Adult Social Care in Scotland | BetterCareScotland - holding Scotland's social care system to account!

Scotland’s Parliament exposes care home residents to risk!

Scotland’s Parliament takes the Care Inspectorate on trust

Failing to hold Scotland’s social care regulator to account exposes care home residents to risk.

On 25 August, 2020, Scotland’s Parliament had an opportunity to hold the country’s social care regulator, the Care Inspectorate, to account when its then chief executive was called to give evidence to Parliament’s Health and Sport Committee at a meeting to consider the question: “How well is the Care Inspectorate fulfilling its statutory roles?”.

This was at a time when people in Scotland were losing confidence in the public administration of the country’s social care system – Scotland’s government, local Health and Social Care Partnerships (HSCPs) and the Care Inspectorate were perceived to have exposed residents and staff in care homes for older people to the risk of infection from Covid-19 by expecting care homes to admit from clinical settings people who had not been tested for the virus and, later, to have breached care homes’ first line of defence against the virus by requiring them to open their doors to the Care Inspectorate inspectors and local HSCP officials to, in effect, count the face masks.

BetterCareScotland’s data show that these inspections were poorly-targeted and, therefore, needlessly exposed residents and staff, including the Care Inspectorate and HSCPs’ own staff, to the risk of infection.

Against this backdrop, it is hard to imagine a more pressing time for Scotland’s Parliament to examine rigorously the role of the Care Inspectorate.

But the minutes of this meeting show that Scotland’s Parliament failed to represent the evidence solicited from care providers and industry groups who had, for compelling reasons, expressed the concern that Scotland’s social care regulator is failing to fulfil its statutory obligations. And, with Parliament having failed to hold the Care Inspectorate to account in committee, the chief executive of Scotland’s social care regulator informed the Care Inspectorate Board on 30 September 2020 that “the session went well”.

It had, of course, gone very badly indeed! That the Care Inspectorate chief executive failed to see this validates the concerns care providers had expressed.

Unlike Scotland’s Parliament, BetterCareScotland would not claim to have all of the answers to the issues in social care provision facing Scotland but we do have the questions that Scotland’s Parliament seemed unwilling or unable to ask. And, by making sense of publicly-available date and using statistical techniques we know where and how to find the evidence to support the awkward questions to which the public officials who administer and regulate Scotland’s social care system should be expected to provide answers.

The aim of the Health & Sport Committee meeting on 25 August, 2020 is clear: to determine “How well is the Care Inspectorate fulfilling its statutory roles?”

But, the transcript of the meeting shows that Scotland’s Parliament paid lip service to the question and failed to reflect the views of those who had responded to Parliament’s call for evidence and, so failed to challenge the regulator’s then chief executive. This is unfortunate since there are serious flaws in the Care Inspectorate’s operations that need to be addressed.

Knowing the questions that need to be asked helps to get at the facts. For example, that the Care Inspectorate lacks the economics, analytical, and technical expertise and risk management and compliance experience without which no professional regulator in any sector can function. And that, where a professional regulator uses its own resources and refines its data and processes to better identify and respond to the risks of a regulated entity, the Care Inspectorate claims to be “intelligence-led” which means it depends entirely on other people to flag issues of which it would otherwise be unaware. In essence, the Care Inspectorate has sub-contracted its responsibilities to outsiders.

With clear implications for people’s welfare and human rights!

To receive by email a copy of BetterCareScotland’s, February 2021 research paper for Scotland’s Parliament,

HOLDING SCOTLAND’S CARE INSPECTORATE TO ACCOUNT?
A critical evaluation of Parliament’s scrutiny of Scotland’s social care regulator!

please click here.

WHAT YOU CAN DO!

Join BetterCareScotland and campaign to see people in Scotland and their human rights treated with respect at their time of greatest need.

Join forces with us and support people being silenced by their local authority.

Help us to hold local authority chief executives and social care bosses for exposing vulnerable people to risk.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Help to ensure that the vested interests and perverse incentive structures in Scotland’s social care system can be be designed out of the National Care Service so that the Scottish Government can deliver on its promise of good care outcomes, as standard, for all people in need of care in Scotland.

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on August 19, 2022 by editor

Accountability, Adult Social Care in Scotland, Better Care Scotland, BetterCareScotland, Care Homes for Older People in Scotland, Care Inspectorate, Care Inspectorate Scotland, Free Personal Care Allowance, National Care Service Scotland

Better Care Scotland, Maya Angelou, Risk Management

3 times when your social worker was not on your side!

a roll of the die in social care in Scotland

Why social care outcomes in Scotland depend on LUCK!

The nature of people’s relationships with their social workers in Scotland is a topic which animates our subscribers. People should be able to expect these relationships to be positive and productive. But, increasingly over the years, the poor social care outcomes being delivered by social workers in Scotland have led people in desperate need of care to realise that social workers cannot be presumed to be on their side. And, never were, they find when piecing together and making sense of the delays, the unanswered questions, the unexplained pieces of what turned out to be grotesquely-bad advice. So profound are the mental health and financial impacts of this realisation that people are left unable to move on with their lives.

Our subscribers describe not sleeping since the day they discovered the awful truth that they were targeted at their time of greatest need by duplicitous local authority staff who had set out to gain their trust only to deceive them. They tell us of social workers bent on creating divisions within families. That nothing makes sense any more. That they have lost faith in Scotland’s social care system and no longer know whom they can trust. All made exponentially worse when they are told, in effect, by the attack-dogs employed by Council chief executives for the purpose, “You got what you deserved!”

People needing care in Scotland end up having to fight for their statutory rights when it becomes clear that the system doesn’t work – if they have the strength or appetite for a fight, that is! Many just give up. For the local authority, this is ‘job done’! They know that people do not challenge authority. That it wouldn’t even occur to people, who are no longer fully self-reliant and need care and support, to question their social worker in any regard, let alone about their motivation. Typically, therefore, realisation dawns only when it is too late for many.

But, there are some simple and straightforward things you can do. Things your social worker would do for you, as a matter of routine, if Scotland had a functioning social care system. In essence, this means keeping a record of everything and emailing your social worker with your understanding of what was discussed or agreed and asking for clarification of things about which you are unclear.

Your emails are unlikely to be acknowledged, since social care bosses in Scotland know that maintaining faithful records would leave them exposed when things go wrong, but don’t let the Council’s poor practices dissuade you. Treat the emails you send as insurance against the risk of the Council’s chief executive silencing you if things go wrong.

Facing the odds-on prospect of a poor social care outcome, according to the findings of the 2021 Report of the Independent Review of Adult Social Care in Scotland you have nothing to lose! You might even get your social worker on your side. A long shot, but worth a try!

So, why would Scotland’s social workers ever not be on your side?

We hear from social workers themselves.

Few of us would doubt that those who enter the social work profession in Scotland do so, in the main, in anticipation of being able to make a positive difference to people’s lives despite the demands and challenges they expect to face. This is a laudable ambition.

Scotland’s universities claim that their social work degree courses will prepare you for the challenging and rewarding role of social worker. But, the high attrition rate of social work staff, specifically those in their first six years in the profession, tell a different story: that this is not the reality, that something has gone wrong!

Information from a sub-sample of our subscribers – former social workers who chose to leave the profession or have retired, together with those still in-post – attribute the unsustainably-high staff turnover rates to the toxic work cultures which pervade Scotland’s social care system.

They tell us that disillusionment sets in within the first few weeks for new recruits who find their every move monitored by “psychopathic” line managers, “drunk on power”, who put their own self-interest ahead of the delivery of care by willingly accommodating management teams and social care bosses whose incentive is to save the local authority as much as possible which, translated, means paying as little as possible for care … driving down the quality of care for everyone in the process.

Feeling unsupported by their trade unions, those who bring their careers to a premature end do so fearing for the long-term ill effects on their mental health of bullying by co-workers, knowing that local authority whistleblower policies provide no safeguards against retaliation, having witnessed, first-hand, how ordinary members of the public are treated when they reach out to the Council with justifiable concerns about social care delivery or provision. These are the people best-placed to monitor and, therefore, to be aware of issues in social care. Who are, in effect, blowing the whistle. But, who, for alerting the Council chief executive or Head of Social Care to operational and governance problems find themselves stonewalled, silenced, ridiculed, blamed, threatened by the chief executive’s attack dogs – some wearing badges bearing the words “democratic” and “governance”. Even punished, by having care removed.

Perhaps, we should remind you that we are talking here of modern Scotland! Not, some Evelyn Waugh dark comedy!

Those who manage to bash on, despite the bullying, are troubled knowing that the generous pension they accrue is funded by the likes of the very people whose care they are required to delay or deny. The Department for Work and Pensions calculates that, in 2021, the average public sector employee had £7,370 paid into their pension compared with £2,110 paid into the average private sector pension.

All agree that stress is caused, primarily, by social care bosses requiring them to deprive people of the social care they need and not the workload itself. Female social workers say they feel degraded by male bosses, without social work qualifications, who occupy policy and leadership roles and expect the female ‘foot soldiers’ to empathise with the people needing social care in order to better exploit them. A vicious circle of state-enabled abuse.

One of our subscribers describes how the awful truth of what she had become dawned on the day that a vulnerable elderly gent, expressing a preference for a female social worker, was allocated to her but that her job was to find out what he was worth. Her advice to social workers in Scotland today is to take a long hard look at yourself every morning and question what you are doing and why!

It is no surprise that the level of discontent in the profession and drop-out rates are so high. Or, why BetterCareScotland’s subscribers describe feeling like imposters and confidence tricksters rather than social workers. Of being social workers in name only when the role involves processing people in ways that will save the local authority money instead of making decisions that will support the welfare of people needing care.

Against this backdrop, BetterCareScotland’s subscribers advise that people in need of care should expect their social worker to lie to them, to delay care assessments for as long as possible, to backtrack on assurances they’ve given, to fail to involve them in decisions and, instead, present, as ‘faits accomplis’, care plans that will not meet their needs, to provide conflicting advice, to present themselves as legal experts in order to intimidate, to create rifts between family members, to override people’s express wishes, to fail to put anything in writing, to advise family members to apply for the carer’s allowance as an alternative to statutory free personal care – the list is endless – enabling the local authority to find no evidence in support of complaints when people reach out.

THREE TIMES WHEN YOUR SOCIAL WORKER WAS NOT ON YOUR SIDE

Feedback from our subscribers reveals that there are many commonly encountered situations where the social care policies of a local authority, with incentives that are not aligned with the interests of people needing care, create moral dilemmas for social workers.

Social workers in Scotland should be incentivised only to act in the best interests of the service user but, by design, as the three cases we outline here illustrate, are persuaded to act in their own self interest.

Here, we outline just three times when your social worker was not on your side. In each case, click on the heading to EXPOSE THE PERVERSE INCENTIVES AND MORAL DILEMMAS IN SOCIAL CARE POLICY. And the risks to which people are knowingly exposed by their social worker. Risks their local authority would prefer remained hidden.

CASE #1: WHEN YOUR SOCIAL WORKER IS UNDER THE NHS MICROSCOPE

You are in your mid-nineties and have been treated in hospital for a respiratory infection … hospital staff have assessed you as medically fit for discharge into the community but in need of long-term support with personal care … despite your age, there is no community care plan in place … hospital staff contact social services to arrange a discharge assessment … four weeks later, a community social worker is assigned who calls you and tells you, before meeting you, that you need 24 hour care which only a care home can provide … you wish to be cared for in the community but the social worker says the only option is residential care.

Many people in Scotland will identify with this case.

Hospital clinicians will not discharge vulnerable people unless it is safe to do so even if they are medically fit for discharge.

The hospital clinician who treated you spoke to your son and said you are well for your age and can return home but that you cannot be discharged until a Community Care Plan is in place and that hospital staff will inform social services.

The hospital’s self interest is perfectly-aligned with yours in order to minimise the risk of your readmission.

Hospital staff declared you medically fit for discharge. Your age alone would indicate entitlement to Free Personal Care and the ready delivery of a standard Community Care Plan. But it takes some local authorities an average of at least two months to process a Community Care Plan with funding in place for basic personal care.

Self Directed Support (SDS) would provide you with the funds to employ a carer and tailor your care to better meet your needs. But local authorities, for reasons of economy, are reluctant to deliver SDS even if resource constraints mean they cannot deliver a Community Care Plan.

In the circumstances, the social worker has no incentive to discuss these social care options with you and your son. The social worker is sensitive to being under the NHS microscope and the perception of NHS staff that your hospital discharge may be delayed by local authority inefficiency.

The social worker, therefore, tells you point-blank that you need 24 hour care in a residential home. If the social worker can persuade you, your discharge could be organised within days and the social worker saves face. You are determined to return home.

The social worker is incentivised to save money for the local authority rather than deliver the care plan that best meets your needs.

Key to the social worker’s incentive to act contrary to your wishes and best interests is that you own your home. This could be sold to cover residential care fees. In such circumstances, we find social workers will use whatever means necessary to persuade people to be discharged to a residential care home – for all the wrong reasons.

And will be incentivised to class your admission to the care home as a ‘private arrangement’ – even though the social worker brokered the deal – making you liable for the care home fees in full while saving the local authority over £800 each month in the Personal Care Allowance to which you would be entitled.

The most recent HM Land Registry House Price Index shows that the average price of a house in Scotland in Quarter 1, 2022 is £180,822.

Family members and friends of anyone living in their own home in Scotland today who may need social care should know that this is an amount your local authority wants to get its hands on. Any way it can! Even if it means violating your right to family life!

Your social worker holds a meeting with nursing staff at the hospital to determine your long-term care plan. Neither you nor your son are invited and find out about it by chance after the event.

We suggested to your son that he might voice his concerns that your right to respect for your family life under Article 8 of the Human Rights Act, 1998 would be compromised if the social worker should override your wish to return home as soon as a Community Care Plan can be delivered.

The social worker responds to this by agreeing to process SDS funding which your son believes would better meet your needs. You currently remain in hospital awaiting delivery of SDS so that you can return home.

When local authorities in Scotland deny people the care they need or deliver poor social care outcomes, they create the risk for the NHS of crisis hospital admissions and the associated risk of delayed discharge of people who are medically fit for discharge from hospital but who cannot be discharged until a Community Care Plan has been delivered.

BetterCareScotland finds that, when making discharge arrangements for people needing care and support in the community, NHS healthcare professionals expose the NHS to the operational risks of local authorities if they take on trust that social workers’ incentives are fully-aligned with theirs and patients’ when there are no safeguards in place on which to base such an assumption.

CASE #2: WHEN YOUR SOCIAL WORKER BECOMES A SOCIAL VISITOR

You are 87 years of age … since your husband’s death two years ago, you have suffered five mini strokes each of which required emergency hospital admission followed by a period of convalescence in an NHS unit … your most recent admission to hospital saw you there for eight weeks and, when hospital staff declared you medically fit for discharge to the rehabilitation unit, they assessed you as a falls risk, as physically weak and needing support with personal care, and contacted the local authority … you were discharged for a period of convalescence in the NHS facility … when you returned home, someone from social services rang and said that, until a social worker was allocated to your case, you would have to pay for any care you need … a month later, a social worker organised walking aids and the fitting of grab rails in your bathroom and a panic alarm … over the next five months, the social worker made frequent visits but has not delivered a Community Care Plan.

Hospital staff declared you medically fit for discharge to the rehabilitation unit to regain mobility and stamina. This was arranged on the assurance from social services that they would deliver a Community Care Plan for you on your eventual discharge but with no apparent safeguards in place to ensure that a Care Plan would be delivered.

Your circumstances would indicate entitlement to Free Personal Care and the ready delivery of a standard Community Care Plan by the time you returned home and yet your social worker failed to deliver a Care Plan or explain the delay.

The hospital had alerted social services to your care needs. Social services should not have told you to pay for your care if you were entitled to Free Personal Care.

There are long waits for Community Care Assessments in some local authority areas but, in the circumstances, a standard Community Care Plan should have been fully operational by the time you returned home. You should not have been discharged by the NHS when it was not safe to do so.

We find that people being denied the Free Personal Care to which they are entitled is par for the course in some local authority areas in Scotland. When challenged, the authorities’ ready response is that, people are not ‘entitled’ to anything until they’ve been assessed irrespective of their circumstances.

In your case, over a period of many months the social worker has visited, often at awkward times for you, and for no apparent reason. Your Community Care Plan should have been delivered before your discharge from the NHS convalescence unit.

If you suffer harm that is attributable to your local authority’s failure to deliver a Community Care Plan, it may be determined that the NHS discharged you before it was safe to do so, creating a legal issue for the NHS.

Our data show social workers are incentivised to expose the NHS to the operational risks of local authorities’ policies and governance issues. We find that, unlike the NHS, local authorities fail to acknowledge the risks of their operations but are able to cover-up their operational events.

The risks taken by your local authority in denying you a Community Care Plan is not aligned with the hospital’s incentive to discharge you only when it was safe to do so if there is any likelihood of your readmission or a risk of litigation.

You feel discomfited by the social worker’s frequent visits and wonder if the social worker is ‘casing the joint” for some reason but you are afraid to ask! You do not know if, over this period of five months, the social worker has even assessed your care needs. She is adept at failing to answer your questions. You have no immediate family or friends nearby who can help.

Predatory behaviour by social workers is a red flag. It concerns us that, since Free Personal Care is a non means-tested entitlement, the social workers should take an interest in your financial means. Every aspect of this social worker’s behaviour seems predatory.

Unsurprisingly, without a Community Care Plan, you found yourself struggling increasingly to cope with basic household tasks. At our suggestion, you asked your social worker why things are taking so long. You went one step further and asked if it would help if you were to contact the chief executive. Well done! You are now receiving four visits each day and find that this arrangement works well for you.

Now that the Community Care Plan has been delivered, you are no longer subjected to the social worker’s needless visits.

BetterCareScotland concludes that your social worker was incentivised to delay the delivery of your Care Plan. This created welfare issues for you and legal issues for the hospital. Our data show Care Plans being delayed by over a year, one for SEVENTEEN MONTHS for a BetterCareScotland member. We regard this practice as an infringement of human rights when it restricts your ability to exercise your rights.

The social worker’s visits are a cause for concern. They may have been information-gathering exercises since community social workers in Scotland today will needlessly direct people with the means to pay to residential care homes for reasons we will explore in a future blog.

CASE #3: WHEN THE SOCIAL WORKER MEETS THEIR MATCH

At the age of 84, your father was diagnosed with vascular dementia with a prognosis of three years … he is no longer self-reliant … after a fall at home, social services allocated a social worker to assess his care needs with you, his daughter … you are your father’s Power of Attorney … you live nearby and are, in effect, his unpaid carer … the social worker said that demand for community care exceeds supply, that your father is a low priority, that many others are much worse off than him, and that it is anyone’s guess when, if ever, he will reach the top of the list … the social worker concluded that there was, therefore, no point in assessing your father’s care needs … this conversation took place by telephone before the social worker had met you or your father.

When your father had difficulty performing basic routines and was no longer self-reliant, his GP referred him to a psychiatrist who conducted memory tests in your presence and diagnosed vascular dementia with a prognosis of three years. Your father’s GP contacted social services to assess his care needs.

The social worker showed no interest in your father’s care needs and failed to discuss social care options.

At your insistence, the social worker agreed to visit. The social worker reiterated the telephone advice that a Community Care Plan was not possible because two care firms had ceased trading. You asked about Self Directed Support to fund your father’s personal care. The social worker brushes off your suggestion without explanation.

The social worker proposes that, as your father’s main carer, albeit unpaid, you are entitled to a Carers Assessment entitling you, at the very least, to four weeks of respite from caring for your father during which time he would be cared for in a residential care home. You ask who would pay for the residential care over those four weeks. The social worker says without hesitation, “The Council!”

A week after this meeting, you send the social worker an email outlining your understanding you have from these discussions. The social worker does not reply to your email but telephones and tells you that you were confused and backtracks on everything that had been discussed previously.

You tell the social worker that you are recording the call. The social worker accuses you of breaching the Council’s Code of Conduct. You point out that you cannot breach a Code of Conduct by which you aren’t bound. The social worker then suggests that it is morally reprehensible of you to record the call without forewarning her. You say that there needs to be a record of whatever is discussed for the avoidance of doubt. The social worker relents. You thank the social worker for understanding your position.

You ask again about Self Directed Support. This time, the social worker agrees that SDS can be delivered and calculates a weekly amount, promising to achieve more if possible.

The social worker tells you “it would be better” if you were to care for your father in your own home instead of moving back into the family home which he occupies. When you ask why, you are told only that “it would be easier”.

BetterCareScotland finds that social workers expect family members to act as unpaid carers even if this means having to leave the labour market. In your case, you have taken early retirement. However, these facts do not permit the social worker to decide not to assess your father’s care needs. Your father’s care needs must be assessed. They may be more complex than you are aware.

You should not have had to insist on the social worker delivering Self Directed Support. It should have been discussed with you as an option from the start and certainly not ruled out when lack of resources meant a Community Care Plan could not be delivered.

We find that social workers will routinely rule out all options but residential care when people have the means to fund their care fund their care. In your father’s case, with no home to sell, the social worker ruled out care completely.

The social worker should not have proposed a Carers Assessment for you as an alternative to a Care Plan for your father. You were right to doubt the promise of free residential care for your father for four weeks at some future indeterminate date. Well done!

We feel that, if people are expected to take social workers on trust, Carers Assessments could become the social care equivalent of PPI mis-selling by banks.

The social worker proposed a care arrangement which could leave both you and your father homeless one day. Your father lives in a Council house. You rent a flat nearby from a private landlord. We cautioned that, since your father’s tenure is assured, you would be well advised to proceed with your original plan and move into the former family home. This will provide security and allow your father to continue to live in surroundings with which he is familiar.

It is odd that the social worker should provide such questionable advice after you had disclosed that you were recording the call. If, as seems likely, the social worker had forgotten that the call was being recorded, this lapse in concentration shows a social worker primed to act in a manner which would disadvantage someone in need of care and support.

This case illustrates that a third party may be less likely to be as easily deceived by social workers than the person in need of care. However, in general we find that family members are frequently taken in by social workers whose word, they assume, can be taken on trust.

BetterCareScotland’s data, derived from the lived experiences of our subscribers, show that Scotland’s social workers routinely deny people the social care they desperately need, and do so at the direction of social care bosses and, ultimately, their unaccountable local authority chief executives.

Our data suggest that, in one of the world’s richest countries, local authorities employ social workers for the express purpose of denying people the care they desperately need. And that social work practices, which do not reflect the statutory obligations of local authorities in letter or spirit but which are supported by social care bosses and local authority chief executives, represent social care policy in Scotland today.

The only people who seem to benefit are social care bosses and the local authority chief executives themselves but only by being able to avoid being held to account when things go wrong.

The fact that social care bosses are not required by local authorities to have qualifications or backgrounds in social work suggests that social care policy in Scotland today is primarily about spending as little as possible not providing essential services.

It should come as no surprise, therefore, that social workers’ morale is low, absenteeism is high, and there is an attrition rate which creates recruitment issues.

CONFLICTS OF INTEREST

It is clear that the incentives of a local authority in Scotland looking to pay as little as possible for care will be problematic when quality of care should be of paramount importance.

The generally well-regarded Nordic model of social care, to which Scotland would aspire, is predicated on the belief that quality of care provision is key and should never be traded off against cost. This approach should ensure that social workers are employed to do what social workers are supposed to do and providers of good quality care do not leave the market.

So, delivery of care should see good quality care delivered within cost constraints and not what we see in Scotland today – people being denied the care they need, providers of good quality care being driven out of the market leaving providers, which undercut the competition to accommodate their local authority, unable to cope. This drives down the quality of care for everyone and requires carers in the community and in commercially-unviable care homes, being kept in business by their local authority, to agree to working practices and conditions of employment that the local authority would not expect their own staff to accept. Nor should they.

We see people with modest life savings treated as cash cows by their local authority. One day, this aspect of social care delivery in Scotland could be the undoing of unscrupulous local authority chief executives and social care bosses who prey on Scotland’s most vulnerable at their time of greatest need yet face no sanctions when things go wrong.

It is a grotesque abuse of position for local authority bosses to expect social workers to knowingly act in their own self-interest and prioritise career progression over the the delivery of good social care outcomes. And controversial, since public sector pensions are funded by taxpayers some of whom are being denied care. It seems clear that local authority social care policies and practices are at the root of the high attrition rate in social work.

Some social workers take their grievances to their trade union and professional/licensing body but vested interests lead these bodies to be incentivised perversely to support the system not their members. Such a response not only perpetuate the issues that have become hard-wired into the current system, but enables them.

It is only a matter of time until local authority chief executives who look the other way and social care bosses who fail to supervise social workers are held to account.

BetterCareScotland’s subscribers would caution, NO MORE COVER-UPS WHEN YOU MESS UP!

THERE IS HOPE

Despite their experiences, BetterCareScotland’s subscribers are hopeful that, one day, everyone in Scotland will inherit a social care system that is revered, not feared! With social workers seen in the same light as our NHS professional health practitioners, our doctors and nurses who work to, and are held to, scrupulously high standards in challenging conditions. Standards that are not observed in social work and social care in Scotland today.

We look forward to a fully-operational National Care Service, which has been pushed back till 2028, untainted by the vested interests and perverse incentive structures of local authorities which have brought the current system to its knees.

WHAT YOU CAN DO!

Join BetterCareScotland and campaign to see people in Scotland and their human rights treated with respect at their time of greatest need.

Join forces with us and support people being silenced by their local authority.

Help us to hold local authority chief executives and social care bosses to account for the poor outcomes they deliver to people whose taxes pay their salaries and fund their pensions.

LET BETTERCARESCOTLAND KNOW

When did you start to question whose side your social worker was on?

Tell BetterCareScotland about the doubts you dare not express for fear of retaliation.

If you have concerns about the response you received from your local authority when you reached out after things went wrong for you or a family member or friend, let BetterCareScotland know!

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Love and Peace!

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on July 20, 2022 by editor

Accountability, Adult Social Care in Scotland, Better Care Scotland, BetterCareScotland, Care Homes for Older People in Scotland, Care Needs, Care Plan, Free Personal Care Allowance, Human rights, National Care Service Scotland, Public Sector, Risk Management, Scottish Local Authorities, SDS - Self-Directed Support, Social Worker, Whistleblower

Better Care Scotland, Governance, Maya Angelou, National Care Service, Risk Management, Whistleblower

One woman tells her story … #5

lack of expertise of Scotland's Care Inspectorate

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract V: Scotland’s hippie dippie Care Inspectorate

From the sitting room window, I watched the RSPCA van pull into the care home car park. On impulse, I smiled and waved in its general direction then saw that I might be regarded as one of those poor people I’d seen staring bleakly at passers-by through care home windows. Not waving but drowning, I’d thought, waving cheerily back but wishing I could do more. It turns out I was right.

“If only they could take me too!” I said, turning to address the room’s only other occupant and pointing towards the window. “The RSPCA!”

The room’s only other occupant didn’t look up but seemed to smile. Or was that a grimace, even a grrrrrrrrrrimace through gritted teeth! I couldn’t tell. She carried on, head down, flicking through pages in the file balanced on her knees, ticking boxes, it seemed. She was from the Care Inspectorate. And, I’d been told to be on my best behaviour.

I’d been told, also, to tell the woman from the Care Inspectorate, “It’s great that places like this exist!”

Three days this week, in the lead-up to the Care Inspectorate’s visit, we’d done role play with Liz, the part-time activities coordinator. Liz took the role of the Care Inspectorate inspector which seemed to require her to pull on a black wig and smile at each of us in turn, saying, “Hello, how are you?”, to which, we were to reply, “I’m fine thank you. It’s great that places like this exist!”

Fran said, “Nobody puts words in my mouth! I’m saying nothing!” and the rest of us murmured in agreement.

“Shouldn’t we be saying, it’s great that this place exists?”, George wondered. “It doesn’t sound right if we’re glad that places like this exist. It’s as if we’re not fully behind this particular place.”

All but Liz, the part-time activities coordinator, agreed with George’s every sentiment. She thought it wrong to change horses mid-stream. She said so!

I tried out the line on my son when he came to take me for tea.

“It’s great that places like this exist!”, I said, apropos of nothing and, perhaps, without sufficient sincerity and we creased up at the thought of anyone trying to brainwash me … and, presumably, the Care Inspectorate … and came up with our own variant. I daren’t disclose what we thought I should say and, in the event, the woman from the Care Inspectorate showed no interest whatsoever I me so I had no opportunity to let her know.

I sat down in an armchair close enough to watch the woman from the Care Inspectorate in action, as it were. Authority figures fascinate me. Poor deluded fools who think they know better than the rest of us! Someone ought to tell them!

“I’m Elle!”, I said. The woman from the Care Inspectorate was too busy to reply. She wore a laminated card on a ribbon round her neck. I couldn’t read her name from where I sat.

Since moving into the care home, I’ve taken to sitting with my fingers crossed, hoping that the overgrown elm in the garden would land on the building and put us all out of our misery. Or, short of that, that the porridge pot would explode and rip apart the kitchen, preferably before they start serving breakfast, so that the whole dump can be officially declared unfit for human habitation, that sort of thing. For, it is a dump, this care home. And, I don’t know why the council keep sending people here, to be frank, or why the Care Inspectorate doesn’t seem to notice. As for the owner, we won’t go there!

“Why don’t you come and stay a while?”, I suggested. “I wouldn’t recommend the food! And, you’d need to take care in those heels not to trip on the worn carpets. But, don’t let me put you off.”

Head down, Mrs Inspector continued smiling/grimacing.

“By the way, I wouldn’t sit in that chair, if I were you.”, I said, leaning froward and lowering my voice. “Some poor soul had what’s called an accident in it a few days ago. The smell has lifted but they haven’t cleaned it yet! I don’t expect them to!” All his was factually correct but Mrs Inspector wasn’t listening. She’d zoned out, as they say.

When I said, “You could do with losing some weight!”, scrutinising her with one eye closed, she looked directly at me for the first time, quite expressionless, as she got up! I uncrossed my fingers just for the moment and smiled.

“I’m Ellie!”, I said to her back as she left the room.

My son says that Care Inspectorate inspectors have no incentive to engage with care home residents on inspection visits for fear of being made aware of something they’d actually have to investigate and that they prefer to be blissfully ignorant or, as he calls it, “wilfully blind”.

The most fun I had in that care home … or hell-hole as my son calls it … was reading aloud with Annie and George and Margaret the ‘residents’ feedback’ in Care Inspectorate reports my son printed out and trying to guess which area of Scotland the care home must be in.

It doesn’t take a genius to know that Scotland is a melting pot of accents and that, for a multitude of reasons, people end up in care homes nowhere near the place of their birth and they take their accents with them.

We decided that the Care Inspectorate employs someone to sit in their fancy offices in Dundee … or at their kitchen table, now that they don’t even bother going in to work … to come up with likely-sounding phrases that they run through a dialect app to transform them into likely-sounding pieces of Doric, Lallans, Morningside, or Dundonian vernacular to fool us into believing that they take an actual interest in care home residents. It keeps people in a job, I suppose!

But, there is a serious side to this which the Care Inspectorate don’t recognise: the risk of the most vulnerable residents feeling the need to pick up local slang used by staff in order to ‘fit in’. With hindsight I can see that, when I was abused in the care home of which I was expected to say, “It’s great that places like this exist!”, I developed coping mechanisms to get by including mimicking the staff’s coarse vernacular for it made them laugh. I reasoned that, if I were popular, I’d be a less-likely target for abuse. The thought that my abuser would turn their attention from me and focus on one of my fellow-residents is something that haunts me to this day!

BetterCareScotland’s data, from the lived experience of our subscribers – care home residents, their family members and friends together with care home staff, former and in-post social workers, and Care Inspectorate staff who dare not blow the whistle for fear of the consequences – show that Scotland’s Care Inspectorate lacks the professional expertise expected of a serious regulator.

By actively seeking to recruit people with “soft skills” when risk management, governance, regulatory and compliance expertise and technical and analytical skills and experience are needed, we find a Care Inspectorate with historical leadership issues and an organisation that has lost its way so completely that it is now fully out of its depth.

Our analyses find that Scotland’s social care regulator has a consistently-high fail-rate in targeting care homes which pose the greatest risk to the wellbeing of residents and staff. This is unacceptable in a care sector that can, literally, bury its mistakes.

It leads us to question whether Scotland’s Care Inspectorate plays a meaningful role in uncovering issues in the delivery of care. And, if this is by design or outcome – for Scotland’s Care Inspectorate does not operate in a vacuum. And our subscribers’ experiences suggest that it fails to act independently of local authorities when things go wrong.

We test the hypotheses that the Care Inspectorate is fair and consistent and recognises the key-risk-indicators in residential care provision for older people for we find evidence of it failing to target commercially-unviable care homes for older people that are strategic-fits for local authorities despite the risks to residents and staff from under-resourcing when the care provider has no economies of scale on which to draw.

BetterCareScotland asks, also, if the Care Inspectorate fulfils its statutory obligation to act independently of local authorities in High Level Investigations or if it is incentivised to close ranks and follow the local authorities’ lead. And, therefore, if the Care Inspectorate in its current form adds any value whatsoever to social care delivery and provision processes for older people in Scotland.

SCOTLAND’S HIPPY DIPPY CARE INSPECTORATE

The recently-retired chief executive of Scotland’s Care Inspectorate claimed that the “soft skills” of the Care Inspectorate’s staff enable them, in some hippy dippy way it seems, to “sense” when things don’t feel right on inspection visits to care homes for older people in Scotland.

BetterCareScotland’s data show that the Care Inspectorate’s crystal ball doesn’t work!

Email BetterCareScotland for a copy of our February 2021 research paper for Scotland’s Parliament,

HOLDING SCOTLAND’S CARE INSPECTORATE TO ACCOUNT?
A critical evaluation of Parliament’s scrutiny of Scotland’s social care regulator!

SO LAST CENTURY

In general, our data indicate that the Care Inspectorate’s philosophy, operations and methods are ‘so last century’. By way of example, during the pandemic, the Care Inspectorate produced fortnightly reports for Scotland’s Parliament from which nothing can be ascertained or comparisons made or conclusions drawn from one report to the next. At a time when Scotland’s decision-makers needed key facts and reliable hard data that could be eyeballed by busy people, the Care Inspectorate supplied bed-time stories.

What these fortnightly reports do provide, however, is an insight into the Care Inspectorate’s inconsistency of approach on inspection visits, a common complaint of care home managers. We see this as evidence of ill-discipline which no well-regulated sector should observe of its oversight bodies when confidence is needed and springs from the Care Inspectorate’s reliance on “soft skills” which, by their nature, create bias and subjectivity where certainty is key.

By extracting the information content from these fortnightly reports, BetterCareScotland has produced the sort of meaningful data Scotland’s Parliament should have expected to receive. It is an irony that, despite BetterCareScotland’s resource constraints, our data are superior to those of the regulator of Scotland’s social care system.

LET BETTERCARESCOTLAND KNOW

If you have concerns about the response you received from Scotland’s Care Inspectorate when you reached out, let BetterCareScotland know!

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Love and Peace!

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on July 17, 2022 by editor

Accountability, Adult Social Care in Scotland, Better Care Scotland, BetterCareScotland, Care Homes for Older People in Scotland, Care Inspectorate Scotland, Compliance, Governance, National Care Service Scotland, Public Sector, Regulation, Social Care Regulation, The democratic social contract

Better Care Scotland, Care home abuse, Care home neglect, Governance, Maya Angelou, National Care Service, Whistleblower

One woman tells her story … #4

strong sedatives are used routinely in care homes for older people in Scotland

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract IV: ‘Control, not Care’ in commercially-unviable care homes for older people in Scotland

Dr Well-Beloved

I call her Dr Well-beloved for all sorts of reasons.

For being completely unfazed when I rocked up at her surgery a week before Christmas 2018 and bawled the place down when she tried to stick a needle in my arm.

For showing patience and understanding when she failed to persuade me that it wouldn’t hurt. And, for being non-judgemental when I refused to cooperate.

For three weeks, I was shielded from people who intrude, those who regard it their right to pry, since being rescued by my son from the care home, but a visit to the GP was needed and it fell to Dr Well-beloved to examine me. Tall and willowy, she would have looked equally at home in jodhpurs and riding hat. I understood perfectly well that I should have felt in safe hands.

Poor Dr Well-beloved! How was she to know that the most effective way of getting rid of my abuser from my room in the care home was to holler at the top of my voice. Or that, since the abuse began, I trusted no-one which seemed reasonable since, at my great age, pretty much anyone, who so wished, could do me harm. By hollering, I was in control. And not as defenceless as I felt … or as any potential abuser might think!

The trouble was, immediately it began, I saw everyone as a potential abuser, out to hurt me. So, I retreated into myself and was crotchety with anyone who just wouldn’t leave me alone.

Looking back, this seems a perfectly rational and reasonable response – to me – but someone really ought to explain it to so-called dementia experts in Scotland, in my opinion. And, by ‘dementia experts’, I don’t mean teenage care home staff who know no better or misguided social workers who would have every new care home resident declared insane on admission, giving care home staff the green light to needlessly exercise discretion in the use of chemical coshes and restraints on people like me.

A cautionary tale

My abuse was covered up by the local authority but my GP’s diligent record-keeping and my son’s detective work have let us piece together the whole sorry matter.

It began shortly after the care home staff learned that I was self-funding my care.

They should never have got to know this nor been free to discuss it openly but it became a talking point with staff who could not comprehend why someone with the means to shop around for good quality care would choose such a grotty care home. They did not to know that my social worker had directed me to this specific care home, advising against almost every other, for reasons the local authority see no reason to explain.

For a few days, until they got used to the idea, I was teased in what seemed a good-natured manner by staff unable to decide what to make of it. Then, one night someone came into my room, turned off the light, grabbed me by the wrist and told me that I was “no better than anyone else” just because I was paying to be there and warned me that there would be no preferential treatment. That night, I barely slept, fearing what would happen next.

The following day, I asked to be left alone in my room and had nothing to eat or drink until accepting a cup of tea at 4pm. My so-called ‘dedicated carer” recorded only that I was “a little under the weather”!

That night, my abuser threatened to “pee” in the cup of tea I desperately needed. This was the last time I would ask for a cup of tea for comfort when I couldn’t sleep.

At 5am the following day, the duty nurse called for an ambulance.

What the duty nurse told the medic who attended is on my medical record. What she told the care home manager I can but guess as no time was wasted in persuading the local health authority to start the process of having me declared insane. And, in double-quick time a psychiatrist diagnosed vascular dementia with a prognosis of three years – all without my or my family’s knowledge and having failed to involve my GP who recorded that he found “no evidence of incapax”.

Six years later – three years after I should have succumbed to the diagnosis – I am here to tell this cautionary tale.

According to my medical records, on a date two months after my abuse began, the afore-mentioned psychiatrist came and chatted to me in the care home. I assumed he was a doctor on a routine visit. As we spoke, he noted that I was bright and alert and that I engaged fully with him, that I knew my name, how old I was, the day of the week, the month we were in, and so on. He noted, also, that I answered, “In prison!” to the question, “Do you know where you are?”

It’s in my nature to engage in verbal sparring when people pry and I thought he would appreciate the joke. As you will understand, I’m sure, some awkward truths underpinned my reply but, what I said was not meant to be taken seriously. However, the psychiatrist detected no humour or irony and concluded on the basis of this response alone, which he didn’t even question or ask me to explain, that he found unambiguous evidence of dementia.

How ironic that a more correct and appropriate diagnosis would have been a sense of humour which, one day, would be the end of me.

And, with a flick of his pen, this dementia ‘expert’ set me on a slippery slope without so much as a cheery wave. The care home’s persistence had paid off.

BetterCareScotland’s data, from the lived experience of our subscribers – care home residents, their family members and friends together with care home staff, former and in-post social workers, and Care Inspectorate staff who dare not blow the whistle for fear of the consequences – show that the routine-sedation of residents in care homes for older people and the use of restraints follow directly on from Adult With Incapacity (AWI) certificates that are issued in the complete absence of safeguards against abuse.

Our data indicate AWIs being sought for the convenience of the hard-pressed staff and, therefore, the direct benefit of the owners of commercially-unviable care homes kept in business by local authorities – looking to pay as little as possible for care – with a steady stream of state-funded residents and, whenever possible, the reward of unsuspecting and more desirable, from a commercial perspective, self-funding residents.

In care homes for older people, where staff have come to expect GPs to produce AWIs on demand, we find residents being CONTROLLED rather than CARED-FOR and that this can happen in plain sight. But it gets covered-up by local authorities and ignored by the Care Inspectorate whenever it fails to act independently of the local authority!

The risks to which residents are exposed need to be recognised and addressed with urgency since social workers who ‘indulge’ hard-pressed care home staff who cut corners and bend the rules in order to ‘cope’ and Care Inspectorate staff who “somehow” cannot “sense” on inspection visits that something is wrong have degraded the social care system of one the world’s richest nations.

SCOTLAND’S HIPPY DIPPY CARE INSPECTORATE

The recently-retired chief executive of Scotland’s Care Inspectorate claimed routinely that the Care Inspectorate’s staff can, in some hippy dippy way it seems, “sense somehow” when things don’t feel right on inspection visits to care homes for older people in Scotland.

BetterCareScotland’s data show that the Care Inspectorate’s crystal ball doesn’t work!

Email BetterCareScotland for a copy of our February 2021 research paper for Scotland’s Parliament,

HOLDING SCOTLAND’S CARE INSPECTORATE TO ACCOUNT?
A critical evaluation of Parliament’s scrutiny of Scotland’s social care regulator!

GARBAGE IN, GARBAGE OUT

BetterCareScotland views as a critical issue the concept of ‘undiagnosed dementia cases’ feeding into the decisions and assumptions of social workers and care home staff in Scotland. And that flawed, so-called ‘diagnoses’ create issues which local authorities may have perverse incentives to exploit.

Biased data lead to poor forecasting and should not be relied upon for funding decisions.

In the extreme, it takes little imagination to see a time when some misguided individual with power or influence proposes issuing everyone in Scotland with a dementia diagnosis together with their bus pass when they reach the age of 65 and be done with it once and for all!

LET BETTERCARESCOTLAND KNOW

If you or a family member or friend have concerns about a dementia diagnosis, let BetterCareScotland know!

Flawed and misdiagnoses of dementia undermine care outcomes and lead to genuine dementia sufferers being denied the care they need. And, could have perverse implications for research into the condition if data are flawed.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on July 16, 2022 by editor

Adult Social Care in Scotland, Better Care Scotland, BetterCareScotland, Care Homes for Older People in Scotland, Consumer Rights, Human rights, National Care Service Scotland, Scottish Local Authorities, Whistleblower

Better Care Scotland, Care home abuse, Care home neglect, Care Needs, Maya Angelou, National Care Service, Whistleblower

Ticking time-bombs!

Ticking time-bombs at the heart of Scotland’s social care system!

Increasingly, the people best-placed to monitor social care delivery and provision in Scotland find themselves stonewalled when they reach out to their local authority or to Scotland’s social care regulator, the Care Inspectorate, when things go wrong for them or for a family member or friend.

From their experiences, it is clear that scrutiny of the operations, performance and risks of Scotland’s 32 local authorities and the country’s Care Inspectorate is so lax that public sector staff working in social care in Scotland are, in effect, taken on trust while chief executives look the other way.

This is reminiscent of the light-touch regulation that sections of the British banking industry once enjoyed but which set the scene for high-profile scandals and blow-ups, like that of Barings in 1995, and led to the current ever-evolving system of financial regulation and risk management designed to align the incentives of retail banks, financials services firms and their customers.

BetterCareScotland exposes the unfortunate consequences for people experiencing poor social care outcomes in Scotland on the very day that the UK Parliament’s cross-party Joint Committee on Human Rights acknowledges the pain and suffering that public institutions and state employees can knowingly inflict on people at their time of greatest need.

Against this backdrop, people in Scotland are routinely silenced, blamed, even threatened by high-handed and judgemental local authority and Care Inspectorate staff when they reach out, their concerns deflected and covered-up. For, Scotland’s local authorities and its Care Inspectorate have brought the country’s social care system to its knees, a fact that the heads of these bodies take care to conceal.

The lived-experiences of BetterCareScotland’s subscribers reveal grotesque abuses of position by local authority social care bosses and chief executives and a supposedly-independent Care Inspectorate lacking in conviction and seemingly unaware that it has a role in exercising oversight of social care delivery by Scotland’s local authorities. It is clear that Scotland’s Care Inspectorate and some of the country’s local authorities should have been placed in special measures years ago.

From 2028/29, if Scotland’s dysfunctional social care system is replaced by a fully-operational National Care Service, local authorities will no longer have responsibility for the delivery of social care. But 2028/29 cannot come soon enough. With ticking time-bombs at the heart of the country’s social care system, four years is a long time for things to go badly wrong!

By analysing data from our subscribers’ lived experiences of social care delivery, provision, and regulation – whether as a service user or a family member or friend, a carer, a former or in-post social worker, or a Care Inspectorate staffer, none off whom dare blow the whistle for fear of the consequences – BetterCareScotland identifies risks to which people in desperate need of care in Scotland are exposed but which become apparent to them and their family members and friends only when it is too late.

Our data show that, when things do go wrong, local authority and Care Inspectorate staff are incentivised to go to great lengths to keep people at an informational disadvantage when transparency should be expected. And to deny people a remedy, even when the only remedy sought is the assurance that no-one else will be abused as they were. It is hard to imagine a social care system further removed from the Nordic model to which Scotland aspires.

The experience of our contributors is that no form of retaliation seems out of bounds to local authority staff when people reach out after things go wrong. In the words of Tom, a BetterCareScotland subscriber, “You will be deflected, denigrated, discredited, ridiculed, blamed, even threatened by the chief executive’s staff – and that’s just before lunch!” But, such remarkable stoicism conceals the dreadful impacts on the mental health of people finding themselves at the mercy of uncaring local authority and Care Inspectorate staff.

In a series of ‘ticking time-bomb’ blogs, BetterCareScotland will reveal the grotesque nature of the risks to which people at their time of greatest need are knowingly exposed by local authority and Care Inspectorate staff in Scotland who, despite their duty of care, are found to act in their own self-interest at the direction of senior co-workers, management teams, department heads and, ultimately, unaccountable chief executives. And of governance gaps and leadership issues which enable vested interests and perverse incentive structures to be hard-wired into Scotland’s social care system for the convenience of public sector staff.

Subscribe to BetterCareScotland to receive by email our ‘ticking time-bomb’ blog posts.

Love and Peace!

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on July 15, 2022 by editor

Accountability, Adult Social Care in Scotland, Better Care Scotland, BetterCareScotland, Care Inspectorate Scotland, Governance, Human rights, National Care Service Scotland, Public Sector, Social Worker, Whistleblower

Better Care Scotland, BetterCareScotland, Governance, Maya Angelou, National Care Service, Ticking time-bombs, Whistleblower

One woman tells her story … #3

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract III: caught in the Council’s social care web

My heart sank on seeing myself back where I was three years ago, listening to a social worker bent on persuading me to agree to something I would come to regret … but, this time around, knowing I was being deceived. After the phone call, we checked the diary and found that it was three years to the very day since the previous social worker pulled the self-same stunt, one that saved her employer, the local Council, an amount of around fourteen thousand pounds at my expense for it deprived me for seventeen months of my entitlement to Free Personal Care. And, here was the new social worker, making contact for the first time, intent on deceiving me the same way.

Free Personal Care in Scotland is a social care benefit to which people, aged sixty-five or over and assessed as being in need, are entitled, irrespective of means. In my own case, three years ago I was in my hundredth year and had moved in with my son after being abused in a care home for older people. My own home had been sold to pay for my residential care. And, with only the last vestiges of the proceeds of the sale of my home left to me and a small pension for a rainy day – an increasingly more frequent event you will discover if you reach my age – the local Council had resolved to impoverish me completely.

I looked at my son in disbelief. “To the very day!”, I said, knowing that this aspect of the matter was of no real significance but, somehow, it encapsulated my sense of outrage.

“It’s a scam!”, my son said, summing it up perfectly. “You’ll remember we worked out that the previous social worker had pulled a fast one when the Council blamed us for what she’d done. This latest attempt shows it to be a scam, I have absolutely no doubt!”

“A scam!”, I repeated, nodding as if I were deliberating on the meaning of the whole thing, its implications and all it entailed. “But, it’s so simple! Too simple!”, I said. “How on earth were we taken in the last time!”

My son was frowning. He’s a level-headed economist with a reputation for making sense of raw data but – while I have no trouble stating that I hate cheats, period – he has his Buddhist beliefs to consider. He got up and made tea. I switched on the radio. The anti-Fascist message of Shostakovich Seven that was playing on Radio 3 was lost on neither of us.

Over tea, my son explained that some of the most successful scams are unsophisticated but, for people to be taken in by them, scammers need to appear, not just plausible but, genuine. He said that social workers who abuse their position won’t typically face such hurdles as they expect to be and are taken on trust which makes their crimes especially egregious. But, what bothered him about the telephone call today was that it was made by a social worker determined to shaft me without any of the usual foreplay. “That’s a measure of the Council’s cynicism!”, he said. “There wasn’t even the slightest pretence at common courtesy.” As my son spoke, had I been less superstitious, I would have cursed her, yet another who was willing to exploit the fears and anxieties of people like me.

“The fact that your new social worker has just tried to pull the same stunt means there’s a systematic aspect to this scam, that it’s a well-worn as it’s worked in the past and that you or, rather, we are seen as an easy target. Since they know there’s nothing to lose, they’ll miss no opportunity to perpetrate these sorts of scams.”

“Oh dear! Easy targets! Does this new social worker really think we’ll fall for it again?”, I asked. I felt uneasy about Council’s staff having me in their sights.

“It’s likely she won’t know you’ve already been scammed. From what I’ve seen, the Council’s records don’t reflect the facts. They’re more a work of fiction.”

“The effort the last social worker went to!”, I reflected, “All those visits when I had better things to do than listen to her waffle on about her parterre. Leading me to believe she cared! Does she never stop and think of the harm she causes!”

“Do you remember, we used to think her ineffectual at best or lazy at worst?”

“But, it turns out that she’s nothing short of a psychopath!” My son looked intently at me. I could see he agreed. “Only a psychopath would gain someone’s trust only to take advantage and then lie about it to cover their own back!”

“It’s a blessed relief she’s no longer your social worker. And, that we know now to question absolutely everything this latest social worker says! She won’t be happy about being challenged!”

“Good!”, I said. “Good!”

To my relief, listening to my son, I realised that I no longer harboured doubts about involving him in this hideous business, pitted against people who do not share our values. I could see why the Council chief executive was so desperate to get him off her back. But, being dismissed, ridiculed, blamed, threatened, ignored, even threatened by her staff told us she had things to hide. And, strengthened our resolve.

“So, our emails to the chief executive about the last social worker depriving me of my Free Personal Care allowance won’t be on my file!”

“If they’re anywhere in the Council’s records, they’ll be buried. They won’t be flagged. The chief executive took care to do no more than acknowledge our emails. But I made sure to copy her into absolutely everything so that she can’t claim to know nothing. Today’s phone call might end up resurrecting the whole matter!”

“I fail to see why the Council needs a chief executive to do a job a robot could do! I’d know where I was with a robot!”

We laughed!

“The most primitive robot circa 1976 at that!”, my son agreed! “Just think of all the social care that could be funded from what the Council would save on her salary and fat pension!”

“You’ve become almost as cynical as your old mum!”, I said. “I’m lucky to have you on my side. I dread to think what might happen otherwise!”

When I suggested that the chief executive would respond differently if it were her mother being scammed by the Council, my son squeezed my hand.

“Your fists are clenched!”, he said. “Is it safe for me to sit so close?”

I agreed to put the whole matter to the back of my mind and leave it to my son to send a friendly email to the new social worker outlining our understanding of today’s telephone conversation, taking care to avoid alerting her to our concerns for, this time we needed hard evidence of the Council’s cynical intent.

We could not have known how that seemingly innocuous email would be received!

BetterCareScotland finds local authority chief executives making no attempt to see serious complaints investigated fully and resolved properly and, instead, employing staff for the express purpose of gaslighting and deflecting those who complain so as to ensure that the authority’s operations escape scrutiny – even if, as here, the complaint in question exposes a clear conflict of interest with a social worker’s deception saving the local authority a great deal of money at the expense of a service user and could indicate fraudulent activity by a rogue social worker if such activities are not, in fact, sanctioned by the authority.

Those of our subscribers with direct experience of what they have come to characterise as scams, designed by local authorities to deprive them or their family members or friends of social care funding they desperately need, report that the more serious the nature of a complaint, the less interest the local authority chief executive will show, that the staff who investigate complaints will typically be those complained-of, which creates another conflict of interest if this deters people from complaining, that staff will curtail all correspondence when they, invariably, fail to “find evidence” to support the complaint. It is, of course, naive for any local authority chief executive to imagine that, when things go wrong, the authority can systematically rely on such a defence of its failure to keep proper records.

BetterCareScotland would advise people to keep a simple log of all telephone calls and visits from social care staff. Even better, ask your social worker for their personal email address and follow-up every meeting or communication with an email outlining for the record your understanding of what was discussed. Do not be deterred when they fail to reply.

Service-users and their family members and friends should never find themselves having to second guess local authority staff or question their incentives, but our subscriber’s experiences of dysfunctional social care departments and a culture of cover-up when things go wrong suggest that the days of taking on trust your local authority in Scotland are long gone.

Extract III: caught in the Council’s social care web, shows that family members may be as vulnerable to scams perpetrated by local authority staff as the service users themselves when the relationship is based on trust. In properly-regulated sectors, like banking and finance, every imaginable safeguard has been put in place to protect consumers. Not so in social care delivery in Scotland where local authority chief executives are neither held accountable nor sanctioned when things go wrong. This creates no incentive to get things right or to disclose the true state of the authority’s operations.

Subscribe to BetterCareScotland and receive by email further extracts of this brave woman’s compelling story and the stories of other subscribers whose concerns are stonewalled by public bodies entrusted with social care delivery and regulation in Scotland!

If you have a story that you need to tell and you would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Love and Peace!

If you have a story you need to tell and would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

We will protect your information and will not share it with others.

If you prefer to remain anonymous, you can tell us of your experiences by completing only the ‘Message’ box of the feedback form on our website’s Home page.

Be in the loop and receive updates from BetterCareScotland today!

Love and Peace!

Posted on June 18, 2022 by editor

Accountability, Adult Social Care in Scotland, Better Care Scotland, Care Homes for Older People in Scotland, Care Inspectorate, Care Inspectorate Scotland, Care Needs, Care Plan, Free Personal Care Allowance, Governance, Human rights, Public Sector, Risk Management, Scottish Local Authorities, Social Care Regulation

Care home abuse, Care home neglect, Care Needs, Deflect, Gaslight, Governance, Maya Angelou, Risk Management, stonewall

One woman tells her story … #2

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract II: this great age!

I was 96 years old and locked-up in a care home when the abuse began so, although I may have wanted to run away – flight was out of the question. In any event, my instinct is to stand up to bullies, so fight it was!

I could not identify my abuser or abusers, I could give the Police officers only a description of the uniform worn and confirm that it would happen when I was in my room, most likely during the night. Nor did I recognise the voice from its menacing tone. I had not looked at my abuser’s face. When they asked me why, I explained that I didn’t think a human being capable of such cruelty so I dared not look up for fear of finding myself staring into the eyes of the Devil. That was a measure of my fear. The Police officers made notes. I was old enough to be their granny. I wondered what on earth they made of it all.

When they asked me if my abuser or abusers could have been male, my son excused himself and left the room. He returned just a minute or so later and apologised; he’d needed some air, he said. He told me later he’d been caught off-guard by the question. Without wishing to be cruel but needing him to question his assumptions – I may, in fact, have said ‘misconceptions’ – I told him that I will never be able to reveal the extent of the abuse. As he stared out of the window, I reflected that my words were heartless and that I felt oddly unmoved as I watched him breathing heavily.

I had assumed myself invincible but I began to see I’d been an easy target for my abuser. This bothered me. There were many times over my ten decades when I was aware of my own mortality, experiencing loss and hardship, from which at times I thought I would never recover, but had survived despite it all. It’s what we do! I think there’s some logic there! I confess I may have thought myself worthy of respect at this great age so may have invited the abuse despite being raised to expect nothing from others.

I saw that the very characteristics that made me a target – my quiet and shy nature; that I am polite and respectful – qualities my parents taught me to value, had exposed me to abuse by people with quite different standards, made me an open invitation, perhaps, to someone inclined to abuse. And, although I do not nor have ever consciously regarded myself as vulnerable on account of my sex or great age, I imagine that my abuser likely thought otherwise.

Unable to identify my abuser, despite being aware today that it must have been one of the night staff, I felt I could trust no-one and withdrew into myself. Mercifully, my change in mood went unnoticed as the care home owner had taken in three high-needs residents, each of whom needed one-to-one, 24-hour care, leaving just two out of the usual contingent of five carers, to work twelve hour shifts without breaks ministering to the various care needs of the rest of us.

When taking in these unfortunate high-needs residents, the care home owner deprived the rest of us not only of the care he was in business to provide but also of what I considered to be the home’s most valuable resource, the dining room, since he had turned that over for use as a ‘ward’ for the new high-needs residents and the carers who sat with them. I never met these poor souls who would spend the next eighteen months or so closeted in the former dining room.

Like me, my fellow residents also missed the dining room but, from my perspective, while it had ensured that I got some exercise each day getting there and back for meals and provided opportunities to socialise, I did not begrudge the high-needs residents its use – none of us did. Nor did I fail to see that its loss allowed me to occupy an armchair for days on end further reducing the likelihood that I would inadvertently interact with my abuser. What luck!

When our enthusiastic activities coordinator was incapacitated and unavailable for six months, the volume on the television sets was turned up and we were left to our own devices. Pure and unadulterated neglect at a time just when I needed to be left alone. I could scarce believe my good fortune!

For days on end I sat undisturbed in this manner. However, although this arrangement suited me, it happened to suit also the hard-pressed day carers, with the unfortunate consequence for me that, on days when they failed to toilet me, I would know to dread the arrival of the night carers and what lay in store for them … and me.

If my luck was in, the night carers would allow me to sleep in the armchair I’d occupied all day rather than toilet me. But, on nights when they insisted, despite my protestations, that I had to go to bed, I could expect my abuser to appear and exact revenge for increasing the workload, standing over me hissing “filthy bitch”.

My son came most days and took me for trips along the coast. He would chat as we drove along, asking me how I was, how things were, but I preferred to sit quietly catching glimpses of the sea between gaps in the hedgerows and speaking only to reminisce. With the care home so under-resourced, often we would take with us one or two of my more able fellow residents. Even the most junior member of staff seemed to have authority to grant us permission. I wondered if the staff would notice if we failed to return or if anyone but I had considered the legal implications were we to roll off the coast road and into the sea. I suspected not on either count!

The current manager was a family friend of the owner and recently retired, with no experience whatsoever of caring for the elderly and infirm. With my head down, I would watch her from under my brows. I could tell that she missed nothing – and, that she lacked empathy. Once, I saw her reduce Peggy’s son – a respected solicitor – to a blithering wreck when he arrived to find that his mother had been hospitalised. I could see, however, that this manager respected my son for he never failed to look her straight in the eye.

She happened to be ‘available’, it seems, just when it was discovered that the previous manager of several years was not qualified for the post, was “unfit” in the jargon, so had to go. Within a short time of her arrival, the new manager organised the admission, without reference to the existing residents or our family members, of the unfortunate high-needs residents I mention, and did so for the sole purpose of lining the owner’s pockets according to staff who, like us, the existing residents, were disadvantaged by the decision.

Our activities coordinator claimed she’d heard the new manager telling the care home owner that he wasn’t making enough money out of us and that she’d fix it. And, fix it she did!

The care home owner, a socially-inadequate man in his early forties, was rarely in evidence and would run for cover whenever a visiting relative appeared so my son took his concerns about understaffing and under-resourcing to the local Council’s chief executive for the home was largely Council-funded. The chief executive showed no interest whatsoever even though frail residents were falling over and suffering bruises and fractures like never before, bearing testament to the risks – had they been recorded and reported to higher authorities.

The Council’s disinterest would be the deciding factor in my quitting a care home which merits the warning “Abandon all hope, ye who enter here!” My ‘eventual’ discharge from that place, I’m told, could have been handled within the space of a week but took the Council five months to organise, during which period, they continued used to dispense largesse with my dwindling modest life savings for the care provider ‘s benefit.

My social worker, whose approach to her duty to safeguard my safety and welfare seemed to require her to chat about her new house and garden and her love of mid-Century design, was candid that my experiences would evoke little sympathy as I had lived to tell the tale. As an observer at close quarters of how my Council treats vulnerable citizens, and realising that social care is something the Council does ‘to’ people rather than ‘for’ them, I had already worked out for myself that, by surviving, I had given the Council work to do.

Quite how much work my blurting out over supper, in the warmth of my son’s home, that I had been abused would become apparent with time. As would the lengths to which the Council would go to silence me! And my determination to ensure that no other vulnerable care home resident in Scotland would share my experiences.

For the Council’s stonewalling of my son’s concerns would lead, just seven months later, to the abuse of at least three vulnerable older women and the bullying of female care staff by a man who, despite his criminal conviction for smashing his wife’s head against a brick wall in a public place, was employed by the care home owner – and kept in post even after these incidents of abuse – to provide care to his residents.

Given the silencing of my disclosures of abuse, it should come as no surprise that Executive Officers of the Council would assume the freedom to diminish the ordeals of these women and deceive elected representatives in order to avoid the need for an investigation. This is social care in modern Scotland!

BetterCareScotland finds that the care provider in question deprived his care home residents of a valuable resource and exposed them to the risk of understaffing by taking in three high-needs residents without reference to the residents or the residents’ family members.

The Council in question did not verify that the care provider would meet the care needs of the 3 high-needs individuals in addition to those of existing residents, several of whom had complex care needs. The Council’s response mirrors its disinterest when concerns were raised by family members.

BetterCareScotland finds social workers working for this Council expressing a long-held frustration that the Council takes this care home owner on trust.

The Care Inspectorate expressed no interest.

If you have a story that you need to tell and you would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Love and Peace!

Posted on June 18, 2022 by editor

abuse, Accountability, Adult Social Care in Scotland, Care Homes for Older People in Scotland, Care Inspectorate, Care Inspectorate Scotland, Care Needs, Disclosure, Governance, Human rights, Risk Management, Scottish Local Authorities

Care home abuse, Care home neglect, Care Needs, Governance, Maya Angelou, Risk Management

One woman tells her story … #1

BetterCareScotland fights for social care reform in Scotland - Better Care Scotland

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract I: being silenced

“They would pull my nipples and laugh!” I was sitting at the kitchen table in my son’s flat. “They thought it amusing!” My son stared at the newspaper in front of him but said nothing. Despite his clear discomfort, I couldn’t bring myself to stop: “They would pull them right out to here!”, gauging from memory the extent of the affront. My son looked up and stared at my tired, old hands.

He did not look into my eyes or search my face. He knew what he was hearing was true: he’d had sufficient doubts about the competence of the care home owner and the new manager to know that he had to “rescue” me, as I describe it – and, so, just days after my 99th birthday, had whisked me away from the god-forsaken place where I’d funded my care for three years and five months. Over those final five months, the social care department had dragged-out a discharge process, which let the local Council continue to dispense largesse with my modest life savings for the benefit of the inept care home owner!

Now, as I spoke, my son was reliving all those times over the past three years when, on visits, I would tell him I was frightened but clam up when he asked me why. Out of fear, I had dared not tell him.

I had survived the ignominy of being bathed by gauche girls, completely unprepared for the task, who covered their embarrassment by pulling my nipples and laughing uproariously. I do not blame them. And I had survived without a cup of tea for comfort whenever I couldn’t sleep for I took seriously the hardened night carer’s threat to “pee” in it as punishment for being a nuisance. I needed no second warning.

I had survived being strapped to the bed to stop me reaching for the panic button and disturbing the night staff and had banished my teddy bear to the back of the wardrobe after they said he would bite me if I didn’t do what I was told. I had struck up an unlikely friendship instead with a large seven-legged spider who lived under the sink in the loo and emerged every morning without fail to look at this strange sobbing creature towering above it.

I had recovered from the fractured pelvis I sustained from rough handling, shall we say, and the consequent weeks of painful physiotherapy all of which went undocumented and, I believe, unreported by the care home – whatever difference that would have made – and had sat without company for days on end whenever fellow residents chose to sit alone and depressed in their rooms nursing their own unexplained bruises and fractures.

I had even survived the physical consequences of the powerful chemical cosh they administered daily to keep me sedated. And, after my escape, I had quickly regained my mobility, was no longer daytime-incontinent nor, after a great deal of TLC and regular visits to the GU clinic, any longer “prone” to urine infections, the care home’s leaving gift to me.

I survived for I did not give in, did not abandon hope, nor react like the kicked dog which tries to please its abusers. I refused to relinquish my pride despite knowing that this would likely do me no favours and, instead, took comfort in things that reminded me of the life I’d had … pieces of studio pottery and paintings my son had brought … and I developed coping mechanisms, refusing to let my abusers win. But, I did not survive unscathed. I am damaged goods and I have come to trust no-one so I dare not drop my guard.

My GP says the routine chemical cosh is likely to have lasting psychological effects from which I may never recover and to take things one day at a time and not to worry that I may not be as amiable as I was. And, I think of the thousands of others in my position – elderly and no longer self-reliant – and how they are being treated in the time left to them in care homes owned by people whose moral standards are never questioned.

“There is no greater agony than bearing an untold story inside you.” Maya Angelou

I did not assume that life in a care home for older people would be as meaningful as the life I’d led or that giving up my independence and the family home would be without its issues. But, taking my lead from Diana Athill, a contemporary who threw caution to the wind and took up residence in a care home in 2010, I had expectations of a place befitting the price I was expected to pay and not the squalid, poorly-resourced, and (latterly) badly-managed place to which my social worker directed me. I could not have imagined that, in modern Scotland, an individual with no demonstrable interest in care, would be able to preside over my neglect and abuse and, like some latter-day Victorian husband, have me declared insane. This in an age when, in wider society, anyone who leverages power over another would be condemned rightly as predatory.

But, dreadful though my treatment was at the hands of this individual, my story is prompted by the response of the local Council which helped him to evade investigation by Police Scotland officers (who were non-judgemental and treated me with humanity and respect, for which I thank them), then added insult to injury by going out of its way to launder his reputation while denigrating me. And, I find myself trying to rationalise the lengths to which the Council went to silence and further abuse me for reaching out … and I wonder why, what purpose it serves. There surely has to be a reason. My local Council does not run itself. Like every other, it is run by people and the people who run my local Council have closed ranks against me. They see me as a threat to them in a personal sense! I’m aware of their desperation!

As I tell my story, I think of those others whose degrading abuse and neglect in care homes for older people went or will go undiscovered as would mine had I left the care home in the manner to be expected by its owner and staff rather than sentient and in a wheelchair. For, this is an industry that can bury its mistakes … quite literally! And, I hope that, by lifting the lid on my own experiences, I can help to ensure that those who are motivated to abuse people in under-resourced care homes for older people and Council staff who turn their backs when people reach out will be denied the opportunity to imagine that their crimes will go undiscovered.

Over three years have passed since I asked the Council chief executive respectfully, in the time left to me, to account for the Council’s role in the cover-up of my disclosures of abuse and since she replied, “I note what you write!” before throwing the matter to her attack-dog, the staff she can rely on to get me off her back. My son has unearthed more than enough to persuade me that the Council chief executive’s only incentive is to cover up my abuse.

I need to shout louder! Wish me luck!

So many red flags!

A woman with the courage to speak out being silenced by those in positions of power!

If you have a story that you need to tell and you would like to discuss it with BetterCareScotland, please feel free to get in touch with us by email.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Love and Peace!

Posted on June 7, 2022 by editor

Adult Social Care in Scotland, Care Homes for Older People in Scotland, Care Inspectorate Scotland, cover-up, Disclosure, Governance, Human rights, Scottish councils, Social Care Regulation, Social Work

Care home abuse, Care home neglect, Diana Athill, Maya Angelou, Police Scotland, Sedation as a chemical cosh

Scotland’s Parliament takes the Care Inspectorate on trust

Failing to hold Scotland’s social care regulator to account exposes care home residents to risk.

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Why social care outcomes in Scotland depend on LUCK!

So, why would Scotland’s social workers ever not be on your side?

We hear from social workers themselves.

THREE TIMES WHEN YOUR SOCIAL WORKER WAS NOT ON YOUR SIDE

CONFLICTS OF INTEREST

THERE IS HOPE

LET BETTERCARESCOTLAND KNOW

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

SCOTLAND’S HIPPY DIPPY CARE INSPECTORATE

SO LAST CENTURY

LET BETTERCARESCOTLAND KNOW

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract IV: ‘Control, not Care’ in commercially-unviable care homes for older people in Scotland

Dr Well-Beloved

A cautionary tale

SCOTLAND’S HIPPY DIPPY CARE INSPECTORATE

GARBAGE IN, GARBAGE OUT

LET BETTERCARESCOTLAND KNOW

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Ticking time-bombs at the heart of Scotland’s social care system!

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract III: caught in the Council’s social care web

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract II: this great age!

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this:

Of misplaced trust. Of bureaucracy & cover-up. Of a social care system paying lip service to the needs of Scotland’s most vulnerable.

Extract I: being silenced

“There is no greater agony than bearing an untold story inside you.” Maya Angelou

“There is no greater agony than bearing an untold story inside you.” … Maya Angelou

Share this: