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Paying for social care (older people)

Complaining about care

This page covers:
• The importance of talking about concerns with care providers
• Examples of problems and how they were resolved

Most people we spoke to were pleased with the quality of care they were paying for, whether this was care at home, day centres or care homes. There could be teething problems when care was first arranged but these were often ironed out over time. However, sometimes people felt that the care they or their loved ones were getting could be improved. People told us about times when they had complained about care or perhaps just suggested to care providers some ways to improve the care they were giving.

Getting the best from care providers

People told us how much they rely on care providers to look after their loved ones and keep them safe and happy. Family and friends try to make sure people are getting the care they need by discussing this with their care providers.

 

Sally says that good, two-way communication is key to getting the best care.

Sally says that good, two-way communication is key to getting the best care.

Age at interview: 66
Sex: Female
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They were very good; there would be, there’s a coordinator who is obviously in the offices and they, they coordinate all their carers and communicate and, and if a carer has been delayed then we usually, I mean occasionally we didn’t, but we would usually get a phone call from the office coordinator to say, you know, so-and-so’s going to be running, you know, a quarter of an hour/twenty minutes late so, you know, tell your mum, tell your dad not to worry, they are on their way yeah. So that was yeah, that was good. But, you know, it boil, everything, everything in the process boils down to good communication; I think you know, so long as people communicate on a two-way basis it’s, it works but you can’t, you have to keep your expectations real as well, you know, they’ve, they, you book them for half an hour or an hour and they’ve got huge workloads and you have to understand that but clearly you obviously want your money’s worth as well, and you’ve got to make sure that they work efficiently when they’re there.

And then not being afraid to challenge, if you like, the carers if you were concerned about something, or stipulating what your expectation was from them as well was very important, you know.

 

Rosemary tried hard to be constructive when talking to care workers about her husband’s care.

Rosemary tried hard to be constructive when talking to care workers about her husband’s care.

Age at interview: 65
Sex: Female
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What was your interaction and sort of communication with the staff, the caring staff and perhaps the management of the residential...?

[Laughs] Probably more than it should have been. I remember my mother saying to me at one point, fairly early on in the process, “Rosemary, you are not the care home manager [laughs] stand back.” [Laughs]. Because, you know, that’s what I’d done, I’d managed things, you know, and I was used to making things happen and making things run efficiently and properly and whatever. And I had to be very tolerant at the outset because it was a new home, it was finding its feet, it was establishing its systems, and so that was fine. I’m sure there were times when they looked out of the window and thought oh God, here she is again. But I tried really, really hard not to be that sort of person and I would always make a point of complimenting them on the things that they did well, saying, you know, “Oh Graham’s had a really good day, thank you for.” You know, I really, really worked hard at that but I equally did say to them when I was not happy with the quality of care, not because, as I said earlier on, there was any question of abuse or cruelty or malevolence or something like that, in some regards, on some occasions, it just wasn’t good enough.

Unfortunately, things did not always go smoothly. Some people said they worried for others who perhaps did not have anyone to look out for them.

 

Deryck says it is unfair that people are dependent on family to get things done.

Deryck says it is unfair that people are dependent on family to get things done.

Age at interview: 71
Sex: Male
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Well again I think this is where the system is wrong that if you’re prepared to make an argument and be persistent, my experience is most times it’ll get through; I won’t say it’ll happen every time but most times it will. But why should it be dependent upon a family member to dig their heels in and say this isn’t right; but somebody else in the same circumstances, possibly in the next room, is denied it. I mean that to me seems to be absolutely crazy.

Local councils and some charities can help find advocates. An advocate is a spokesperson who can help someone through the process of getting and receiving care, including making a complaint. Local Carers Centres might also be able to help. The Care Quality Commission (CQC) website explains how to make a complaint and the different steps to take. 

Problems with care at home

People who were managing care at home said that the timing of visits was the most difficult thing to get right. A few people told us about more serious problems and how they resolved them by changing care agencies or care workers.

 

Tracey refused to have a care worker visit her parents again after a mix-up with medication.

Tracey refused to have a care worker visit her parents again after a mix-up with medication.

Age at interview: 59
Sex: Female
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And then one of the reasons we had to change, we had to change the care company, because there were a few incidences as in an early morning carer gave mum’s tablets to dad and dad’s tablets to mum. So of course paramedics were called and...

How did you find that out?

They told me.

Right. Oh they realised what they’d done?

They, yeah, they realised what they’d done, yeah; and I said, “I don’t want that carer ever going back to mum’s again.” And of course she didn’t.

 

The care workers Hazel had booked to look after her dad when she was on holiday didn’t turn up.

The care workers Hazel had booked to look after her dad when she was on holiday didn’t turn up.

Age at interview: 72
Sex: Female
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Well actually before I got [name of carer] actually we did have an agency.

Oh really?

We did oh God, I’d forgotten about that. It I only had them for two weeks, that’s why and again the only, the because I hadn’t, I was in the process, it was before [name of carer] came and before I was able to interview her and I got the agency in for two weeks and they turned up the first week and they didn’t turn up the second week...

Oh dear.

...and yeah, so then I got [name] and I thought OK, it’s not working with the agency anyway because; and they were, their attitude was, “Oh oh didn’t we?” and I said, and they said, “Did you book it?” And I said, “Yes, I definitely booked it and this was the time and this was the day.” “Oh he must have got, he must have slipped off our list.” And I thought that’s not good enough, he could have been dead, that is not good enough.

That’s terrible, isn’t it, yeah.

Yeah.

And was he expecting them, you know?

Well he was sort of, he ha, we, he kept a diary so I put the na, yeah, so had he looked in the diary, then he was expecting them, so, and then they didn’t turn up, then he just thought well they didn’t turn up, he didn’t really bother why or care why, to be honest, but I cared and I was really angry because I thought my goodness, you know, that could have been anybody and they could have had an accident and then these agency people wouldn’t just have sort of just not known about it really, I wouldn’t known about it until I came back so I thought “OK I’m not using them and I’ve now got [name of carer], I’m seeing [name of carer] next week, so cancel that lot” which I did.

Problems in care homes

People told us the best way to find out about the quality of care in a care home is to visit. They said it is really helpful to be present sometimes when care is being provided, for example at mealtimes or when someone is being helped to get from one room to another. Some people said that considering how expensive care home fees are, they felt that the quality of the service provided was below what they expected.

 

June’s daughter complained to the manager of the care home about her father’s care.

June’s daughter complained to the manager of the care home about her father’s care.

Age at interview: 72
Sex: Female
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We, we did have my daughter complained to the manager actually because my other daughter who lives in [City B] she was down and we went in to see John and he was almost flat in bed and the nurse was actually feeding him porridge almost lying flat and [laughs] and [Daughter] said, [Daughter] said to her, “Don’t you think it would be better if you sat him up a bit?” Because he was clearly struggling; and she said, “Ooh I suppose so,” she said. And this was the, this was the qualified nurse...

Oh goodness.

...so, so I mean she could tell that we were quite annoyed. Anyway [Daughter], [Daughter] went down and complained to the manager that, you know, it was appalling that this woman, who was actually the qualified nurse didn’t know. So then a notice went on the wall behind his bed saying, under no circumstances must you feed John other than sitting up; but you’d think that a nurse would know that really wouldn’t you?

Sarah’s parents usually had care in their own home but Sarah arranged for them to have a short stay in a care home when she went on holiday. The care home could not cope with their challenging behaviour. Sarah said she learnt from this experience that in the future she needs to look carefully at what type of care is available as her parents would need a care home that offered nursing and dementia care.

 

Sarah complained to the local ombudsman about the standard of care and was awarded a part refund of fees.

Sarah complained to the local ombudsman about the standard of care and was awarded a part refund of fees.

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Oh I mean we were really clear before, before we went away, you know, when we went to speak to them about, you know, because, as I say, the one carer that we’d had left at this point because of my dad’s sort of inappropriateness [laughs] you know, sort of sexually, he was being a little bit strange with his, after, you know, with his, with the sort of delirium after his UTI and you know, and we’d, we’d not sort of hidden any of that and they said, oh no, they could, that would be OK, they would be fine, but they absolutely weren’t, and in fact we actually we did get refund from that care, from that residential home, eventually, after quite a battle on behalf of mum and dad.

And so just, just tell me about how you, how you go, went through the process of getting a refund from them?

We just, well obviously just complained; we complained about, you know the care and the state that we found mum in. We’d had, paid for one of our other carers to go in while we were on holiday just to visit them, you know, and keep an eye, and so that she’d reported back how she’d had to go in and change mum and things like that and yeah, just wasn’t good enough. So just, no, just complained to local ombudsman and went through a process and eventually they agreed that, yeah, the care had, had been lacking and so they had to refund some of the care, not the whole thing but they refunded some of it, mm.

Sometimes, families were unhappy about their dealings with the management of the care home, even though the care itself was good.

 

Andrew and his sisters are happy with the quality of care but have had disputes with the management.

Andrew and his sisters are happy with the quality of care but have had disputes with the management.

Age at interview: 58
Sex: Male
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Yeah, we’ve had difference of opinion, you know, because we do, we have considered at various times moving mum from the care home that she’s in and that is, to a certain extent, because although the care she receives from individual carers is fantastic dedicated and loving and very well carried-out we do find that the pressures the management team put on us sometimes from [name of care home]; that’s, maybe I shouldn’t mention them, but have been we’ve been unhappy with, let’s say.

Do you mind explaining what you mean by that?

We feel that we’re, at various times we’ve been forced to make decisions very quickly and we’ve had our hands, arms twisted, I should say. For instance, when the, and this is quite difficult to say because this is completely subjective. When mum had a fall at [name of care home] and she broke her hip the hospital were recommending that she needed nursing care at that stage the hospital were keen to get an empty bed, to get mum to go somewhere the care home were ringing us very regularly to say, “Well if you don’t go for this nursing room now you’re going to lose out on it.” And that was really pressured on us and when obviously we were most concerned about the care, the immediate care for mum [laughs] when we were very worried about her if she would survive that we felt pressured then. Similarly when we were told before Christmas that mum needed, was, we were told specifically by one person that mum was at end of life and she needed nursing care and then as soon as we moved her the actual nurse at the care home said, “Your mum’s not in end of life.” So we feel that was disingenuous, we feel we were manipulated, I’m afraid so we’re not happy about that.

We tend not to have any dealings with the management at the moment. I find it difficult at the moment because of that incident where I feel that we were railroaded I find it difficult to go and talk to them, because we did have a meeting after our complaint, because we did complain and we had a meeting and that didn’t go as well as it might have done, let’s say. So I find it difficult to trust them, I’m afraid; I don’t particularly want to deal with the management anymore.

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