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University expert provides advice on Panorama - Undercover: Elderly Care

23 April 12

Leading dementia care expert from the University of Bradford will appear on BBC Panorama tonight providing advice and opinion about standards of care in the UK and what 'good care' should look like.

Paul Edwards from Bradford Dementia Group in the School of Health Studies worked with the programme which will reveal the appalling treatment of a vulnerable elderly woman in a care home, after it was captured on a secret camera hidden in the woman’s bedroom by her concerned daughter.

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The abuse took place at a home passed as 'excellent' by the national regulator, the Care Quality Commission, and has led to one of the care workers, Jonathan Aquino, being sentenced last week to 18 months imprisonment for assault. Another four care workers at the home have now been sacked.

Paul Edwards said: "Cases like these are thankfully not frequent but we still have a society and staff in care homes who don't treat people with dementia as human beings.  We have safeguards and checks in place, but we don't routinely look at the experience of people with dementia moment by moment and use that knowledge to make judgements about quality of care."

Following the abuse, the Care Quality Commission (CQC) is being criticised for failing to take appropriate action against the care home.  The Relatives & Residents Association, a small national charity which helps families and friends of those in care, say that a report produced by the CQC four months after the incident does not warn the public about the abuse that took place at Ash Court at Kentish Town, north London.

Judy Downey, head of the charity says: "It doesn’t say that a member of staff has been charged. It is not an honest document, it isn’t a helpful document and it isn’t a decent document. This is an area where the CQC can do so much if it uses its powers. They can actually cancel the provider’s registration if they’re shown not to be fit. We would suggest that the provider was very clearly shown not to be fit."

Fiona Phillips - Panorama In Panorama Undercover: Elderly Care tonight at 8.30pm on BBC One, Fiona Phillips, whose mother died in a care home, investigates whether the regulator and care home provider did enough to prevent the abuse that took place and asks whether the system of elderly care itself can be trusted.

Maria Worroll was diagnosed with Alzheimer's in 2008 and had been living with her daughter Jane and her family until her condition became so bad that she required round the clock care. In March 2010, on the advice of Maria’s hospital and social services, Jane Worroll began to search for a suitable care home for her mother.

Following visits to numerous homes in North London, Jane settled on Ash Court Care Centre. She made the decision after reading a report by the Care Quality Commission which gave the home an ‘excellent’ rating. Jane’s mother moved into Ash Court in July 2010.

Six weeks later Jane noticed that her mother had bruising on her hands and arms. She raised her concerns with the staff at Ash Court but was told her mother was bruising easily as a result of taking aspirin. However, Jane wasn’t satisfied with the explanation and in the months that followed, she says there was a noticeable deterioration in her mum’s condition.

In June 2011, she decided to place a secret camera in the bedroom to see for herself how her mother was being treated. On viewing the footage, Jane says she was horrified at the level of abuse her mother received at the hands of her carers.

She witnessed her mother being manhandled by carers, despite her severe arthritis, and put to bed at 5.30pm in the afternoon. On a number of occasions captured on film, Maria’s carers would completely ignore her, never greeting her and sometimes only putting the television on when they entered the room and turning it off as they left.

Jane said: "I was horrified to see that was a day in the life of my mother."

Three days later, Jane filmed her mother for a second night hoping that the first night had been an unfortunate one-off. But the footage she captured revealed an even more shocking level of abuse.

Carer - Panorama Despite the home’s policy that male carers shouldn’t provide personal care for female residents – and Jane Worroll’s strict instructions that her mother should only be cared for by female carers – the camera footage shows a lone male carer enter Maria’s room to give her a night bath. He then proceeds to strike the elderly woman six times on the face, arms and abdomen.

"I screamed when I first saw it," says Jane. "She was just so vulnerable. She can’t get up, she can’t call for help, it’s just totally sadistic."

Jane immediately drove to the care home to show the manager the footage. All five of the main carers Jane filmed were suspended and the male carer, 30 year old Jonathan Aquino, was arrested. He has now been sentenced to 18 months imprisonment for assault. Aquino qualified as a nurse in the Philippines and came to the UK after being hired by Ash Court.

A month after the assault, Peter J. Curtis, then Chief Executive of Forest Healthcare, which owns Ash Court, wrote to Jane Worroll to say that now was a "good opportunity to move forward positively" - even though Aquino had been arrested and the other four female carers were still employed by Ash Court and due to return to work.

Care home - panorama Jane felt that the home wasn’t taking action and went to The Relatives & Residents Association. Judy Downey, the head of the charity, said: "How could five workers not know that she had to be moved gently? You could hear the poor lady cry out in pain at the way she was being moved. That doesn’t suggest a one-off problem, it suggests a deep cultural problem in that home where people were being treated with less respect than slabs of meat."

Five and a half months later, Forest Healthcare finally sacked the other four care workers. Panorama asked Forest Healthcare why this abuse was allowed to happen in the first place.

Forest Healthcare says the assault was an isolated incident, and that although their manager had seen the footage in June, they requested to see it a second time, "to complete the disciplinary process." The company says that immediately after viewing it again "we completed proceedings and all four were dismissed".

The company says Ash Court is "committed to working closely with all families and residents" and that they receive positive feedback on their care which is subject to "continual improvement."

The Care Quality Commission, the national regulator who had rated the home as 'excellent', produced a report three months after Jane filmed her mother being abused which concluded: "Ash Court ensures that people who use the service are protected from abuse, or the risk of abuse, and their rights are respected and upheld."

Jane Worroll is angry that the report doesn’t warn the public more explicitly that abuse has taken place at the care home - saying instead the local council and police had been informed of "safeguarding concerns" -  and that staff were suspended, an investigation was ongoing and that an action plan was in place.

"When I read it, it was another slap around the face. It makes me worry for other people who are potentially about to put a relative into a care home."

The Care Quality Commission says that it inspected the home within four days of learning what had happened to Maria Worroll but "did not find any new evidence of poor practice or abuse".  It says: "If we had done so we would have taken action."

Fiona and family Panorama The CQC says that inspectors recently returned to the home again unannounced and found "improvements". It told Panorama: "CQC is confident it has acted swiftly and correctly in light of the evidence it has available."

Maria Worroll is now in a different home where she is happier but Ash Court remains open.

23 April 12

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