The Small Picture
Crumbs! My weekend blog post about Lenore Care’s plan to build a “40 unit supported living centre” has leapt into my top 10 most read blog posts within five days. Looking at my blog stats, the most read posts are often when I write about care home stories – St Andrews, the bad Hillingdon Mencap Care home report. I’m not sure why this is. Perhaps it is partly because a lot of readers are parents or carers and these stories tap into the worse fears we live with daily.
I’ve had quite a few social media discussions about the content of the post. To be honest, it has felt a real relief that the majority of people have shared my horror that in 2016 such a place would even be considered. The discussions have often broadened out to include large care homes. It’s at this point some of our paths diverge. A few of the professionals commenting have mentioned looking at the “bigger picture” and how a large care unit may be the best option for some people. I think I am able to see bigger pictures but obviously, as a Dad, I’m going to be interested in the smaller picture too. I guess it’s natural but I can’t help as I read the CQC report on Lenore Care’s current home trying to picture the sort of life Steven would have there. And it’s when I look at the smaller picture that I experience gut wrenching pain. Trying to imagine Steven’s life in Lenore Care Home demonstrates why every single joyous moment we share together carries a terrible sadness at the same time. No matter how much we laugh during a shared music session, it ends with me feeling melancholic because I know in my heart how short lived those joyous moments will be. One day, all the things that give Steven’s life meaning and fulfillment will end because the system wouldn’t consider them important.
Whilst I’m talking about pictures, as well as bigger and small pictures, I think we’re often presented with Distorted pictures as well. I cannot bear how the word “independence” has become exploited. The CQC report for the existing Lenore Care Home mentions independence a lot. But what does it mean in the reality of those 23 people’s lives? I’m not there, so I don’t know for sure. What I do know from Steven’s time in the ATU, was how they put a huge emphasis on “increasing independence skills”. In Steven’s care plan at the time, one of these was going to get the milk for the house a couple of times a week. His support workers were given strict instructions not to let him buy anything for himself whilst he was in the shop – the trip was just about buying the milk. Did that make him more independent? Or did it save a member of staff from having to go for the shopping? I think it was the latter and if I’m right, that is a distortion. In the CQC report it talks about residents accessing the community but then the only examples they give are GP or dentist appointments. To me, that’s just basic care dressed up to sound like something valuable is taking place.
I discussed the blog at a conference in Leeds on Monday. Somebody said that by writing about our lives I add a ” great big slab of reality meat onto the bones of social care discourse “. I guess that’s what I mean by the smaller picture.
Last night, I laid in bed and read 10 recent CQC reports of LD care homes. 8 of them had been rated ” good”; 2 of them were rated “requires improvement”. Needless to say, I quickly succombed to the smaller picture and tried to imagine Steven’s current life fitting into any of these environments. I failed pitifully. I started to question what does a ” good” rating mean. The more I read, the more it seemed to be about doing the barest minimum. Feed ’em and clean ’em. Or as Neil Crowther said this morning, “life and limb care”.
I just want to give a few examples of Steven’s present life and see whether any of it would be possible in a care unit:
- Would anyone be able to spare two hours to put the music together for Steven’s Wednesday morning disco? I doubt it.
- Bearing in mind that Steven needs 2:1 support when he goes out, if the home has a staff ratio of 3:23, would he ever get to his water aerobics group? I doubt it
- Would he have access to a computer/tablet, so he could continue with his Massive Good Songs Radio Station? It takes him about 2 hours each week to browse YouTube to find the songs? I doubt it.
- Would someone remember that he likes to chat to Uncle Wayne on the phone every Tuesday, Thursday & Sunday evening and be able to facilitate that call? I doubt it.
- Would he be able to chose which TV shows he watched, or like in the ATU, would he have to negotiate his viewing with all the other residents? Probably the latter.
- Would he be able to eat his meals on his own because he cannot bear being watched as he eats or will he have to have his meals in a communal dining room? Probably the latter.
- If he wants to buy the latest Take That CD, will someone be able to facilitate that? Will he even have the money to buy a CD or will all his money go on care fees?
- His clothes are important to Steven. They don’t get lost or muddled up in the Cowley house. Will he have to get used to his clothes disappearing or wearing other people’s clothes?
- Will anyone be able to spare an hour on Friday to read through the Radio Times with him, so he can see if there are any Mr Bean repeats on? I doubt it.
- Will anyone be able to sit with him for hours at a time to look through his photo albums and listen to his detail packed stories to accompany the pictures? Will anyone consider his 24 photo albums important enough to actually have them all in the home? Probably not.
- Will he ever go on holiday?
- Will he be asked what he wants for Christmas?
- Will he be able to have six bourbon biscuits every other Wednesday?
- Will anyone try to learn the names of all the minor characters in Fawlty Towers?
- If, the person doesn’t learn Mr O Reilly’s name and Steven gets frustrated, will the consequence bevthat he’ll be pinned face down on the floor? Possibly.
We’re not talking about the most exciting, adventurous life in the world here. I’m talking about a life that Steven enjoys, understands and helps him make sense of his world. It includes love. It includes people who are interested in him.
In my small picture of his future life in a care home, he will lose everything I’ve written about in this post. Despite the care home being given a “good” rating.
P.S. The excellent Steve Broach has just used a Human Rights quote about this post. He’s spot on. This is about those “human rights in small places”. I hardly ever read human rights mentioned in a CQC report. They talk about the Mental Capacity Act a lot but as we’ve learned, the MCA counts for nought if the person’s human rights don’t come into the picture (the bigger or smaller picture).
From → Social Care