Kevin Saving on
Can Gerry Robinson Fix Dementia Homes?
(Part Two, the inglorious sequel)
(B.B.C. 2, 9 p.m., 15.12.2009 - Part 2 [of two])
Well, no (surprise, surprise) he didn't.
Poor, poor Robinson...just when he thought things were about to turn around...when his 'show-cased' Home had improved its rating from 'Poor' to 'Adequate'...when even the soundtrack was growing jauntier ...then, suddenly, (unspecified) allegations are levelled at 'Summervale' and it was summarily closed down.
Still, at least we have now been afforded an exceptional opportunity to watch 'The Robinson Way' (or should that be 'Gerry-building'?) in action. Its modus operandi appears entirely to consist of: (1) 'grilling' the ineffectual, obviously dis-spirited manager; (2) conducting an 'Unannounced' (3 a.m.) inspection; and (3) arranging a staff-meeting in which care-staff were censured for placing call-bells out of reach, and restricting the access of 'residents' to the outside world. (By-the-way, the officially-sanctioned form of address is now 'service-user'). So there we have it: it was all the staff's fault after all.
Robinson's 'staff solutions' (if I have not misunderstood them) seem to be for the staff to spend more time 'one-on-one' (fair enough), for them to wear 'civvies' whilst eating alongside the service-users and (bizarrely) for the older, confused females to be given plastic babies.
'Summervale' appeared to operate on a system of two care-staff to twenty two service-users (in my experience, a fairly representative ratio which can often rise to 1:15). The 'recommended ratio' is, we are told, one-to-four (which, outside of he well-funded 'Learning Disability' sector, I've never yet encountered). So: if we've got one staff-member to (say) a dozen confused, elderly people, that's not - even with the best will in the world - going to translate into much 'personal time' left-over, once we've finished the 'meds round' and completed the washing/changing/feeding/toileting slog. One answer might be 'more staff' - but, hey, aren't we supposed to be a profit-making enterprise today? Eating with the service-users whom we're simultaneously feeding (and whilst wearing one's own clothes) - is a policy strictly enforced in some establishments- though not to everybody's taste, nor especially hygienic, either. Sir Gerry, I notice, did not elect to take up this option. 'Plastic babies' I'm not even going to dignify by discussing: just imagine how you'd feel visiting your mother/grandmother whilst she's sat in her chair, 'nursing' one of those things.
Still, at least the soundtrack got jauntier...
Poor, poor Robinson...He clearly found the management of 'Summervale' to be inadequate (which, in truth, it probably was). But then: I'd be inclined to wonder what effect having tv cameramen and sound-technicians blundering around invading my service-user's privacy, would have in respect to the creation of a warm, safe and homely unit.
Just for sir Gerry, I'm about to disclose two appalling secrets about residential care: in many Homes it is made intentionally difficult for service-users to get outside. This is, generally, because confused elderly people have been known to wander off on to busy roads. And the great British public would be sure to have a view about that. Call-bells should, quite categorically, never, ever be placed out-of-reach. Unfortunately, some service-users will activate them (as it is their inalienable right to do) constantly and at all hours of the day and night. So. yes, the odd call-bell will, occasionally, get 'hidden' (a practice
which I'm not condoning, simply trying to place in context).
Sir Gerry does seems to have what we call 'the touch'. He sits sympathetically, stroking a service-user's (anyone fed-up with the nomenclature, yet?) hand -and for at least as long as the cameras are on him. An obvious solution begins to form in my befuddled mind: sir Gerry must manage his own care-home - certainly after a couple of week's instruction via the wonderful National Vocational Qualification (N.V.Q.2). I calculate his, Gerry's' age at 61 -and our marvellous government is busily arranging for everyone's state-pension to be paid at an age far in excess of that. Yes, sir Gerry, let's visit your home after you've had six months in charge.
That, I'm afraid, isn't going to happen. At the end of the programme our 'fixer' gets into his taxi and is driven off, away from the condemned 'Summervale' and its betrayed, newly-evicted residents. He promises to see everyone again. Earlier in the 'show' (because that's what it is) one of the more combatant elderly ladies told him to 'fuck off' (and I thought she was supposed to be suffering from dementia!). Well, Gerry certainly fixed it for her.
Allegations can be extraordinarily corrosive. The present author was once given a 'verbal warning' (recorded on his supervision notes) for 'manually handling' -aka 'catching'- a falling resident (in those days we had 'residents'). Care-workers are currently supposed to allow them to sort-of cascade down a braced leg onto to floor (yes, really!) It's kafka-esque.
'Summervale' appeared to be no better, no worse than the vast majority of care-Homes of my experience.
I truly believe that most allegations of 'abuse' are inflated out of all proportion by people who have no idea of the realities of residential, or nursing, care. The whole gamut of 'Neglect' versus 'Abuse' is, for instance, a far greyer continuum that many realise. They don't understand this, because they don't, really, what to think about it. It is, probably, too facile to categorise a whole system of care-provision as 'abusive' - but if we continue to place people in 'paranoid' environments, if we continue to bureaucratise their practice and we continue to pay them - quite literally - 'bottom dollar', then we will continue to manufacture our own, new, wholly-p.c. Bedlams.
I once (long ago in another life) used to try to explain how the word 'care' has both 'custodial' and 'affective' aspects: we have both to care 'for' people and care 'about' them. But then, talk, as they say,
is cheap (unless you're a managerial-consultant).
Poor, poor, Robinson.
Poor, poor, us.
Kevin Saving © 2009
Kevin Saving was involved in what is now known as the 'care industry' for upwards of a quarter-of-a-century. He has been employed in the N.H.S. and in Local Authority (social services) care Homes and Day Centres. He has worked in private nursing Homes (both as care assistant and registered nurse) and has managed a unit for persons diagnosed with 'Asperger's syndrome'.