Nursing Homes Undercover Panorama

Tonight, I'm undercover in nursing homes were sometimes it seems they

just couldn't care less. Were some old and vulnerable

residents are left helpless. We ask, is the regulation of nursing

homes working? There is a hard-core of unacceptable, and resourced

practice going on and these places should be closed down. And I find

out what life can be like in a failing nursing home. I can walk out

of the door today, I'm lucky. But I feel for those that can't.

There are more than 250,000 people in care and nursing homes in England

and Wales. I'm of an age where I one day join them. I am about to go

undercover in two homes, in a quiet corner of rural England. Homes which

promised top-quality care. But we've heard a different story.

This is St Theresa's. It is run by the Morleigh Group, the biggest

private provider of nursing and care homes in Cornwall.

They think I've got a memory problems and I am here to give my a

break. They charged me ?750 a week to stay here. St Theresa's can

provide nursing care for up to 45 people. Many of them are funded by

the Council and the NHS. I would say there are between 20 and

30 people staying here. Many of them seem to be permanently in their

rooms and others spent virtually all day sitting watching television.

There is an overwhelming noise of TV throughout the building.

It is my first evening, and half of the lights in my room aren't

working. St Theresa's promises residents

dignity, independence and privacy. I've been here four days and it is

not the impression I'm getting. A resident is calling out for the

bathroom. At about 10:30am, I noticed that

BLEEP was asking for the toilet repeatedly. It was only by about

10:45am that people actually came and took into the toilet. As a

resident, I can only see so much. We decide to send in another reporter,

Alice. She gets a job some days later and is shadowing a care

assistant when another resident asks to be taken to the toilet.

Often, residents, even those that can walk with help, are left in

incontinence pads, instead of being taken to the bathroom. Dr Peter

Holden is an experienced GP whose elderly care has been rated as

outstanding. The problem with being left on the incontinence pad is that

hearing and faeces are chemicals, they are not designed to be left in

contact with the skin. The skin will be damaged. It is a dignity issue.

It is health and hygiene issues, it's a comfort issue. You wouldn't

do it to your baby, why are we doing it to the elderly? The Morleigh

Group says refusing to take a resident to the toilet or using

incontinence pads instead would result in disciplinary action. I'm

beginning to wonder what I'm getting for my ?750 a week room, that is

?3000 a month. Bins that never get emptied. Soap dispensers with no

soap. There is a light here, it doesn't work. The toilet seat, not

fixed. It seems that staff are rushed off their feet, even though

the Morleigh Group says staffing levels are adequate. Alison should

not be left alone with residents because St Theresa's has yet to

receive the results of a criminal records check. But the nurse on duty

asks Alice to feed a resident on her own.

Then the nurse arrives with the resident's medication.

The nurse says she hasn't got time to give the medication and asks

Alice to supervise instead. Later the same day, Alice asks I

experienced member of staff about working without having her criminal

records check. CQC, or Care Quality Commission,

regulates nursing homes. It told St Theresa's more than a year ago to

improve the screening of new staff. I have been here for nine days. I

have had sleepless nights and seen people in distress. But I've heard

that things are even worse at another home in the Morleigh Group,

Clinton House in St Austell. That is where I am headed for some more

respite care. Clinton House has a history of being

given warning and improvement notices by the CQC, although the

regulator had found some standards were improving. While I am checking

in, another undercover reporter, Lucy, is starting work as a care

assistant. Straightaway she hears reports of problems, this in the

kitchen. It has been an absolutely shambolic

morning. The kitchen flooded. Then it was cold. Although there seemed

to be people coming around and feeling the radiators, they weren't

on. It is late September and I'm not the only one feeling the cold. It

seems it is a common complaint at Clinton House.

The Morleigh Group says that Clinton House is heated all year round and a

temporary problem with the heating system was fixed. The company, which

runs six care homes in Cornwall, is owned by Patricia and Steven Juleff.

This is where they live. The Morleigh Group reported ?1.5 million

profit after tax in 2015. Last year, Cornwall Council paid more than ?3

million to the Morleigh Group to take care of elderly people.

Back in Clinton House, undercover care assistant Lucy discovers a

serious problem. The alarm system used by residents to call for

assistance is faulty. It directs staff to the wrong rooms.

To confirm which room and resident they actually need to go to, staff

have to check a list on the wall. The Morleigh Group says a new alarm

system was ordered in August and they are still waiting for it to be

delivered. Nursing homes, unlike care homes, dispense medicine and

deliver nursing care. You would expect the way Clinton House handles

medicines to be watertight. You'd be wrong. Lucy spots medication that

has been left by the sink in a resident's room.

This is just poor medicine management, it's a risk because

somebody might not be getting the medication that they need, somebody

might be getting medication that is not intended for them. Lucy is

astonished to discover another resident being given a prescription

supplement that is two years out of date. Worse still, it was actually

prescribed for somebody else. Four days later, she finds the original

prescription label has been peeled off. The out of date supplement

relabelled for use by the current resident. Peeled, replaced.

That is primary sin number one, two relabelled medicine and give it to

somebody else. If that is the kind of thing they are up to, the risks

that places patients and is enormous. Clinton House promises a

warm, friendly environment. But while I have hot water in my room,

many of my fellow residents did not. Lucy complained to a nurse about the

water and was told that plumbers were supposed to be dealing with it.

Lucy often had to go in search of hot water with a bowl, so that she

could wash residents. At various points during her shifts

she found at least nine rooms had no hot water.

The Morleigh Group says there were some problems when a new boiler was

installed, and that residents were provided with hot water throughout.

Clinton House also promises residents dignity and independence.

Lucy finds a resident has been left on a bed pan.

If you leave somebody on a bedpan for a long length of time,

eventually what happens is their skin through the body weight begins

to push through down the orifice of the bedpan. They will get stuck. Not

only is that undignified and uncomfortable, but it's a risk to

the skin. It takes two care assistants to free

the resident. We showed the footage to her

daughter and grandson. I didn't expect that to happen, no. No. Not

in this day and age. I don't think it's a very nice environment for the

old people, because they don't really have a clue what's going on.

The TV set is Blairing out. The -- blaring out. The staff is running

round. It's like chaos really. A woman her age shouldn't be left on

there for that amount of time. She's old, she's frail. It's not

acceptable. Clinton House says staff are

qualified to care for people with mild dementia. Our undercover

reporter has no training at all and is still asked to lock after someone

with dementia. The resident's dementia is severe.

She needs 24-hour, one-to-one care. The home is paid around ?3,000 a

week to provide it. With just a few words of advice from

a care assistant, Lucy's left alone with the resident. Lucy notices a

bedpan in the corner of the room. Then she sees the safety rail on the

bed is loose. The resident becomes calm when Lucy holds her hand.

Lucy's worried she might injure herself on the bed.

Lucy notices the resident has a wound on her leg.

Another care assistant comes to take over from Lucy.

This care assistant won't hold the resident's hand.

We asked Professor John Williams, one of the country's leading experts

in adult social care for his opinion. I think my reaction is

there was no care given at all. I think she was treated badly and I

find the attitude of the staff really very disturbing. The

conditions in which she was living were appalling. The bed was unsafe.

There was a dirty bedpan there. She was clearly very, very, very

distressed and understandably so. Few days later, Lucy finds out the

resident is being described by staff as "end of life". It becomes clear

they don't know how the resident's leg was injured. Even though she's

supposed to have round the clock care.

The Morleigh Group denies the bed rail was faulty and says a number of

the staff received relevant training. But says any failure to

treat residents with dignity and respect is unacceptable. I spent

five days at Clinton House and even without seeing what was going on

behind-the-scenes, I was relieved to go home. I can walk out of the door

today, I'm lucky. But I feel for those who can't. Lucy stays on. She

attends a resident who has a degenerative disease.

The resident has a prescription for morphine as required, that shouldn't

include keeping her quiet. I'm horrified. Morphine is not there

to be a cosh on patients. There's so many issues there. If I read that

clip rightly, they're using morphine as a liquid cosh. That won't have

been prescribed for that and would never be so. We asked the nurse

about what we'd filmed. She didn't respond. The Morleigh Group says

she's been suspended whilst an internal investigation is carried

out. During 14 shifts at Clinton House, Lucy uncovered a catalogue of

poor care and neglect. She also worked there without a criminal

records check being completed or referenced being taken up. What I

have seen on here is scandalous. I would hate people to think this is

every nursing and care home in the land. Because I don't believe it is

for one minute. But I think there is a hard core of unacceptable,

unresourced practice going on, financially driven and frankly,

these places should be closed down. Three weeks ago, we alerted the Care

Quality Commission, Cornwall Council and NHS Kernow to the results of our

investigation. They suspended all new admissions to both homes and

provided extra nursing staff. Clinton House is now being closed by

the Morleigh Group. We had a letter from the Morleigh Group to explain

that Clinton House would be closing and then another letter from

Cornwall Council to inform us there would be a meeting, which I attended

and many relatives attended as well. As far as I'm aware, and I'm pretty

sure, there was no-one from the Morleigh Group that attended this

meeting, which, that makes me angry. Clinton House had been regularly

inspected by the CQC and told to improve. New admissions had been

temporarily suspended in 2013 and 2015. So why weren't residents

better protected? What this is ultimately down to is the provider,

the Morleigh Group, making sure that they are doing the job that they are

being paid to do. We were trying to get the service to make sure that

was happening, that it hasn't happened and that they've allowed it

to deteriorate so badly is just awful, is awful for the people that

are affected and it's not something that we can tolerate. We've shown

our findings to legal and medical experts. They've said the regulatory

system just isn't working. The regulatory framework is a very

important aspect of how we make sure that people get the care that they

have every right to expect. If we say a service requires improvement,

that's what it means. It also requires people who are

commissioning those services, so the local council and clinical

commissioning group, to think about what are they doing in terms of

commissioning from a service that we've said requires improvement.

Both Cornwall Council and NHS Kernow say they worked with the Morleigh

Group to make improvements, but they weren't maintained. They have

apologised to residents at St Theresa's and Clinton House.

Residents at Clinton House are now being found alternative

accommodation. But rehousing residents when homes close,

particularly in rural areas, can be difficult. The market economy was

supposed to introduce competition. There would be lots of providers.

That hasn't happened. If the Care Quality Commission threatened the

closure of a home, then local authorities and health authorities

are faced with finding alternative accommodation for 40, 50 or maybe

more older residents. That is the problem. It is not a market to some

extent, it is a system based on monopoly suppliers. The Morleigh

Group denies that it failed to give proper attention to the quality and

safety of residents' care. It says it had already dismissed the manager

of Clinton House before it became aware of our investigation. The CQC

has now downgraded four Morleigh Group Homes to inadequate. They told

us basically lessons will be learned. Will they? I've got my

doubts. The regulator has said it will refuse to let the owners of the

Morleigh Group open another home. But how worried should we be about

the more than 3,000 other care and nursing homes in England that have

been told time prove? -- told to improve?