- 22 January 2019
- 7 min read
An insider's perspective of care homes - why you shouldn't believe everything you see in the media
There is often negative press surrounding care homes. However, we shouldn't generalise the experience of individuals, and we shouldn't believe everything we read. Registered manager and author, Liam, debunks some common myths surrounding care homes in this blog.
I’m a 46 year year male with experience managing UK based care homes.
I have worked in a balance of third sector and private care homes and hospitals.
I hope this gives me a fairly fresh set of eyes to talk about the myths of older people in care homes.
Let’s start with the biggest misconceptions;
Myth 1 - Relatives put their loved ones into a care home because they don’t care for them.
In my experience, this is rare.
Typically people move into a care home in their late eighties after all other options have failed.
Sometimes there is a slow deterioration and after finding home care visits inadequate, the difficult subject comes up and is addressed.
Other times it is brought on by a crisis, often after a fall or heart attack / stroke.
The only reason I’ve come across for family members moving their loved ones to a care home is risk to life through continuing to live at home without enough support.
When elderly loved ones start to significantly struggle with shopping, cooking, cleaning, looking after themselves, over time they can descend into a state of neglect.
This often leads to a decline in their health and well-being. When you add a high risk of falls (especially for those with worsening mobility) the risk to life becomes too high to do nothing.
Myth 2 - People get worse and decline when they go into care homes
In the experience of my care home manager job, it is far more common that a person’s health improves when they go into a care home.
Their health often improves as they will take their medication regularly, be offered nourishing food and plenty of drinks, be supported and encouraged to look after themselves well, have people take interest in them (staff, visitors, other residents) and in most places be loved by the staff.
Often they will live far better than they do at home, when living independently on their own.
This is why their health often improves.
Myth 3 - Care Home Operators are motivated by greed and put profit before the well-being of residents
This is for the most part an unwarranted accusation but there are exceptions; in my experience the exceptions are independent owners who treat their care home as a private bank account and have little empathy for the residents.
This can lead to them refusing to let staff order essentials / have adequate staffing.
Happily most of these homes and operators are being closed by tighter regulation by the CQC.
The 2nd exception are large scale care home operators imposing impossibly tight staffing budgets on their homes to boost financial performance for investors – this does happen but it’s rare.
The good news is that in nearly all cases, the staff are so committed to their residents, that they will still make sure everyone is given acceptable care.
Never under-estimate the depth of bond between care home staff and those they care for.
See my other blog post, How my career as a Care Home Manager has evolved, where I talk more about this bond between myself and patients and how deeply resonated they are within me.
Myth 4 - Care Home fees are a rip off!
Care home fees vary from c £400 per week to £1500+ per week depending on location, provider and the calibre of home.
The biggest determinant of price is location and that relates to land price which in turn reflects build price.
Most of the time, these prices reflect the market price and present good value.
Care homes are established by reputation and nearly always charge prices that are consistent for the service and quality they offer in that area.
Care home fees represent a total basic living costs fee – including accommodation, food, staffing, cleaning, laundry, rather than just accommodation.
If you compare it to a hotel for £100 per night (mid range) you get a room only.
In a care home, you get 3 meals a day, unlimited drinks, staff to check you’re ok, room tidied, personal laundry done, help with personal care all for £100 per day (£700 per week).
Do you see the difference?
Many new care homes are financed through pension funds. Whilst they are looking to make a return they also bring much needed capital to build / refurb these homes.
I don’t say all providers are inherently altruistic but I do say that the pension funds used to provide good quality accommodation are welcome.
Myth 5 – there’s so much abuse in care homes! Every week or so, we hear of some atrocity against an elderly / vulnerable person
This is difficult to counter and yet if you work in care homes you'll already know it does not reflect the vast majority of care homes in the UK. These individual cases just get far more press coverage.
There is no place for actual abuse of the vulnerable and rightly there are robust controls in place to manage and reduce these risks.
However, bear in mind, if a person at home forgets to take their medication or it runs out or their partner helps them in an awkward way to get off a seat, nothing happens.
If this happens in a residential care setting, reports will be made, investigations made about alleged abuse.
I welcome this rigour as it leads to better care but when you are judging statistics of abuse be aware that some of it would be judged as neutral if that person was living at home.
Myth 6 – all older people are kind and patient
This is all about context.
Whilst this is often true, there are many in care who behave in ways that would be hard to understand outside care.
Be it spitting, swearing, hitting, or punching staff (it’s very common).
A resident may have an underlying health / or mental condition / specific trigger that means they are unaware / unable to moderate their behaviour.
Care homes have access to expertise to manage these demands but for those unfamiliar with these conditions, they may assume that the care home is mistreating them.
We offer love, not judgement.
We give the best care we can, backed by an array of professionals, offered with compassion.
We simply look to meet their needs as best we can – be that emotional, physical, social needs etc and in a way that suits them.
In summary, I have simplified some of these matters for the sake of brevity.
Clearly, there are always exceptions where human nature is involved. Social care is no different to the wider world in that.
However, with the CQC raising standards for inspections and taking enforcement action and a committed and (for the most part) skilled social care workforce, poor care is less prevalent than you may think.
Let’s be balanced in our assessments of the care sector based on what we read in the media.