Last weekend I blogged about some of the lessons that families need to learn that have arisen from the evidence at Richard Handley’s inquest. One of those lessons was about trying to recognise the sham of rebranding a care home into supported living and the dangers that can follow that move.
The last two days of the inquest have seen staff from Bonds Meadow give evidence. Some of them have only worked there since the place was reclassified whilst others knew both regimes. I’ve been horrified but fascinated about the little details that reveal the bigger picture and the language used that gives the whole game away.
I have to admit that my idea of good supported living is very sketchy. Most of the examples I’ve come across are purpose built (or converted) complexes with several flats being housed in a single structure. The sizes vary dramatically. The one by me has 24 flats. I’ve heard of others with just six. I guess my image of those flats is of a self contained home: a living room, a bedroom, a kitchen and a bathroom. Sometimes they are studio flats with a living room and bedroom combined. The bigger ones often have a large communal indoor space for social gatherings and often tend to have an office on the premises for staff to gather. But the life someone would lead inside their own front door would pretty much self determined, independent and with the support they uniquely need.
Bonds Meadow sounds nothing like that. Here’s a few statements from the inquest that reveal that perhaps it’s still a care home in all but name:
“Richard spent a lot more time in bed. He didn’t really come down for tea”.
Coming down for tea suggests there was still a communal dining room and kitchen. If he had his own flat with his own kitchen wouldn’t it have been, “He didn’t really get up for tea”.
“There was a budget for food and cleaning supplies”.
Why? Richard had his own income. He could have brought his own food and washing up liquid out of his own money. Does this mean that all the residents’ money was pooled and supplies bought en-masse? How would the Office of the Public Guardian feel about that considering I had to differentiate between my toilet rolls and Steven’s toilet rolls at last year’s audit?
“He would be encouraged to join in but he did spend a lot of his time in his bedroom”.
Join in? With what? With who? Again this suggests lumping all the residents together in one space. Surely having your own flat means you can chose times when you socialise and invite people in or go out and times when you can be by yourself. Joining in immediately makes me think that there were never enough staff on duty so to cover that up and make it easier to manage, the residents were herded into a communal space.
On the subject of shopping: “We’d always encourage the service users to come with us so there was some participation”.
By referring collectively to the “service users” the implication is that again, the residents are grouped up together. A trip for three to Tesco? I dunno but that makes it sound harder to achieve a truly person centred shop. For many people, shopping is a chore. A necessary evil. I do both mine and Steven’s weekly shop online because Sainsburys is likely to trigger a meltdown for both of us. And what’s with the “participation”? Its service speak. It’s someone on the outside being allowed to come inside.
“Originally supper was for people who needed something with tablets before bed but they all jumped on the bandwagon”.
“They”. Typical othering. The dehumanising of the learning disabled person. And jumping on the bandwagon! They were talking about supper snacks! There’s a contempt in that statement that makes me heave. The follow up piece of evidence mentioned that Richard kept his snacks on a “shelf in the kitchen”. Once again, I suspect this was communal – “the” kitchen, not “his kitchen.
Somebody on Twitter tweeted “This is so different from how Steven lives his life in his home”. That thought kept me awake for hours last night. It never occurs to me that Steven’s home is supported living. Nobody I know has ever used that term in reference to his house. One social care professional once described it as his “placement” but I made her eat 6 hard boiled eggs whilst singing Green Door and she’s never used that phrase since. Steven’s life and the life of the Bonds Meadows guys are poles apart.
How does this deregistering a care home business work? Does the manager of the home ring up the CQC one day and announces they built several front doors and everyone is now wonderfully independent? Do the CQC check that the new regime is what the provider is claiming? Deregistering seems very popular at the moment. I’ve read of several ATUs that are going down the same road.
Everything changes. Nothing changes.
But from the information from the inquest (and my gut tells me this is commonplace rather than a rarity) deregistering can make a place become dangerous overnight. Standards and checks that would have been in place become history overnight. And the residents are left with a regime that they are unable to manage.
Where is the Mental Capacity Act? At the time of Richard’s death, the Deprivation of Liberty Safeguards didn’t apply to supported living. But they do now. Is anyone checking that the residents’ legal rights are being upheld? We know the answer to that question. Who gives a toss!
The more I learn about Richard’s and the other residents’ experience of supported living, the more terrified I become. To imagine that as Steven’s future breaks my heart.