Safeguarding Vulnerable Adults: Care Homes

Tracey Crouch Excerpts

Tuesday 26th February 2019 Commons Chamber

[Dr Allin-Khan]

It is for the very reasons that my hon. Friend so beautifully articulates that I am using this platform to raise this issue. This is no longer about my father; this is about every single member of our society—the veterans who fought in our wars, the older people who worked so hard for us to enjoy the liberty that we have today. I am speaking about this for our families, friends, neighbours, loved ones and the people to whom we owe our lives.

[Tracey Crouch (Chatham and Aylesford) (Con)]

I join colleagues from across the House in commending the hon. Lady for her incredibly brave speech. I am in awe of how she is articulating her case this evening. As a former co-chair of the all-party parliamentary group on dementia, I am conscious of the fact that we are at the start of a ticking dementia timebomb and that more and more people will fall victim to this cruel, horrible disease in the coming years, making them far more vulnerable in their communities than ever before. Does she agree that now is the time to ensure that the right safeguarding measures are in place, both for today and for the future?

[Dr Allin-Khan]

I thank the hon. Lady—I will call her my hon. Friend—who is tireless in fighting against loneliness and for people to have dignity in their communities, and she makes the most essential of points: we are at the start of a ticking timebomb.

While all this was going on, my father was admitted to hospital one afternoon for a routine issue. As we were undressing him, we found bruises all over his body. Did the Ensham House care staff phone to check on him? No. Did Optivo show any care? No. Instead, we were served an eviction notice, detailing a list of allegations against my father without any evidence. How heartless is it to receive an eviction notice while in hospital? What did Wandsworth Council do at this time? Nothing. What was London Care doing? In the space of just five months, London Care had five separate managers at Ensham House. This all started after the first incident with my father. One manager after another came and went, unfamiliar with my father’s safeguarding cases. Some were hostile, others made up incidents involving my father being difficult. Dementia is a degenerative illness, but it does not spiral downwards overnight. Prior to those incidents, as I previously mentioned, not a single issue regarding my father’s difficult behaviour had ever been reported.

In all meetings, it was agreed that the extra care setting was appropriate for my father as he still knew his way around the area, he had a level of independence and my very young daughters felt comfortable visiting him there. Why deny someone their last few months of independence? The extra care setting was deemed by the social services team and everyone involved to be entirely appropriate for him. However, each time we interacted with Ensham House care staff following the first incident in which we found my father beaten, and when we had not been called, we felt as though we were on trial, that we had somehow made up the fact that he was acting afraid, and our concerns were dismissed by a different manager every month.

We found multiple examples of my father’s medication not being written on the drug chart, with London Care saying that he had refused medication when we had seen him take it. We even found one manager had written a note in the staff communication book asking staff to write negative comments about my father in his care notes. The final nail in the coffin, and the point of no return, was when we found my father unconscious on the floor, with blood on the walls and the floor, and a carer’s set of keys left next to him. Following this, he spent one month in hospital.

Four months after that final event in October, there was nothing from Wandsworth Council addressing any of these concerns. The catalogue of disasters crescendoed last week, when the director of adult social services at Wandsworth Council, Liz Bruce—who had refused to look at photos of my father’s injuries, did not know how many open safeguarding complaints there were relating to my father, did not talk to anyone else who knew my dad and had never met him herself—declared that my father had sustained the injuries because “he had asked for it.” Despite police voicing their concerns in the meeting and saying that they cannot rule out abuse, despite her failure to investigate London Care fully and despite her clearly having no detailed knowledge of the case, she chose to use Optivo’s letter, which was full of unsubstantiated claims in the language of the Ensham House managers, as her proof. Well, I think we can all agree that this is a dangerous, highly unprofessional and highly unsatisfactory approach.

Of course it is easier to blame the patient and the family, anything other than looking inwards and accepting responsibility for the fact that the council is awarding care contracts to organisations that are, frankly, unsafe. Quoting CQC ratings in safeguarding communications, when it is well known that patients are fearful to talk, is frankly unacceptable. If this were happening to the UK’s children, the country would be in uproar, and rightly so. Someone living with dementia is just as dependent in their final years as children are in their first years.

--- Later in debate ---

[Caroline Dinenage]

It will be held for all parties to consider recommendations going forward and the hon. Lady will be able to attend. We look forward to hearing the outcome, and we will all be keeping a close eye on what transpires.

[Tracey Crouch]

Does my hon. Friend agree that this is slightly shocking to us all and in particular the family member of the victim in question, who has not been told by the council that this meeting is taking place? In many respects, that is part of the issue raised by the hon. Member for Tooting (Dr Allin-Khan): the family of the victim have not been included in any of these discussions or any of this process in the first place.

[Caroline Dinenage]

That is a very fair point and I am very keen that family members should be involved in the next stage of this meeting going forward. I will be keeping a very close eye on whether that does happen.

In the last few moments available, I want to talk about some of the things we have been doing to protect vulnerable people and some of the actions people can take if, heaven forbid, they find themselves in a similar situation. The Competition and Markets Authority published its care homes market study in 2017, shining a light on some instances of very poor and unacceptable consumer practices in the care homes sector. We accepted all its recommendations and have been putting forward a package of measures to address this. The CMA has also recently published guidance that it provides to care homes on how to meet their consumer law obligations. That has been a key milestone for the sector, and I am encouraged by the commitment some providers have already made to challenge some unfair practices.

Individuals and their families always have a right to complain about the care in a care home or about a domiciliary home care provider. Care homes must make it easy to complain and deal with the complaint quickly and fairly. Any care home that does not meet its obligations is in breach of consumer law, as well as many other things, and could face enforcement action by bodies such as trading standards or the CMA. The CQC encourages the public to share their experience through an online feedback mechanism.

Of course, it is only worth having a complaints system if people know about it and how to access it, which is why, through a joint sector initiative called Quality Matters, we are taking action to improve access to complaints systems and improve the feedback culture in the sector. That is an ongoing piece of work involving the local government and social care ombudsman—to which complaints and concerns about adult social care should be raised—and Healthwatch.

We are committed to preventing and reducing the risk of harm to adults in vulnerable situations. We have made it clear that there is statutory guidance to support the Care Act 2014, and we expect local authorities to ensure that the services they commission are safe and of high quality. We also expect those providing the service, local authorities and the CQC to take very swift action if there are any allegations of abuse, neglect or poor care.

Under section 42 of the 2014 Act, local authorities have a duty to carry out safeguarding enquiries. To aid them in that, they have the power to request information from a provider’s business. The CQC monitors how well providers are giving that information. As part of its inspection regime, the CQC also has to check whether there are effective systems to help to keep adults safe from abuse. The CQC has a duty to act promptly whenever safeguarding issues are discovered during inspections. As the hon. Member for Tooting said, abuse is ultimately a police matter, and if it is suspected, the police must carry out an investigation to determine whether offences have been committed.

We have introduced the new wilful neglect offence specifically to help to eradicate the abuse of people who depend on care services. We have also introduced tougher inspections of care services by the CQC. Thanks in part to this strengthened regime, we have seen a steady improvement in the quality of services, with 83% of adult social care settings now rated as good or outstanding by the CQC. Obviously, every single incident like the one the hon. Lady described and every single concern raised by worried family members makes us want to redouble our efforts to raise the quality. We have been supporting the CQC to understand how it can better hold providers to account where there is any failure.

Let me end by highlighting the hon. Lady’s enormous dedication, representing not only her constituency but the whole country. Whether someone is looking after their own father, mother, husband, wife, son or daughter, we all expect the care provided to be caring and of good quality. We must work and redouble our efforts to ensure that where failure happens, it must be stamped out and cannot be allowed to continue.