From 2013: Neglect and Low Standards at Bupa Care Homes in Scotland

This is from Private Eye’s edition for the 1st – 14th November 2013.

Bupa in Scotland

Home Affront

Something appears to be seriously wrong within Bupa care homes in Scotland.

Company bosses were summoned to a meeting with Scottish health secretary Alex Neil last month after it emerged that police were investigating the deaths of four elderly residents at Pentland Hill care home in Edinburgh.

Bupa has also just apologised to the family of a 78-year-old terminally ill woman who was found screaming in agony in the lounge of Eastbank, another “leading” care home in Glasgow, last July. By the time Eastbank acquired the morphine she desperately needed, Mrs Margaret Hall had died. six months earlier Mrs Hall’s dau8ghter had found her mother shivering in a cold bath.

Pentland and Eastbank are not the only Bupa homes with a history of poor care. Private Eye and the charity Compassion in Care (CiC) have found that of the chain’s 30 care homes in Scotland, there were seriously failings at ten and nine give some cause for concern. Teny were found to consistently good; while one, Balcarres, a small home for 36 in Dundee, stands out as consistently “excellent”. (Our list is very similar to the 21 – slight more – Bupa homes that the Scotland Care Inspectorate currently consider “high” or medium” risk and subject to frequent unannounced inspections).

Pentland, a home for around 120 residents, some with dementia, is now closed to new admissions after the inspectorate found residents had been left without food or water, along with evidence of poor care, dangerous medication practices, poor management and untrained staff. Since then four more complaints, unrelated to the criminal investigation, have been made.

The warning signs about Pentland were not new. The home has barely been rated above “weak” or “adequate” since a former care worker was jailed in 2010 for dragging an 86-year-old resident along the floor, leaving her bruised and bleeding.

It is a similar tale at Eastbank, where Mrs Hall suffered her agonising death. The home’s chequered past dates back to 2007 when Margaret Carroll, who had dementia, died of heart failure after staff failed to notice that she had broken her hip, needing immediate treatment. It was not until her paramedic son visited some 12 hours later that an ambulance was called. Since 2009 its care has never been rated better than “adequate” or “weak”.

After studying a list of serious upheld complaints and recent inspection reports, and after hearing concerns from relatives and staff about some of the Bupa homes, the Eye finds that the reality of “weak” or “adequate” ratings can actually mean misery and neglect for residents.

One of the worst is Darnley Court, another large Bupa home with 120 residents Glasgow. Since at least the beginning of 2011 it has had many serious problems, including poor pressure care, nutrition, hydration and medication, along with a high level of accidents. There has also been a shortage of properly trained staff. In June inspectors called a meeting with managers and local authority representatives – but to no avail, it seems. The inspection report in August made distressing reading.

“We continued to have significant concerns about the level and nature of care,” said the inspectors, who found that medication was being used as a chemical cosh, rather than a last resort, and that some staff were “desensitised” to their vulnerable charges. Personal healthcare and oral care were poor, with several residents sitting without their dentures; there was no evidence of teeth cleaning and toiletries weren’t available.
Inspectors found one resident slumped over and unable to eat until they called for assistance, and food was out of reach for others. Despite previous warning there was no proper monitoring of residents who were at risk of malnutrition.

There had been 17 cases of staff misconduct resulting in dismissal or warning, which the home had not reported to the care inspectorate as it should have. Nor were injuries to residents properly reported.

Rather than properly address Darnley’s serious failings, however, Bupa commissioned a glossy in-house “satisfaction” survey so it could claim on its website: “Darnley Court provides exceptional care and support for those requiring long or short term care”.

Another Bupa home with a poor history, Victoria Manor in Edinburgh, was downgraded by inspectors from “adequate” to “weak” after complaints that a resident had developed pressure sores, and call bells were not answered. At understaffed Deanfield in Glasgow, one of 10 care homes Bupa has in the area, inspectors found that just “adequate” care was being “further compromised” by staff being sent to provide emergency cover in other understaffed homes.

At one of those, Millview in Barrhead, inspectors alerted Bupa’s regional manager about serious problems with residents’ money and valuables. They discovered that a “large sum” which had belonged to a resident who had died more than three years previously had not been passed to family or an executor. Even more worryingly, nor was the home alerting inspectors to deaths.

Even at Kirknowe, a home for 90 residents in Wishaw which is currently rated “very good”, the Eye discovered that six complaints from two people had been upheld this year, two relating to hydration and nutrition, another to oral care and one to infection control. Kirknowe hit the headlines last year when a member of staff thought it funny to feed a dog biscuit to a resident with dementia.

Problems persist too a Haydale, another Glasgow home which has barely been graded above weak or adequate since it opened in 2008, and Braid Hills in Edinburgh; while at Arran View in Saltcoats, a vulnerable resident “escaped” while inspectors were at the home.

For this, Bupa charges from £550 to £1,200 a week, depending on the level of care required. Those with dementia with most needs often pay higher fees, but receive the worst treatment. Bupa – which posted profits of £59.2m for all its services in Britain in the first six months of the year – is a private limited company which boasts that it “re-invests in more and better healthcare”. It is certainly investing heavily in rapid expansion worldwide.

A spokesman for the inspectorate told the Eye: “We have worked intensively to help Bupa make improvements in each of these homes, and have seen evidence of limited improvement. If care persists as weak or unsatisfactory, like at Pentland Hill, these homes will face enforcement action or face potential closure.”

In a statement, Richard Jackson, operations director of Bupa Care Services, said that 26 of its 30 care homes “meet or exceed” inspection standards and that the other four “all have robust action plans in place and improvements continue to be made”, adding “over 100,000 people with complex and challenging conditions have been well looked after in our care homes.

“We are sorry when anything goes wrong, however rarely. But we are open and transparent when it does and take immediate action. We invest whatever resources are needed to put things right and to try to prevent them from happening again.”

Bupa added that because its homes were listed high and medium on the inspectorate rsk list, did not mean “there is neglect or poor care”. A change of manager or an out-of-work lift could trigger an alert.

But Eileen Chubb of Cic accused Mr Jackson of playing down serious concerns: “Complacent acceptance of weak or adequate care is not acceptable by any company with a duty to care for frail, vulnerable people.”

This is of serious concern, not just because of the history of abuse, neglect and even what very much looks like theft from a resident in the care homes themselves, but because Bupa is one of private healthcare companies that has expanded over the previous decades due to successive governments’ attacks on the NHS. And Bupa aren’t the only one. There have been other instances of appalling neglect and abuse in others, including one near Bristol, which were owned by a private equity firm. Care homes are expensive, to the point that many people find them almost unaffordable and for such neglect to occur is disgusting. Yet such abuse is not reported to the same extent as neglect or abuse in the NHS, as the government attempts to privatise even more of the health service.

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