As West Sussex coroner Penelope Schofield rules that neglect contributed to five out of 19 deaths at Orchid View care centre, and that the then Southern Cross run home was riddled with "institutionalised abuse", BASW professional officer Joe Godden looks at what went wrong.
Jean Halfpenny, Wilfred Gardner, Percy Bates, Ellen Bates, Graham Miller, Maisie Martin, Maureen Donaghey, Margaret Tucker, John Holmes, Enid Trodden, Bertram Jerome, Doris Fielding, Jean Leatherbarrow, Ethel Mehemet, Brenda Anderson, Winifred Redhead, Vera Redmond, Barbara Wilkinson and Ronald Kenward, were all residents at Orchid View care centre.
Reports of the deaths of five of these people and the neglect of many others at the Orchid View home makes harrowing reading.
The coroner said there had been “mismanagement from the top down” at the home that was run by the now defunct Southern Cross. The home was described as “state of the art” a classic case of all the emphasis being put on furnishing and fittings, with the quality of care being swept under the carpet.
It seems that the Care Quality Commission were taken in – giving the home a “good” rating, describing it as “a well maintained home that is clean throughout”. This judgement was delivered during a time when neglect and ill treatment seemed to be the order of the day. A serious case review has been ordered.
So what went wrong and what can social workers do to protect older people? Firstly it is important to know that Southern Cross – the owners of Orchid view, who subsequently went out of business, was an enormous company.
It was driven by private equity investors who saw the care industry as a potential gold mine. At its peak Southern Cross owned 750 care homes, with 30,000 residents. Owners of Southern Cross demanded 90% occupancy, which they needed to fund the massive and aggressive expansion that had taken place over just a few years.
In 2008, I interviewed several staff in a home that had been taken over by Southern Cross 12 months previously. This is a really worrying example of the total commodification of care. The following are verbatim accounts of what several staff said:
“I will be truthful with you. Since Southern Cross have taken over everything has been chopped in half and we are not very happy”.
“A lot of our people have been made redundant and none of us knew about that and we didn’t think it was fair”.
“I loved my work. I used to go home very satisfied that I'd done the best that I could on each shift that I worked. Now it's frustration”.
“We can't give them enough of our time. You're lucky if you have the time to do what you need to do without just having that little bit extra to be able to sit and, you know, have a minute talking to them”.
“We never had this, never as bad as this”.
“Just people falling sick; just don't know what's happened. There are people who've left and they've never been replaced”.
“The residents are very, very important to me, knowing that I'm giving them everything what I could give them, what they'd need - require throughout the day. I mean they're friends as well and that's what I like about it. You know, you meet some absolutely extraordinary people and I still love knowing that I can do - give them a little bit of help, more so than anything”.
“Frustration not being able to do as much as I can. We are exhausted, stressed, just tired. You're dragging your feet when you walk out on a night”.
“And I have been saying that I'm going to be looking for another job because the care here, I think the care since Southern Cross took over has plundered quite a lot and everything - everything is just going down”.
“The care's not what it used to be. You haven't got time to do this. You haven't got time to do that. And the only people that's suffering, to me, is the residents”.
In circumstances such as these you have to ask, why don’t staff whistleblow? The reality is that it is very hard for people on low wages to risk their jobs. In the end at Orchid view it was whistle-blower Lisa Martin who alerted the authorities of bad practice – it was reported that she was ordered by managers to “fill the home, fill the home”. Ms Martin has recently given an interview to the Daily Mail in which she said she now can't get a job and faces losing her home.
The inspection and regulation of care and nursing homes must improve, which is something that has been acknowledged by Andrea Sutcliffe the new Chief Inspector of Adult Social Care in a CQC publication A fresh start for the regulation and inspection of adult social care in England. It is absolutely right that inspectors need to be knowledgeable and trained in the specialisms that they are inspecting, but at BASW we have real concern that the proposals do not go far enough.
A fundamental problem is that inspectors have become divorced from the communities that they are meant to be serving. Social workers often come across care that causes concern in residential and home care, yet they no longer know the inspectors, or have an easy mechanism for working with inspectors to expose poor practice.
Partly the problem is that inspectors are not locally based, and partly the social workers and inspectors are far too over-stretched.
Social workers are also under pressure not to favour one home over another – they are supposed to remain neutral and not recommend one home over another even where they have concerns about the quality of care.
Orchid View, a pretty name hiding an awful scandal. There will be more injustices to come unless there is a fundamental change in the way that care of older people is organised and resourced.