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Inside Out: Care home investigation - who can we trust?
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A ³ÉÈËÂÛ̳ investigation has uncovered serious failings in the system
that's supposed to police care homes for the elderly – Inside Out,
³ÉÈËÂÛ̳ One East Midlands, 7.30pm, tonight.
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A journalist
working undercover in a Nottinghamshire care home discovered
evidence of poor infection control and lapses in care – yet the
Moorlands Nursing Home in Brinsley was passed as satisfactory by an
official inspection and a council audit.
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It took the Commission for Social Care Inspection (CSCI) 54 days to
act after the ³ÉÈËÂÛ̳ highlighted its findings. It should have taken
just 24 hours.
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The CSCI have now re-inspected the home and found
significant problems. It has launched an enquiry to find out what
when wrong.
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The ³ÉÈËÂÛ̳'s undercover reporter worked inside Moorlands Nursing Home
in Brinsley, Nottinghamshire.
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The home is owned by Regal Care Homes
Ltd and offers both nursing and residential beds for up to 40
elderly people.
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The residents are particularly vulnerable to
infection, making it crucial that staff follow procedures to
protect them.
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Yet Inside Out found evidence that some staff were
confused about who was infected by MRSA and sometimes neglected
basic hygiene precautions.
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Superbug expert Professor Richard James from Nottingham University
watched video footage of cleaners at Moorlands wandering out of the
room where someone was believed to be carrying MRSA.
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"Cleaners... not wearing an apron, not taking their gloves off before
they left that room, wandering along a corridor... it would be quite
likely that any resident in the care home could become an MRSA
carrier," says Professor James.
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Regal Care Homes says the resident was clear of MRSA when the
filming took place. But, ³ÉÈËÂÛ̳ evidence shows staff were unsure and
were unable to clarify even when they checked the resident's notes.
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The Inside Out reporter also discovered that, at times, residents
with dementia were left unsupervised and others had to wait
unreasonable periods for basic care.
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He found one resident had been
left sitting in urine-soaked clothing. The carer who treated his
sore skin said he had not been fitted with the leg bag he required.
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Regal Care homes disputes what happened and says leg bags were
available at the home.
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In another incident a resident left unsupervised in a lounge area
had soiled herself and removed much of her clothing.
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Her relative Raymond Skelton, distressed by the ³ÉÈËÂÛ̳'s footage,
says: "It's quite obvious there could not have been anybody there for
some considerable time because she would not have got into that
state in a couple of minutes.
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"I want answers. my initial reaction
is I need to take her out of there now."
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Regal Care Homes maintains the lounge was never left unattended
that evening. But it says staff do have to leave residents alone
occasionally. It says it is inevitable some will have accidents of
this sort.
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While Inside Out's reporter was undercover he raised his concerns
about care and hygiene with the home's management but saw little
change.
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When Mike Rourke, CSCI's director of inspection, regulation and
review, was questioned about the delay in responding to the call
from the ³ÉÈËÂÛ̳'s reporter, he says: "At this stage it looks as if there may have been a number of
people who were involved and we want to understand what they did
and why they didn't act as our procedures required.
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"But our view is
that this is an exception, there are lessons I'm sure to be learned
from this and we will do so."
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The commission is responsible for inspecting all 18,500 care homes
in England.
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Last October one of its inspectors went into Moorlands.
Its report suggested Moorlands had no significant failings.
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Part of the inspection regime is self-assessment. Moorlands' own
management filled in a questionnaire before the inspector arrived.
The inspector based his report on it – and the care notes of just
four residents.
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Former inspector and nurse Ruth Poole spent more
than six years inspecting care homes.
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She believes the inspection
system is now not robust enough to protect residents.
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"It's has been watered down to such a degree that in my opinion
inspection reports are nothing more than tick boxes."
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But the CSCI's Mike Rourke says: "We wouldn't accept that our
inspections are tick box. We've tried very hard to make sure that
our inspections really begin with the service users' experience.
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"We
want to know what it's like to live in a home. We want to know what
it's like in terms of dignity, independence, safety, all of the
things that people who use services tell us are important."
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The CSCI stands by its October 2007 report and says it is perfectly
possible that the problems highlighted by Inside Out had developed
in the weeks after the inspection.
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The CSCI has subsequently re-inspected Moorlands and asked the home
to act immediately to address a number of issues.
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Mike Rourke says: "It is a case that there are concerns around the management of
medicine, infection, care planning, risk assessments, those sort of
areas that we would expect to be addressed properly in a well-run
home."
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During the ³ÉÈËÂÛ̳ investigation, the home was also audited by
Nottinghamshire County Council – its report showed nothing wrong.
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The council has now issued the following statement: "We are extremely concerned about the issues that have been raised
about Moorlands Nursing Home and we have immediately acted to
ensure the safety and wellbeing of the residents in partnership
with the Commission for Social Care Inspection.
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"This year, we have introduced a quality audit process for the
first time to look at aspects of care in independent care homes.
These audits are pre-arranged and provide a snapshot of the
arrangements in any home.
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"This audit at Moorlands was not an official inspection and it was
carried out in addition to the regular inspections by CSCI, which
is the regulator of adult social care in England.
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"The County Council is committed to improving the overall quality
of care at residential and nursing homes in Nottinghamshire and we
have been working with the Notts Care Home Association to do this.
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"We will continue to work with CSCI. and Moorlands to ensure the
future improvement to the quality of service in the home."
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While inside Moorlands Inside Out's reporter also saw kindness and
compassion from staff sometimes working in very difficult
conditions.
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Most relatives who contacted the ³ÉÈËÂÛ̳ were very
supportive of the home and believed it was caring very well for
their loved ones.
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Regal Care Homes say the home is now clear of
MRSA, and it complies with NHS guidelines on infection control.
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But questions remain about how these homes are inspected – how
standards are maintained.
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Former inspector Ruth Poole says unless
inspections take place regularly and unannounced there is nothing
to prevent conditions deteriorating behind closed doors.
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She says: "If you haven't got the inspectorate knocking on your door, coming
in at any hour of the day or night then effectively you are left to
your own devices."
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Inside Out, ³ÉÈËÂÛ̳ One East Midlands
7.30pm, Friday 2 May 2008 Ìý
Notes to Editors
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Inside Out is also available at
bbc.co.uk/insideout from 8.00pm, Friday 2 May.
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³ÉÈËÂÛ̳ Birmingham Press Office
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