abuse and maltreatment of the elderly and frail.