Some suggested answers are in italics.
‘The majority of the residents didn’t have any say when it came to the when, where and by whom of bathing. They were simply told at what time and on what day they would be bathed. They would be bathed by whoever was available.’
13. If this was your care home, what would it tell visitors about the quality of care you were providing for your residents?
• The quality of care is not like that expected in a care home, but more like that expected in an institution.
• Residents are not involved in decisions being made on their behalf.
• Residents are treated as if they were children, being told what to do.
• The quality of care is adequate, in that residents are bathed regularly and do not smell of urine or faeces. Incontinent residents are bathed more often to prevent their skin being excoriated.
‘Lisa was twenty-three and had been working at the home for fourteen months or so… Yet, despite her erratic lifestyle, Lisa was a caring, conscientious and reliable young lady. The old people liked her. Perhaps they saw something of their own younger selves in her. The world in which Lisa lived was, maybe, not so very different in some ways from the world they remembered growing up in.’
14. What has Lisa’s life got in common with the earlier lives of her residents?
• Parents who might not understand young people.
• The need to get a job and earn money.
• Enjoying parties, dancing and nights out.
• Wanting a new boy/girlfriend.
• Dumping your boy/girlfriend.
• Planning to get married.
• Avoiding getting pregnant.
• Liking new clothes and wanting to be fashionable.
• Hearing about wars all around the world.
• Smoking!
15. In what ways is Lisa’s life easier, better and safer than the earlier lives of her residents?
• Better healthcare.
• Immunisations against diseases.
• Contraception easily available.
• National Minimum Wage.
• Holidays abroad.
• Computers and the internet.
• Mobile phones.
• National Health Service.
• Health and safety laws at work.
• On line shopping.
• Childcare, nurseries and child minders.
• The right to maternity leave and maternity benefits.
• Nicotine patches!
‘Like all of the residents, Ralph was accustomed to strangers being shown around the home, his home.’
16. What is it about your care home that makes it feel homely for your residents?
• Having personal items with you such as photographs, ornaments or a rocking chair.
• Matching fabrics such as curtains, carpet and bedspread.
• Meals that take into account your preferences.
• Likes: brown bread, blue cheese, red cabbage, black pudding.
• Dislikes: greens.
• There are no unpleasant smells.
• Feeling safe and secure.
• Being allowed to go outside, or wheeled outside for a cigarette.
• Having friends and family call and visit.
• Being spoken to by your own name.
• Having somewhere to lock away your valuables.
• Being allowed to drink alcohol.
17. Does your care home feel like a home or an institution?
What’s the difference?
• Your answer.
My own opinion is that a care home is where the needs of an individual resident are put first whenever possible and practical. An institution is where the needs of individuals are largely ignored.
Rather than the routine being planned around individuals, in an institution the individuals have to fit in with what is organised.
‘It should come as no surprise to learn that there were those amongst the home’s residents who were unaware of what time of year it was. Or what day of the week it was.’
18. Autumn’s Colours highlights some of the ways in which dementia and confusion show themselves in the lives of our residents. List as many as you can find.
• Dave talking to himself, planning an escape and seeing everyone as an enemy.
• Residents unable to eat their food without getting into a mess.
• Residents using knives and forks upside down.
• Residents eating food with their fingers.
• Some residents not recognising family and friends.
• Residents not knowing what day of the week it is.
• Dave walking into the rooms of other residents at night.
• Vera wanting to get up and go shopping in the middle of the night.
• Residents unable to have a sensible conversation.
• Some residents not able to differentiate fact from fiction.
• Old Rose never wanting a window open, even in summer.
‘The greater the mountain of paperwork, the less ‘accurate’ it was likely to be.’
19. It’s a common complaint. Too much paperwork! List some of the paperwork that you think is unnecessary or a waste of time.
• Your answer.
My opinion is that the assumption, ‘If a task hasn’t been recorded, it hasn’t been done,’ is fundamentally flawed. It’s an unsafe assumption to think that a task has been completed simply because a tick or an initial suggests that it has. Care home managers, owners and inspectors should overhaul and review what paperwork is needed and what records are required to be kept, with a view to reducing it by fifty percent.