As a former Care Home manager of approximately 15 years standing I fully support Katie and her family in their campaign.  I decided to leave this “INDUSTRY” (as it is so lovingly referred to) as I honestly felt that I could no longer deliver the care required with the resources made available as far as staffing levels were concerned.  Over the past ten years or so, the physical and psychological needs of people have increased quite dramatically; the majority of people entering care homes today are very very frail and dependency levels are very high.


What has not changed however, is the staffing levels – the ratio of nurses and carers to the number of residents has not changed despite the increase in dependency levels – staff are now struggling to provide even basic care properly.


On average, the ratio of care staff (non-nurses) is around one staff to five or six residents during the day and one to ten at night. This may sound reasonable but bear in mind that to provide even the basic care in the morning period takes approximately 30-40 minutes – this will include getting the person up, washing or showering, getting them dressed, attending to toilet needs etc.  I have known of some cases where the time taken can be up to two hours.  An average size unit in a nursing home has 20 – 24 residents, so work out the maths! – 24 x 30-40 minutes equals 12 hours plus   – divide that figure by the number of allocated carers (4) and what you come up with will demonstrate that the carers have an arduous task on their hands in order to do what they need to do in a caring, dignified and professional manner.


This kind of pressure on carers will lead to short cuts in care delivery – examples of this could be that pads for incontinence are not changed at appropriate times, drinks are not given regularly, meals may be late, weights not properly recorded and so on.


Nurses are stretched to the limit – medication rounds can take up to 3 hours! – Start the first resident for their 9-00 dose and by the time the last resident is reached it is almost lunch time and the person is just receiving their 9-00 medication.  Recent reports from NICE (National Institute for Health and Care Excellent) suggest that hospitals should have one nurse to every 6 patients – nursing homes have on average one nurse to every 20 residents – why?  Residents in nursing homes have very complex needs so can we hope that this recommendation will extend to include them.


From a personal point of view this is not the fault of the care staff, it is the fault of the organisation that employs them – there are rarely enough staff to be able to provide a care setting whereby people are attended to in a way that is not rushed, where drinks and nutrition are dealt with as they should be and perhaps equally important, that staff have the time to sit for a while with their residents and simply chat with their residents.


Very often you will hear comments such as “well ,they do their best” or “they are so kind and they work so hard” – yes they do – 99.9% of care staff are wonderful amazing people who genuinely want the best for their resident, having genuine affection for them. The people portrayed in the recent TV programme are fortunately few and far between.  If I am able to give advice to any person wishing to complain about care it would be not to direct your frustrations at the carers or nurses, or even the manager, as they are given strict financial guidelines to work to – ask to meet with a regional or area manager – they are the people who decide staffing levels together with other unseen faces who rarely if ever visit individual homes. These people have a duty of care to speak with you – if not as individuals, then as a collective group of family members.  The Local Authority who pay a large amount of the costs of care have standards that they expect to be adhered to and if this is not happening then go the local Clinical Commissioning Group and report poor standards.


If you pay privately, ask where your money is going – private fees can be anything from £900 upwards so you have a perfect right to know what services are being provided for that – an average food budget per head per day is £3-20 up to maybe £4-00.  Multiply that by 7 and you have £28-00 per week at the most, so what about the other £872 plus – how is that answered for?