Goodbye Southern Cross, Hello Open Public Services

So Southern Cross – the largest private care home provider in the UK will be closed.

What of the 31,000 residents who live in their properties? Well, the government has given us its assurance that they will be ok so that’s alright then.

Or not.

Goodbye, Hello

m kasahara @ flickr

On the day that the Open Public Services White Paper was published  (which can be found here – pdf) – which couched in the comfort of positive words like ‘choice’ , we would do well to heed the warnings of the way in which social care was sold off in chunks, from public to private and reflect on whether it is better to allow care homes to ‘fail’ in order to prove that the strongest will rise to the ‘top’.

The problem is that Southern Cross WAS the strongest. It did rise. It also speculated on property and ownership transferred away from the core business base of providing care and homes for those who needed both.

But on a more pressing issue, what will happen to those who live in Southern Cross homes and work for Southern Cross homes.

As the Independent says

Analysis by the GMB union revealed the names of 80 landlords who own 615 of the homes, many of which are subsidiaries of larger companies registered overseas. This makes it much harder to obtain financial information about the companies as rules governing accountability and transparency, especially in “tax havens” such as Jersey, Cayman Islands and British Virgin Islands are significantly more lax.

In addition, the GMB was unable to trace more than 120 landlords, which mean thousands of people are living in care homes where the identities of the owners and directors are unknown.

In the absence of full company accounts and other relevant information, such as the names of directors, it is “nigh on impossible” to assess whether they are suitable to run care homes funded in large part by public money, according to Andrew Craven, GMB statistician and researcher

At least the ‘Department of Health’ spokesman says

“Whatever the outcome, no one will find themselves homeless or without care. We will not let that happen. Today’s announcement does not change the position of residents. The Care Quality Commission will continue to monitor the services provided… We have been in constant contact over the course of discussions and remain ready to talk to all parties.”

That’s reassuring. Or not. Would that spokesman or anyone in the Department of Health want that level of uncertainty lying over their head or the heads of one of their parents? The residents of the homes will not know who their landlords are or whether they are fit to run care homes at all. Of course no-one will find themselves homeless – it will be the local authorities, the elected local authorities who will have to spend and fret themselves out of this one – nothing to do with the Department of Health’s reassurances – unless the Department of Health is going to compensate those local authorities for the time and cost they spend to ensure the welfare of residents of Southern Cross homes that may close.

As for the CQC, I think we have established that it is unfit for purpose and unable to regulate a care industry that has grown too large and too costly to be regulated efficiently. How about an idea? The Department of Health invests very heavily directly in the CQC so that they can provide at least twice-yearly, unannounced inspections together with a host of lay visitors attached to every single residential and nursing home?

No, the Department of Health is weedling out of this crisis as it will weedle out of the cost of ensuring that the residents of Southern Cross Care Homes are not made homeless.

Now, I want to link some of these issues to the Public Service White Paper that was published yesterday and particularly one or two sentences I picked out.


In the context of rolling out more extensive ‘choice’ in other areas of government, the paper says

‘We will ensure that individual service providers are licensed or registered by the relevant regulator for each sector (e.g. the Care Quality Commission) so that those choosing services can known that providers are reliable, without stifling cost”

Does that not lead to a tiny little shiver down ones spine? The CQC is being held up as a reason to trust in this extension of ‘choice’.  Has noone mentioned the cost of good quality regulation, either.  It’s worth reading this post at The Small Places for more consideration of the way the CQC regulates social care services. The CQC has failed to regulate and the care sector is failing to deliver on personalisation so far. The care sector has had time to learn as well. We had direct payments for many years and before that the ILF (Independent Living Fund) which allowed payments to be made directly to adults with disabilities to choose care. The system should be sophisticated enough by now to deliver good quality, equitable services but it has taken many years even to reach this point. There’s a long long way to go.


“The wider public sector has much to learn from local authority successes in commissioning, for example, in adult social care”.

See, look at us, government, we’re a success! Success. This is the end-result of success. Adult care commissioning is not a success. It has not extended choice unless of course (and I think I’ve found the key) success is based on the principle of privatisation and provision of contracts to the those who deliver at the lowest cost regardless of quality. That is the adult social care ‘success’ that the government is lauding in the Open Public Services White Paper.

We are dazzled by words such as ‘choice’ and ‘open government’  but they have no meaning outside ‘lowest cost’ and ‘discharge of responsibility’.

Think of Southern Cross. Think of Adult Social Care. It’s coming to our homes, our hospitals, our high schools and our highways.

So much for my week of positivity!

Distractions and Uncertainty

Of Local Distractions

I met one of the hospital social workers earlier this week. We don’t actually catch up with each other very often but when we do we always make a point of hanging around in whatever corridor we bump into each other in and chat.

This time, we again commented on the ebb and flow of work which seems to be balancing on an almost perpetual ebb without much flow at the moment.

We are all on edge at the moment. Another reconfiguration is in the pipeline and so many rumours are abounding that it is making it very difficult to actually get very much done.  Announcements and decisions are in the offing and have been put back again and again so all we know is that ‘this is a big one’ and that some jobs are going.

Good place to leave it with us, management team!

Seriously I do wonder if any of the so-called management executives who are paid most highly with their years of skills of organising complex projects ever remember those very first baby steps in communication skills and ponder on the way that rumours spread when a team of people are bereft of actual facts.

So my kind of friend, the hospital social worker, filled me with a swathe of new rumours that I hadn’t heard before about how our jobs were going to be directly affected by these changes and in turn, I shared with him the hotch-potch rumours that I’d heard from another AMHP at a training session a couple of weeks ago who, although she is prone to hyperbole, still seemed to deliver a fairly gloomy outcome of what might happen to all our jobs.

We smile. We chuckle. We remind ourselves how complicit we are in spreading the uncertainty through these rumours. Then I return to the office and immediately tell everyone what I’ve just heard from my new source about the talk that is going around at the hospital. He, in turn, no doubt returns to his hospital team with the latest gossip in the ‘community teams’.

And in the meantime, of course, work goes on. The increasingly distressed calls. The organisation and co-ordination of assessments and the desperate attempts to make some kind of priority from the pieces of information that have been fed through to us.

This is life at the bottom of an organisation when the top is reorganising. This is the pit of the rumour mill where scraps of invented truths and fears are ground together and occasionally spit out nonsense but this is what we are talking about in the large open plan offices. This is what is happening while the government is talking about pumping more money into the NHS. This is what is happening when officials are prevaricating and making the policies that end up on intranet sites that we don’t have time to access and read.

And it made me think of Southern Cross – I’ve been thinking about Southern Cross a lot lately.

Of National Job Losses

The announcement of 3000 job cuts yesterday although, I suppose, unsurprising coming from a company that is in such severe financial straits. Considering that they have sold off their property assets, staff costs are likely to be one of their highest expenditures. I wonder how the staff employed today feel. I wonder how the residents who  might have built up relationships with staff members feel and I wonder how people who are about to make placements in care homes feel.

Am I less likely to place someone in a Southern Cross Care Home today? Yes.

The Independent states that

The jobs to be axed are expected to include over 300 nurses,1,275 care staff, almost 700 catering posts, 440 domestic jobs and 238 maintenance posts

They don’t sound very ‘back office’ to me. Although Southern Cross maintains that this will not affect quality of care provision, it rather makes you wonder what the staff were doing in that case.

Ideally, it would be useful to check the data from CQC inspection reports to see what the inspectors said about staffing. The difficulty is that publicly available inspection reports that are recent enough to give up to date evidence.

I decided to look at a few random Southern Cross inspection reports from the London area.  Professor Google spat out some results and this is by no means scientific as I didn’t have the time for a more extensive ‘study’.

Romford Grange? Good report in 2008. That seems in order. Of course 2008 is three years ago now. A long time between actual inspections but we know they are not actually going to do inspections so frequently now. Still, three years seems to be pushing it. Lots can change overnight, let alone in three years.

Tower Bridge Care Centre? Well, that had an inspection in 2010. Oh good, I think. But wait, that was only because there were concerns regarding medication management that had been raised specifically.

Another random check on Camberwell Green Care Home  – oh, an inspection in 2010, surely that’s a good sign? Silly me, the recent inspections seem only to be where there are problems identified. Here’s what the report says

The service has been performing poorly for some time and matters have not been addressed by Southern Cross.They have started to do that recently but that has lead to lots of staffing changes and a turbulent time including managers leaving quickly. The ship has been steadied by a management team who have been sent in to the home. This inspection has identified some of their successes but more work is needed and a key need is for a stable, consistent management team to be in place. Until such time we can only view the home as adequate

Care planning is not personalised and is not considering all areas of individuals need, therefore the care arrangements are not always well informed.
The complaint’s procedure needs to be improved, it has to be open and transparent with complainants feeling that they are listened to and that issues are acted upon. Communication too is not as good as it should be, all issues whether they are minor concerns or not must be addressed.
Despite staff receiving up to date training on Safeguarding Vulnerable people,
procedures are still not fully robust at the service.

Burgess Park? Oh, it had 4 inspections in 2010. That’s what I call exceptionally good monitoring. Ah, one look at the most recent report and you’ll see that it is because there are problems that there has been so many inspections.

For example, their April 2010 inspection report states that

Our observations of a lunchtime on the second day of the inspection showed us that the systems for shift planning need to be improved. We saw that one member of staff was the only person in the dining room where there were fifteen service users. They needed various degrees of assistance and we observed that the lack of staff caused difficulties for them An example was a service user who had to wait an unreasonably long time to be assisted to go to the WC; another service user fell asleep while waiting to be assisted to eat her meal.

and while the July report says that these issues have been ‘addressed’ and more staff were recruited, it does make you wonder where the cuts are going to come from.

Lauriston House? Home to 100 older and disabled  adults – last inspected in 2007.  In fact, a random glance at the ‘most recent available assessments to view’ tells a sorry tale.

Previous reports

  • Inspection report 2007/10/26
  • Inspection report 2006/09/06
  • Inspection report 2005/11/15
  • Inspection report 2005/08/05
  • Inspection report 2004/12/14
  • Inspection report 2004/06/29

Oh, it got a good report. In 2007. But for 100 people, that’s a pretty poor show. In fact, if anything is to tell the tale of the toothlessness of the CQC and the way that CSCI was heading prior to it’s inception – it’s that list of dates. Look on it, ministers and make a decision if that is the level of scrutiny and regulation you want to maintain?

Back to the job losses though. So what will that mean for today’s residents and staff? Uncertainty. Rumours. Whispering.

Whatever we say when we look back at what we can achieve and improve today for our own old age and for that of our children – we definitely can’t say we are living in uninteresting times.

CQC and Southern Cross – a retrospective

I’ve bemoaned both the changes in the CQC and the financial troubles of Southern Cross over the last few years since I started writing this blog.

For today, a bit of a ‘lazy post’ – I thought I’d collate all the posts that I’d made on those two subjects. It provides a little bit of context and stops me repeating myself.

Southern Cross

Trouble at Southern Cross (2/7/2008)

Active Care – Another Tale of Southern Cross? (16/8/2008  – READ THE COMMENTS!

Alton Centre, Active Care and Southern Cross – An Update (5/9/2008)

Southern Cross and Hillingdon (19/12//2008)

Frozen Reading (12/2/2009)

8 deaths – 10 days (26/2/2009) – oh the irony when I comment that Southern Cross own a lot of real estate.

The concerns and worries about the financial management of Southern Cross go back a long way. This is not ‘new’ news. The ‘new’ news is that the company is now close to the brink of collapse. There is almost an inevitability in this as those who sought to make a quick buck in the care sector realise that sometimes the figures don’t add up. Property doesn’t always pay. But making money on the back of what was a public monopoly (provision of care services) can lead to some rich pickings until some of that money needs to be spent. Corners are cut. Staff costs are cut. Older people are warehoused in increasingly larger residential and nursing homes while the roll-out of the so-called personalisation agenda rings very very hollow at the moment for those who are the most dependent and those who need long term care. Where this the personalisation within residential and nursing care services? Where are the small group homes with support for older adults with dementia? They don’t exist because they wouldn’t make a profit.

That is what those involved with personalisation need to address. Not how people who have capacity and ability to manage personal budgets or have families to help them will manage but how will personal budgets (health and social care) and personalisation help and create better systems for older adults in dementia nursing care. Give me an answer to these questions and I’ll have more faith.

CQC – Care Quality Commission

From the first day the CQC came into ‘being’

DoLs, IMHAs and the CQC (1/4/2009)  – these were all introduced on the same day. Do look at the quote from Barbara Young, the first Chair of the CQC. VERY telling.

Britain’s Homecare Scandal (10/4/2009) – another Panorama investigation.

Inspections (3/12/2009)

Can Gerry Robinson Fix Dementia Care Homes? (8/12/2009) – another TV programme.

Linford Park Nursing Home (3/8/2010)

Closing Care Homes (30/9/2010)

Lessons from the Care Sector (26/10/2010)

Trouble at the CQC (3/11/2010)

Johann Hari’s Manifesto for Change in Care Homes (26/1/2011) – one of which was ‘proper inspections’.

Scrutiny, CQC and ADASS (15/2/2011)

Excellence Ratings for Care Homes (1/3/2011)

Inspections and the CQC (11/3/2011)

Whistleblowing (7/4/2011)

Which Care? What Care? (19/4/2011)

Care Home Crises (16/5/2011)

So is this surprising? I wish it were.  I want to emphasise though that it is the management of the CQC that I feel is badly serving those who need support and care rather than the individual inspectors who I know have as many criticisms of the system as the rest of us do. How did this, or the last government allow regulation so toothless just as they are ratcheting up the OFSTED inspections? Does it say anything about how we, as a society, want to value or hide away adults with disabilities?  I suspect it does.

Care Home Crises

Lakeview Care Home. One of two modern care hom...

Image via Wikipedia

I have been following with interest the fortunes, or rather, misfortunes of Southern Cross.

Southern Cross is the largest care home provider in the UK.  It owns 750 residential and nursing homes throughout the country and cares for 31,000 residents.

I have never placed anyone in a Southern Cross Home – it might be to do with geographical spread of their care homes but nonetheless I’ve been following their fortunes for a while, since I first wrote about them teetering on the proverbial financial brink in 2008.

Southern Cross is owned by a US private equity company and some of the background is explained in the Guardian. It pumped out profit while speculating on property prices and paying staff the minimum wage in order to garner a sufficient profit to make the shareholders/investors happy.

Wouldn’t Lansley be proud? The efficient private sector at its’ finest – no?


The crash came. Property plummeted. Southern Cross have been involved in a number of cases of neglect and mistreatment and mud sticks. Indeed, I’ve written about a few of the cases here, here and here

Even with the CQC taking their eye off the ball as frequently as they do, culpable deaths are hard to ignore.

So now Southern Cross have an occupancy rate which has fallen from 91% to 82% and, I’d suspect falling further.

I have had two families with whom I am currently working regarding choosing placements raise the sceptre of Southern Cross directly with me this week –

‘We don’t want mum/dad to go to a Southern Cross home because we don’t want her/him to have to move again when it closes down’  – and this is in an area where there are no Southern Cross homes so realistically it would never have been raised as an option.

Actually, this is in an area where there are no easily available residential or nursing home places.

You see, our council, having sold off almost all of its stock of placements, has been reliant on the private sector to provide for the needs of people in the area who need residential and nursing placements and land/rent costs mean that it’s hardly efficient for private enterprises to buy up land or care homes in central London. No, it’s the cheap land in the cheaper suburbs that they are after.

So where does that lead us – as the old care homes have been turned into highly profitable flats for wealthy young city dwellers who don’t fancy a commute?

It leaves us placing people who not only were born and grew up in the inner city being placed further and further away from the only homes they’ve ever known – it leaves elderly spouses and carers having longer and longer distances to travel, sometimes with health difficulties themselves and very very rarely with cars (cars are really not as common in inner city London as they might be elsewhere – I’m a case in point having never acquired a driving licence – let alone a car – myself!).

4 miles might seem close in Cornwall, but in the inner city without a car, it can be a long long way.

This is one of the effect of the purchaser/provider splits which came about after the introduction of the NHS and Community Care Act 1990.

When Southern Cross goes under what will happen to the residents and staff in the homes? Well, considering there is nowhere for them to move to, it’s likely that local authorities will have to step in and pick up the ‘tab’ after all, the placements are desperately needed. The public sector will again ‘bail out’ the profit seekers and venture capitalists from the US who gambled on property without thought of the residents on whom they were dependent. Private sector has all the answers, right? It will be costing local authorities a whole lot more.

Be mindful of my Cassandra-like words, if you don’t want to see exactly the same thing happening but instead of care homes for the elderly, we’re discussing children’s hospitals  – then, maybe, more people will care.

Trouble at the CQC

A lot of people working within the social care sector have had misgivings about some of the changes that have been taking place at the CQC (care quality commission). The CQC is responsible for monitoring and registering care services (as well as health services,  but I’m going to concentrate on care services because it’s what I know best) since its inception when it pulled together various previous regulatory bodies and picked up their functions.

There are a lot of lessons to be learnt for the future within the CQC  as we draw to a point where lots of services across health and social care will be merging and we are pushed towards joint management. There is a lot to be wary of.

Private Eye has an expose’ piece in the current issue (dated 29/10-11/1, in the ‘In the Back’ Section p29). Unfortunately the piece doesn’t appear in full on their website so you will all have to go out and buy a copy (seriously, if you are concerned about the CQC it is definitely worth a read and to be honest, I can’t recommend Private Eye highly enough!).

I wanted to draw on some of the issues raised in the piece so forgive the lack of links for the time-being.

The investigation carried out by Private Eye was alongside ‘Compassion in Care’ which is a charity set up to counter abuse in care homes. The organisation was set up by Eileen Chubb, a former care worker who witnessed abuse and who lost her job because she was a ‘whistleblower’. The organisation campaigns for the vulnerable in care homes.

The report highlights a number of concerns related to the CQC particularly how they have either ignored and in one case ‘upgraded’ via the now defunct star-system homes in which proven maltreatment has occurred.

As the Eye says

‘Only last month we reported how – just two months before a hospital nurse described a care home resident as suffering ‘the worst care of neglect’ she had seen, the CQC had wrongly promoted what had been a failing home, run by care home giants Southern Cross, back up to a two-star ‘rating’.

I don’t have the time to relay all of the information and quite unbelievable lack of teeth of the CQC in the face of appalling care services as relayed by the Eye but it makes for frightening although worryingly not surprising reading to me.

Another part of the article refers to the leaked staff survey results published in Community Care and that backs up informal discussions I have with some good friends who currently work in the CQC.

The Eye states that

CQC Insiders were worried that attempts to push through registration for all homes and agencies ahead of the 1 October deadline was compromising safety in the homes themselves’.

This absolutely mirrors the conversations that I have had with CQC friends, including being told that they were told to concentrate on these registrations at the expense of visiting homes where issues may have been arising –much to their own chagrin.

The other concerning conversation I had with said friends was that the CQC seemed to be increasingly reliant on local authorities ‘quality assurance’ teams to check on the local residential, nursing and domiciliary services. We can only guess at what might happen to some of these teams as the local councils make massive cuts. I don’t know if they will be able to provide as strong a service as they might in less frugal times.

The Eye pulls up the report and interviews given by the head of the CQC last month stating that 34 homes and 8 agencies were closed after they took ‘enforcement’ action as a way to prove their ‘strong arm’ regulation as well as 51 other services which had closed after poor ratings.

This is an area that Private Eye has been investigating and has tried to push CQC to provide details of these ‘enforcements’ as there was nothing about them in the CQC’s annual report published in April 2010. Private Eye and Compassion in Care have tried to find details of the deregistered homes b ut the information  has ‘disappeared’ from the CQC website and they have been stalled in their attempts to investigate.

Cynthia Bower, the Chief Executive of the CQC in her previous incarnation was the West Midland Strategic Health Authority which was responsible for overseeing the Mid-Staffordshire Foundation Trust Hospital. It is quite staggering that the responsibility for protecting standard of care for those who are arguably some of the most vulnerable in society should be under her charge.

I’ve railed against ‘desk based’ assessments which were happening prior to the existence of the CQC where inspectors do not actually visit homes that have previously scored ‘well’ in inspectors but rather rely on ‘self-assessments’. It is a national scandal that we have no reliable and functioning way of monitoring care homes and that the CQC itself is relying on local authority quality assurance visits when it should be setting the gold standard itself.

The piece ends with the comment that while the CQC hasn’t responded to the piece, John McDonnell MP will be raising the issue in the House of Commons so hopefully they will respond to him.

I rail where I can but the difficulty I sometimes face is time and that often homes are able to ‘put on their best face’ for social workers when we visit. We have limited roles usually in reference to one particular resident.

I have to say that all the personal contact I have had with CQC inspectors has been exceptional – when I have picked up concerns at a care home and contacted them directly but it is clear that the time is not allowed in the same way that it had been previously.

We are back to penny pinching and cost-cutting.

Thank you to Private Eye and Compassion in Care for investigating these issues. They should be on the front page of every national newspaper rather than tucked away in the pages of Private Eye – but I have a lot of time and faith in Private Eye to be honest. They have some of the better investigative journalism in  my very simplistic terms. Go out and buy this edition, all the editions and subscribe!

We cannot let it lie.

8 deaths – 10 days

I’m back to one of my least favourite topics today. Southern Cross Healthcare. And yes, the headline just about says it all.

Crown Nursing Home in Harwell, Oxfordshire is a small 16 bedded nursing care home which was run by Trinity Care – bought out by Southern Cross in 2002. It has a good inspection report.

Now, I don’t want to be unreasonable or unrealistic. People who live in nursing homes, by the very nature of the care, have high needs and people die when they become old. It happens. I imagine the death rate in nursing homes is substantially higher than that in the general population and I’d get no statistics or mathematics prizes for making that assumption.

But for half of the homes’ residents, namely, 8 people, to die in a 10 day period between January 9th and January 25th. Well, that is something that I’ve not come across in the years that I have been working with and around care homes.

The BBC report that

Eight pensioners died from “chest-related illnesses”

And a spokesman for Southern Cross says

“These were as a result of individual chest-related illnesses. All regulatory authorities are aware of the deaths and there is no concern over the cause of each death.

“The average age of each resident was 93-years-old and all had been happily living in the home for some years.

“Management at the home have evaluated their infection control procedures, which were of the highest standard, and are reviewing newly issued NHS guidelines.”

And with no knowledge at all of chest-related illnesses except a very cursory one. I think with an average age of 93, cold weather and chest illnesses there is a possible line there for the home to take.

It still seems more than a little uncanny to me.

The Mail offers a little more explanation

Half of the residents at a 16-bed care home died when they contracted ‘chest-related illnesses’ after being left without central heating for up to ten days.

The eight pensioners all died over two weeks shortly after the heating system at their home failed around Christmas.

Last night the son of a woman of 93 who was among the dead, accused the home’s owners, Southern Cross Healthcare, of responsibility for the deaths after it took up to ten days to have the fault fixed.

Now that, at least, offers a bit more plausibility to the story. Especially in conjunction with the story from a couple of weeks back at another Southern Cross Home where the heating allegedly failed with tragic results.

And the Mail have a statement from the Southern Cross spokesman again – he’s quite busy, clearly

A spokesman for Southern Cross Healthcare insisted: ‘The central heating broke down on Boxing Day.

‘Temporary heaters were made available and at no time did temperatures fall below the recommended level.’

The nursing home, which charges fees of £721-£760 per week, was rated ‘good’ by the CSCI at its most recent inspection

So are they honestly claiming that there is no link between broken heating and an uncommon amount of chest infections. I’m no doctor, maybe someone who is can comment with authority, but to me, it just doesn’t sit right.

The home manager, according to the local press, said pneumonia was the cause of death for all the residents, but the Southern Cross spokesman (again) seems to contradict her, as he

said pneumonia was only registered as the cause of death in six cases and instead pointed to “chest-related illnesses”.

The PCT has been very measured in the statement that it has given to a local newspaper

An Oxfordshire Primary Care Trust spokesman said: “The PCT is not aware of an evidenced pneumonia outbreak within Oxfordshire. We cannot speculate as to the cause of the deaths at the Crown Nursing Home, which is a private provider of care services.”

And the local social services have said that

The county council is not aware of any widespread problem with pneumonia in Oxfordshire.”

I am sure that the standard of care by the staff on the ground was good, that’s certainly what the families seem to indicate – but – issues of maintenance of buildings seems to have come up more than once and I admit that this is pure speculation – I wonder if any pressures have been put to save money in areas such as boiler maintenance or emergency central heating repairs.  Surely, this is some kind of corporate responsibility for people who need to be assured of warm, safe buildings and properties particularly throughout the winter.

As a layperson, but knowing that Southern Cross own a considerable amount of real estate, I’d have thought they might see fit to make sure it is at a good state of repair as the opposite can have massive effects.

Again, I had to dig around a bit for the details of this story. I’m amazed it hasn’t been more widely reported. And saddened to be honest. Each time I see one of these stories, I am plain saddened.

Frozen Reading

So I honestly hoped I wouldn’t have to return here, but another Southern Cross Care Home is in the news after a 97 year old woman died last week at the River View Care Centre near Reading as is reported in the Daily Mail.

People die in care homes. It happens. However this particular woman is alleged to have suffered from hypothermia after spending a week, in the afore-mentioned care home, without any heating. In the coldest week for a couple of decades.

It is an allegation still, of course,  but it’s definitely a story as it has been confirmed that the police are investigating – and  I think it is important to follow – the BBC reports a Southern Cross spokesman saying

“On the day that the lady was removed to hospital, the home was visited by nine social workers, and four council engineers,” he said.

“They inspected the heating, which was working normally, and the readings in every room were between 21C and 25C.

“And ever since, all rooms have been inspected twice a day.”

In my experience that is not the usual response to a 97 year old dying in a care home setting.

The local newspaper, the Reading Evening Post reports that

It is alleged the woman died of hypothermia and the police are investigating the privately owned care home, which was given a one-star rating by the Commission for Social Care Inspection in May 2008, deeming it only adequate.

Accusations surrounding the death include a lack of heating in certain parts of the building due to a technical fault which left some rooms in the cold while the outside temperatures were plummeting to well below freezing.

Bench by you.

As usual, I had a look at the latest inspection report for the residential home, dated May 2008. I am not sure what happened to the twice yearly inspections we used to have. River View achieved a one star rating meaning it is ‘adequate’.

Bear in mind that the same inspection report lists the fees as being between £545 and £818 per week.

A quick glance through the report (pdf link)  seems to indicate a lack of social needs being addressed –

Care plans meet residents’ physical needs, they do not address all of people’s social needs and care is not always delivered in a respectful way.

I’ve read a lot of inspection reports in my time, and ‘care is not always delivered in a respectful way’ is actually exceptionally strong by their standards. Definitely worrying. I read on.

During the course of the site visit one member of staff was suspended for inappropriately dealing with a resident.

That has to be remarkable misfortune for there to be an issue at exactly the time the inspector happened to be visiting.

There are, of course positives in the report too, that is the nature of them but they are rarely critical even when a home only receives a one star rating. Maybe they should be less bland in their content.

It is staggering that there isn’t more concern about the level of care in some of these homes that house some of the most vulnerable citizens in the country.

The Telegraph covers the same story and lists a litany of previous failings upheld against Southern Cross

Southern Cross Healthcare PLC was fined £200,000 pounds in January this year after pensioner Maisie Jones fell out of an upstairs window as she tried to escape from one of their care homes in Oxford.

The UK’s largest residential care provider admitted two breaches of Health and Safety regulations at Brookfield Christian Care Home in Greater Leys, Oxford.

In November 2002 Southern Cross’s Bishopsgate Lodge Home in County Duham was found to have a mechanism allowing baths to scald patients with water reaching 53 degrees centigrade.

It was fined £8,000 pounds and costs.

In June 2003 an elderly man died at Alexandra Care an elderly man died at Alexandra Care Centre in Hemel Hempstead, Herts., when he was strangled by a strap on a reclining chair due to a lack of supervision.

The firm paid more than £30,000 pounds in costs and fines.

In April 2005 Margaret O’Mara suffocated in a bed following a series of errors by staff at Hornegarth House in Cannock.

The company was given a record £175,000 pounds fine and paid £15,919 pounds in costs.

I wish I could say it was unbelievable. I know it’s the largest provider of residential care in the UK  but  it isn’t a great track record. By any standards.