Panorama has put this web page together with the help of Action on Elder Abuse, Counsel and Care, Help the Aged and the Relatives and Residents' Association. More information and support is on their websites.
There are many good nursing homes operating across the country. Most people's experiences of care homes are of happy, safe and caring places. But the elderly are of course vulnerable so it is important to be vigilant.
Choosing a care home
Check the inspections
Care homes are regularly inspected by officials from Commission for Social Care Inspection (CSCI). Read the inspection reports carefully. If more inspection reports than expected are shown read them carefully to see why inspectors have been required to visit more often.
If inspections don't appear to have taken place or are not reported ask CSCI why.
Compare the inspections
Go back and compare with previous inspections. If the home was asked to address any issue, was it done quickly or does the complaint appear in subsequent inspection reports?
Has the home undergone any recent changes in ownership or management?
If so you may want to find out why.
Are there restrictions on visiting times or areas which seem out of bounds to visitors?
Many homes operate an open door policy for relatives. Check what the policy is and why restrictions may be made and if you're happy with them.
How involved can you be in the care of your relative?
Is the family carer consulted about the care plan and about any proposed changes to it?
Can the home put you in touch with other residents' families?
Are they happy for you to speak with residents or relatives when you go to look around? If the home is reluctant to encourage you to speak to others ask yourself, and them, why.
What are other people saying about the home?
What's the local reputation? Perhaps speak with your GP or the GP surgery near the home. You could do an internet search by typing in the name of the home. Look for any articles, blogs or letters. Information gathered like this should be taken with caution but may provide a starting point.
When your relative is in a care home
Keep reading the inspection reports
Just because you've chosen a home don't stop the homework. Keep checking the inspection reports on the CSCI website. Good homes will have the latest copies of the reports readily available.
Visiting at different times of day and evening will enable you to see different aspects of the home and your relative's care.
The care plan
Every resident in a care home should have a care plan which sets out their needs and the care required. Make sure you know how involved you will be in making decisions about care. There are confidentiality issues. The home will only involve relatives or carers with the resident's permission or if the relative is acting on behalf of the resident with power of attorney or similar. But do take an interest in the care plan. It should be regularly reviewed.
Speak to other residents and their relatives
Be each others eyes and ears. Get to know the other regular visitors. Is there a relatives group you can join? Are you encouraged to get to know other visitors to the home and share your experiences?
Keep the conversation going
Keep a dialogue between you and the home. Some homes operate a note book system so you can leave messages for your relative's assigned care worker even if they're not on duty when you visit. This can be comments or messages about changes to their care plans and personal requirements.
Is there a resident's association? Can residents have their views heard?
Some homes also run relatives' groups which allows relatives to get together and to meet with management.
Know your rights
If you are unhappy about something or have a complaint, raise it with the home management as soon as possible. If you are not happy with the outcome of the meeting you can ask for a copy of the care home's complaints procedure and decide if you want to register a formal complaint. If you are not satisfied with the way your complaint has been dealt with you can contact CSCI for further attention.
Symptoms of abuse
Older people may not be able to tell you about what's happening. They may feel frightened and intimidated.
Here are some things which may indicate someone is experiencing abuse or neglect:
Recurring or unexplained injuries
Untreated injuries and medical problems
Frequent visits to the Accident and Emergency department of a hospital
Being emotionally upset and agitated
Not being allowed to speak for themselves
Poor hygiene or unchanged bedding
Wearing unsuitable clothing or clothing that's not their own
Unexplained weight loss or dehydration
Appearing withdrawn, depressed, agitated or fearful, experiencing irregular sleep patterns or loss of appetite.
What to do if you or someone else experiences abuse
If something is life threatening or a criminal act contact the police and social services.
If you suspect abuse report your concerns to CSCI immediately.
As soon as possible write down what happened. Keep a diary and write down dates.
Keep any evidence of what occurred and record who was present.
If you are a resident in a care home speak to another resident you trust or contact the social worker who was in touch with you at the time you entered the home.
If you feel able you should raise your concerns with the manager of the home or a member of staff you trust.
If you are concerned about a relative or a friend ask questions until you are satisfied with the answers.
All homes have a complaints procedure.
All homes must be registered with CSCI.
If you are not satisfied with the answers you are getting with the home contact CSCI or social services.
If you have approached social services ask for a copy of their protection of vulnerable adults policy. This is a government initiative which places the responsibility with council social services to investigate allegations of abuse.
Meeting with officials
Ask a friend or relative or someone else you trust to come with you.
Outline the cause of your concern.
Ask what action will be taken.
Ask how the older person will be protected whilst any investigation is carried out.
Make sure you're kept informed of the progress of the investigation.
Ask for this information to be provided in writing.
Make a note of what you said, with dates or times.
Should you be paying for nursing home care?
You can find out more about this by visiting our websites from our previous films.