Safety monitoring


often occur, whether that be resident-on- resident or with a staff member or relative involved.


It is the view of CCFTV that camera-


led, consent-based monitoring systems promote safety while respecting privacy; that they provide visual and audio evidence to manage risk appropriately and ensure that the quality of care promised is the quality of care received. Systems encourage and promote respect of the individual and, above all else, act as a deterrent against abuse. The Winterbourne scandal was a graphic


example of cultural abuse at its very worst. For months on end, residents were routinely abused by staff, and it was only when an undercover reporter using a hidden camera exposed the culture of abuse in that facility that it was shut down. It did, however, result in a government decision to cease placing people with learning disabilities in large hospital and institutional settings and seek instead placements in small community- based residential homes.


Regrettably, the scandal did not


resolve the issue of ongoing abuse of such vulnerable people. Since Winterbourne, further abuses have been reported in small home environments usually with residents who have been unable to articulate their concerns. Often issues only ever surfaced as a result of hidden camera footage confirming the abusive behaviours. Sadly, over the years there have been many abuse exposés yet no structural


38


change has ever resulted. Families expected to be able to rely on regulators to enforce those objectives, yet time and time again they were failed.


Inspection and regulation Most health and social care providers are subject to inspection by the Care Quality Commission (CQC), which uses a framework of inspection relative to the Care Standards Act 2000. Inspection personnel are usually based in the geographical locality in which a provider operates. As a result, inspectors should not have to travel too far to attend a care home, thus facilitating both announced and unannounced inspections at any time of day. However, with the best will in the world,


an inspection is but a ‘snapshot’. It is likely inspection personnel will be on site for around 12-15 hours across two consecutive inspection days. Over a year, it is unlikely any provider will experience more than 36 hours of inspection unless in special measures or if rated ‘inadequate’. In such circumstances, inspectors may spend much more time at a given site.


Thirty-six hours is simply not enough


Very few care providers actually use surveillance systems. Most see them as a ‘last resort’


time. Many very concerning situations have been exposed in homes that had ‘good’ ratings in prior reports. Some of those issues were cultural in nature and were simply invisible on the day of inspection. Even this flawed inspection process all but disappeared during the COVID lockdowns, and with families also absent, no independent, third-party supervision existed for months on end.


The COVID pandemic From the very early days in March 2020, CCFTV began to receive calls from families expressing serious concerns about the transfer of their loved ones from hospital wards to care homes. Families felt proper assessment had not been afforded for care home suitability, and lockdown meant that families could not assess a care home prior to transfer. It was also obvious to us following dialogue with providers that care homes were pressurised to take admissions to facilitate the ‘freeing up’ of beds in the NHS. This at a time when no testing was in place.


Despite the then Health Secretary Matt


Hancock explicitly stating that care home residents would be protected via a ‘ring of steel’, the feedback from both providers and families alike was that older people were transferred from hospital to homes without any testing and without any demands for precautionary isolation. Right at the outset, Personal protective equipment (PPE) was simply not available and many care home


www.thecarehomeenvironment.com September 2022


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