Guest post – interview/article by Fred Turner
‘The victims of abuse are the last people seen or heard,’
stated Eileen Chubb, one of the founders of Compassion in Care, during our interview about the Care regulator – the Care Quality Commission. As someone who has fought to get the victims of abuse heard and protected for two decades, she has knowledge and experience of this issue.
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The charity, Compassion in Care, was set up in 2003 by some of the BUPA 7 whistleblowers, who in 1998 had raised concerns about the care home in which they worked – Isard House in Bromley.
They documented the countless instances of horrific abuse occurring in the care home. This ranged from over-medicating patients to physical assaults on defenceless and frail older residents. BUPA worked to cover up the abuse and continued to employ those accused.
Facing abuse at work from management, the whistleblowers were forced to take these issues to an employment tribunal and then through the court system. The full story is found in Eileen’s recent book, Dismantling the Façade which exposes the full ‘denial and cover up culture’ that pervaded the BUPA care home business.
Following their experiences in BUPA, the whistleblowers began investigating other care homes and set up a confidential helpline for those who witnessed abuse in their work. To date, they have received over 15,000 complaints. The issues revealed in the complaints are shocking , including the physical abuse of patients and people lying for hours in their own waste.
Care homes in England are regulated by the Care Quality Commission (CQC), which is tasked with inspecting, analysing data, following up on complaints and closing those homes where care standards fall. But there is abundant evidence that the current system of regulation is failing vulnerable people and there is something going wrong with the system of regulation, because Eileen reports that 90% of the complaints they’ve received relate to care homes rated ‘good’ by the CQC.
According to Eileen, there is an ambivalence in the regulator, and they have ‘no inclination to bite’ when abuse is reported to them. What makes matters worse is a woeful set of investigative skills – they do not appear to recognise patterns of abuse in specific homes, as indicated in many of Compassion in Care’s reports.
During our interview, Eileen spoke vividly of care homes she had visited just after they had passed inspections. She said they often stank of urine and she could not understand how they passed inspection. They were not environments that promoted wellbeing.
There is a growth of large-scale care providers, with organisations like BUPA and HC-One running care homes for profit. They are interested in protecting their reputations and ‘window-dressing’ their facilities. In the BUPA 7’s experience, they wanted to cover up abuse to avoid reputational damage. Paper work was apparently often filed to disguise abuse such as the dangerous over-medication of patients.
For Eileen, it is ‘shameful’ that these organisations protect themselves over vulnerable people, often with dementia, who cannot defend themselves. The homes place ‘money before lives.’
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But if the regulator is failing, what can be done?
Compassion in Care don’t believe that more powers should be given to the CQC, which would only create another ‘layer of bureaucracy.’
Instead, they have campaigned tirelessly to enact ‘Edna’s law.’ The law, named after a resident who died following horrific treatment from abusers, with no family to support her, seeks to strengthen the protection afforded to whistleblowers and abuse victims. This reform of legislation, they suggest, would give confidence to people to report what goes on, without fearing reprisals from employers or losing their jobs. They do note that the law should be fair with checks to ensure against false claims against employers.
They argue that this law would place the frontline workers at the centre of the regulatory framework. As Eileen states, we need ‘people back at the centre of the law.’
They also want to see the powers of the CQC reduced. Its role should be ensuring the health and safety of buildings and auditing providers of care. Abuse, neglect and all other safeguarding issues should be dealt with as criminal matters, investigated by a police ‘public interest unit.’ They should not be reported to a regulator as merely a ‘safeguarding concern.’
Finally, the whole provision of care needs an overhaul. Making profit from care needs to become a thing of the past. Corporations that pull money from the care system, often with businesses registered in tax havens, who have interests in covering up abuse, need to go. There needs to be more localised provision of care with the wellbeing of people at its core.
As Eileen summarises, this adds up to a simple solution: the opening up of care homes. Residential settings should not be closed cultures regulated by a bureaucracy, but open institutions, where staff have the confidence to report and challenge wrongdoing. They should be part of the community and those inside should be fully included in society.
The system of private unaccountable homes governed by a failing regulator must go.
