This article was first published during May 2009 on this site. It has been extensivly edited, admended and added to to bring it upto date. If you find it of interest please leave a comment.

It never fails to amaze me when the UK government, the public or both express shock and surprise when a damming report is published exposing some “new” horror or scandal, especially as most of them are caused by the current government’s inaptitude, lack of foresight, planning or will to turn the election pledges and commitments into realities. If you, like many, read newspapers, watch the TV, listen to the radio or follow news on the web it’s almost impossible not to be aware of, or have formed an opinion about most high profile and controversial subjects and scandals.

I am convinced that the great majority of the British Public is already well aware of the lamentable standards of care for the elderly in our care & nursing homes!.  So why do we, the electorate choose to ignore this scandal?.  Why are we not marching on Downing Street?.  Why are we not petitioning the Prime Minister, why do we go on turning a blind eye?.  After all, every one of us is getting older and there is a very good chance we, or a close family member will need some sort of personal care in the not too distant future.

The amazing thing about us British is that we are prepared to fight for the right to hunt foxes, or keep dangerous breeds of dogs, or protest against perceived invasions of privacy, or fight for the underdog, Gurkhas settlement right and similar worthy causes but seem incapable of fighting for our own people, for our underprivileged, our disadvantaged, our disabled, and especially our elderly.

The unpalatable truth is;  that today the old are seen by many younger members of our society, and especially by our politicians and our own children as an inconvenience that must be put up with, tolerated, managed, hidden away, disadvantaged and neglected. They are viewed by many as an expensive luxury they could well do without. If the old are going to be so inconsiderate as to keep living longer they must be managed as cheaply as possible, the shameful mantra is “let’s put them out of sight, and do it as cheaply as possible”.

The truth is, until I turned 50 I never really gave getting old and its consequences much thought, none of us do, it’s the “head in the sand syndrome” we know it’s going to happen but we ignore it until it’s too late . Now that I am pushing towards 60 the subject of getting old has begun to take on much more prominence and importance to me with the realisation that I’m nearly there. I point this out, not so as to invoke any sympathy on your part, rather only so you can understand my point of view. It is becoming increasingly difficult for me to examine old age, and care of the old objectively rather than subjectively, as any day now it is possible it will begin to affect me. There, I’ve owned up, as I approach my old age I am given to consider the subject of my own care, should, heaven forbid, I ever need it.

Like most people, it is not dying that worries me, it is having to rely on other people for my basic needs, being unable to feed, wash, use the bathroom and dress myself is what I fear. I often tell myself that when I am unable to do the things I enjoy and life loses its little pleasures I hope that I am sufficiently able-bodied to be able to take my own life rather than become a burden on others. The thought of the possibility that I might end up in one of these awful residential or nursing homes fills me with acute dread.

As I write this article, my thoughts are with those members of our society that have no other choice than to live in these abominable creations of mankind. I mourn the loss of our family values, where in the past each generation would care for the previous generation, the elderly had pride of place at the fireside or at the head of the table.  In those days we valued our elderly, however frail; they had all that experience of life and living for us to draw on, full of advice, someone who would willingly give us an informed opinion, based on real living.

Now for advice we surf the Internet. It is our loss, this wealth of family knowledge, now lost or ignored.  How has it come to this while other societies and cultures  in the world still thankfully value their older members, care for them, respect them, give them the tastiest morsels, and yes, love them, perhaps a dirty word in today’s modern British society.

Before I go further I should point out that I have some experience of caring for the elderly, I worked for nearly a year in a private elderly care home and my wife has been closely involved with caring for older people for nearly 20 years, she is currently a Day Center Officer in an elderly daycare center.

The good news; if there can be any good news where this subject is concerned, is as the number of older people increase they represent a greater percentage of the voting population. Used wisely the “Senior Citizen” vote could and will have a huge influence on future government polices and decisions. Any political party that fails to realise this fact and alienates the senior vote is guaranteed to lose any future election.

Long before any government report is published any intelligent citizen will have realised that something very is seriously wrong in this or that area of local or national governmental organisation.  In this article I am referring to a recently published report compiled by the LibDems after they obtained information from the Commission for Social Care Inspection, but only after they had been forced to make requests to the Commission using Freedom of Information legislation.

Hardly a week has gone by over recent years without the press reporting another scandal involving a care or nursing home and how they have been caring for, or rather not caring for, the elderly who are dependent on them. Many of you will recall reading about the elderly married couple, who had never been parted for even a day, until one of them needed more care than the other could provide. The solution, as far as their local social services were concerned was to split them up, only after a public outcry was there a rethink by social services driven only by the need to prevent further negative publicity resulting in the couple being re-united in a suitable care facility, and don`t be fooled by government statements, this was not an isolated case.

In this instant the couple were fortunate that their case was reported in the media, many similar cases go unreported, it`s very true to say that those who shout the loudest get the most in today`s modern society, not that I am criticising the result in achieved in this instance in any way    For those of you who are in happy, loving relationships, consider what your reactions and feelings would be if you were forcibly separated from your partner and told that you could never live together again?

The inspectorate revealed to the LibDems horrific details of “major failings” in hygiene and cleanliness standards. It was revealed that out of the 10,377 care homes inspected, 169, 1 in 60 were “squalid and had a shoddy attitude to infection control”. Of these, 28 had been given the worst rating on more than one occasion over a three year period meaning these care homes had ignoring demands to carry by the inspectors to carry out what they considered were urgent repairs and improvements.

One has to ask the question;”What’s the point of inspection if the authority lacks the will to enforce improvements when they are identified as urgently required”? These 169 care homes failed on the key benchmark of a residence being “clean, pleasant and hygienic”, surely that is the very least that any resident should expect.  This report compiled by MP’s and campaigners revealed that thousands of our elderly citizens risked serious illness and discomfort as they were forced to “live in filth”. Conditions in some of the homes “verged on abuse” We British do not allow our pets to live in such conditions, there are regular public outcries when reports of abuse to animals is reported in the media so how can we possibly allow our elderly to exist in conditions such as described here.

Inspectors reported that they found rooms stained with faeces and food, urine containers being cleaned in baths, which raised infection risks, and bedrooms that were freezing or black with damp. Foul-smelling incontinence pads were left on floors in some care homes, while others had leaking roofs, water too cold for residents to bathe in and dirty and broken furniture.

Other “horrifying” examples showing lack of hygiene and cleaning included; flies buzzing in every room in one home, toilets hanging off a bathroom wall while thin quilts left elderly people shivering in their beds in another. A home in West Yorkshire had a shower held together with a denture sterilising tube, in another green slime with an unpleasant stench oozed from a bathroom grating. Further examples of poor care included staff failing to change gloves between taking residents to the toilet, outbreaks of sickness and vomiting at other homes going unreported with the cause not investigated.

Some homes that had previously been inspected and condemned as having “major” failings were not re-inspected for more than two years. To be fair, a few have improved following the inspections but do not deserve any sort of recognition just because they now meet the minimum standards any reasonable person would expect, instead they should stand in shame for their previous failings, however, it’s very likely that if there had been no inspection, no improvements would ever have been made.

The report comes ahead of last month’s transfer of Commission for Social Care Inspection responsibilities to the newly-formed Care Quality Commission. Liberal Democrat health spokesman Norman Lamb, who uncovered the statistics, said: “it is indefensible that people in care homes are being treated with neglect that verges on abuse. It is to be hoped that the new body never again leaves vulnerable people in dirty care homes being ignored any more for years without inspection. There must be zero tolerance of these disgraceful conditions. Homes that repeatedly failed to meet basic standards should be closed down. This government has consistently neglected social care and older people are suffering as a result.”

A spokesman for Help the Aged said: “Although the percentage of homes are failing to meet basic standards isn’t high, it is completely unacceptable for many care homes to house residents in revolting conditions.”

It is difficult to understand why the government thinks that by disbanding one failing authority and transferring the responsibility and power to a new authority tasked with basically the same duties will change anything. That this action is a damning indictment of the current administration’s failure to ensure standards of elderly care are high is very clear. This is just another example of the current Labour government`s attempt to paint a rosy picture to the general public when in reality the truth is very different. It is symptomatic of a government that has lost its way and has been in power too long, it has run out of new ideas and consistently failed to deliver on election pledges

Not a day goes by without the media in some form or other disclosing another horrifying example of our elderly in a care or nursing home. These are mostly in privately owned care homes, but sometimes also in council run homes. It would seem that today’s selfish society is happy to sweep all but the worst cases under the carpet, perhaps this is because to do otherwise would prove extremely uncomfortable and inconvenient to many of us.

Let us be quite clear on the subject of privately run care homes for the elderly, the owners of such establishments are not providing this service from any form of altruistic motive,  sense of community responsibility or sense of public duty. They operate their establishment quite simply to generate as much profit as they possibly can, either for themselves or their shareholders. Care for the elderly, infirm, disabled and disadvantaged comes a very poor second to the profit motive. Do any of you know of a care home owner who has decided to open and operate a private care home in order to improve the lot of the elderly? Can any of you place your hand on your heart and say, this owner or that owner provides a wonderful service and puts the care of the elderly before profits, of course not, and to be fair all businesses must make a profit however small in order to survive .

Care of our elderly is far too important to be left to the independent private provider unless these private providers are scrupulously and religiously monitored, inspected and overseen to the highest standards. Far better that councils should operate their own council run care and nursing homes for the elderly. The current government through its financial support polices for local government has made it almost impossible for local authorities to operate or expand council controlled care homes. It will be clear to any thinking person that a policy that removes the profit motive from the care of our elderly will go some way to ensuring that the care provided is of an acceptable standard.

There are, however, around the country a number of private organisations providing care and nursing services where standards are extremely high. However this care comes at a price and is often outside the reach of many ordinary families or elderly people requiring it. Social service departments responsible for placing elderly people in suitable care or nursing homes are often strangled by the need to meet budgetary constraints; it is only natural that they will be looking for best value and most economical placements. It is important that the priority is obtaining the right care of the right quality in the right location for those who need it with cost being the second consideration, however often the need to meet financial constraints means that the care needs will take second place to finding a care home places that fits within the budget.

Often care and nursing home planning applications are only approved when the proprietor agrees to provide a certain number of social care places, in effect this means that the elderly or their families who are fortunate enough to be able to pay for their own care are subsidising the social care places of other less well off elderly.

This is an entirely flawed system encouraging care and nursing homes to make shortcuts where social care is concerned. If you are paying privately for a care or nursing home place and you are unhappy with the care received you have a choice, you can move to a better quality home or pay more for better quality care or both. If you are a social care resident you have no choice but to accept what is provided or try to persuade your social services to find and fund alternative care arrangements for you or your relative.

It is this current government, who by changing the regulations and encouraging care in the community have pushed local councils to close council run care homes forcing them to seek and encourage private care home places for their local needy elderly.  Now don’t misunderstand me. I am a supporter of Care in the Community and the longer elderly people needing care can continue to live an independent life in their own home supported by the social services the better. What the government failed to recognize when formulating this policy is that there will come a time for a great number of the elderly that they will need a great deal more than a couple of hours a day care support.

This resulting “Care in the community” policy has resulted in many of our elderly being forced to lie in bed until their carer (often a different person every day) arrives to help them wash and dress. They are then often placed in a chair, there to remain for the rest of the day until a carer arrives to help them to bed, often as early as 5 or 6 in the evening. They are forced to soil themselves as no help is available to assist them to the bathroom during the day. These carer`s, mainly employed by private contractors, are often so overworked and have so many people to provide daily care to  are often unable to spend even the full hour each morning and evening that has been allocated by the social care services (and paid for by the tax payer).  Repeatedly these same carer`s resign their jobs in great distress because they have been prevented from providing even a reasonable basic standard of care to their clients.

Is this really how we want to care for our elderly and infirm in the twenty-first century?.

If we are really serious about providing high-quality care for our elderly we must be prepared to pay for it either directly or through our taxes, and good quality care is not cheap.

Recent investigations into a number of private “in-the-home” care providers has revealed that the care they provide is extremely poor and in many cases virtually non-existent, with some companies acting fraudulently, claiming to provide more care-hours than they actually do.  Again, these companies are in it for the money, they will do as little as they can and charge as much as they can. How can anybody in their right mind believe that the private sector can offer better standards of care at more cost-effective prices without affecting the well-being of the people they are supposed to be caring for?

On paper, it may appear that some privately owned care and nursing homes are able to provide a more cost-effective service, but this premise makes the assumption that the standard of care provided will be at least equal to, if not surpass the standard of care previously provided in council run establishments and by council directly employed home helps. This assumption however does not take into account that local councils are not required to make profits, while privately run care establishments are.   This profit can often only be achieved by finding ways to reduce the overall care provided to our elderly by taking shortcuts, paying low wages to their staff, employing immigrant workers whose English language skills may be poor, by employing poorly trained staff and then failing to provide adequate training. This lack of care is often cleverly disguised, and not obvious to the infrequent or casual visitor.

Only those who are able to regularly visit relatives in care and nursing homes are in a position to observe the real standards of care provided and look deeper than the often superficial care that the casual visitor may observe. They then may come to realise that the wonderful care they were promised is not actually forthcoming, when examined in more depth it often becomes apparent that is only a facade designed to allay the fears of the family and care home inspectors alike. It must be remembered that there is an extreme shortage of places in care homes for the elderly, and each year as the percentage of the elderly in the population grows and ages, the demand for care home places grows and it becomes more and more difficult for social workers, carers and family to find suitable places for their elderly who need personal care.

Often, relatives come under increasing stress themselves, trying to juggle other family commitments and at the same time caring for an increasingly difficult, demanding and frail relative.  Women are leaving it much later to start families; often as a result of this is they have to care for two generations, the younger one, and the older one.  Recent advances in medical care have resulted in many more people living much longer, this has a knock-on effect in that relatives who are themselves elderly, into their 70`s & 80`s are now having to care for their parents who are into their 90`s and extremely frail.

When, finally the stress and effort becomes such that the carers are only too happy to accept any place offered in any care home for their relative. In their relief they fail to look too closely at the home and the actual care it provides. It is only afterwards, when the dust has settled and there is time for reflection that the flaws and failures in the placement may be seen.  Often however, once the minefield which is the social services has become involved, and it is realised that the home mum or dad have retired too is not the retirement paradise it first appeared it becomes extremely difficult to find an alternative establishment that provides improved care. Unless the relative is extremely well experienced in, and used to dealing with the social services it becomes almost impossible for them to get mum or dad moved to another home.

This high demand and lack of places, puts extreme pressure on social services departments responsible for inspecting, approving and monitoring private care homes. When in extreme cases, a care home is closed by the authorities they must find, in the space of a few hours perhaps several dozen beds in other homes, in situations like that, there is often no choices available for the elderly affected, what must they feel, being uprooted and moved on?  It is not surprising then, that often; minor infringements of the care standards regulations are often overlooked, and even in the case of a major infringement; only a warning and instruction to improve are issued.

In conclusion, unless we are prepared to pay more in taxes to ensure our elderly are better cared for in clean safe and caring environments or as a nation are prepared to care for our elderly our selves we must accept the current lamentable standards of care provided by a large number of privately owned care and nursing homes up and down the country. If we really do care we need to protest, march, lobby, write articles and in every possible way make it clear to this and every successive government that we will no longer accept poor standards of care for our elderly.

I find it absolutely disgraceful that we are prepared to spend millions and millions on the Olympics, which will last only a couple weeks yet we continue to allow vulnerable elderly to be neglected.  To this end we must use our vote wisely in local and national elections to ensure we send a signal to politicians they cannot ignore.

The author, Paul Chaston was a military masterchef in the British Army.  After joining up in 1967 at the age of 15 he served for 25 years retiring from the military in 1992.  He then worked for 9 years as a production manager for a major British catering contractor where he was responsible for providing 10,000 staff meals daily to British Airways employees.  Later he was responsible for providing staff meals at the prestigious Compass Center for Pilots & Cabin staff amongst others. For the past 9 years he has been technical manager for The Mashed Potato Company Ltd which imports and sells the well known US brand “Idahoan™” of Instant Potatoes. Married with 2 children and 4 grandchildren  he works from home. In his spare time he enjoys working with computers and operates a number of websites including http://www.photosoffood.co.uk/wordpress; http://allinstew.co.uk; and http://newsfromreading.org.uk.

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