0:00:02 > 0:00:07This programme contains some scenes which some viewers may find upsetting
0:00:07 > 0:00:09A care home for the elderly.
0:00:09 > 0:00:11But where's the care here?
0:00:12 > 0:00:14And where are the words of comfort?
0:00:19 > 0:00:22How often is this the experience
0:00:22 > 0:00:24of those who are older and vulnerable?
0:00:28 > 0:00:29CRYING:
0:00:36 > 0:00:39We go undercover to discover what can take place
0:00:39 > 0:00:41when relatives aren't there...
0:00:41 > 0:00:43I'll come in a minute, I just need to help here first.
0:00:43 > 0:00:45..the challenges for care workers...
0:00:47 > 0:00:49I've lost count of the times
0:00:49 > 0:00:53I've found people lying in urine-soaked sheets.
0:00:53 > 0:00:55..and what happens when things go wrong...
0:00:55 > 0:00:58No! No!
0:00:58 > 0:01:00..when the caring stops.
0:01:00 > 0:01:03Did she just slap her? She did!
0:01:03 > 0:01:07I mean, that's assault. She's just assaulted that lady.
0:01:07 > 0:01:11At this care home, eight staff suspended.
0:01:11 > 0:01:15At another, grieving families whose relatives died after neglect.
0:01:16 > 0:01:19As a society, we need to say, "This has got to stop."
0:01:19 > 0:01:21We can't have this going on.
0:01:24 > 0:01:27At a third home, secret filming by a family
0:01:27 > 0:01:30that captured their grandmother's hours of distress...
0:01:33 > 0:01:37..as she called for the toilet more than 300 times.
0:01:38 > 0:01:40I'd go in and she'd start crying.
0:01:40 > 0:01:42She'd say, "I just don't want to be here any more."
0:01:42 > 0:01:44We're living longer
0:01:44 > 0:01:47and our needs in old age are getting greater.
0:01:47 > 0:01:50This is a problem no-one should ignore.
0:01:50 > 0:01:53This is a challenge for the whole of society.
0:01:53 > 0:01:55There should be no hiding place for poor care.
0:02:06 > 0:02:08Night deepens across the capital
0:02:08 > 0:02:11and at this nursing home in South Croydon,
0:02:11 > 0:02:14the residents are settling in their rooms.
0:02:14 > 0:02:18It's December 2012. The X Factor is on the TV.
0:02:18 > 0:02:23'Tonight, it's the X factor final!'
0:02:23 > 0:02:2798-year-old Yvonne Grant is finishing a cup of tea.
0:02:27 > 0:02:31SONG ON TV: "Make You Feel My Love"
0:02:34 > 0:02:37Just before 9:30, Yvonne needs the toilet.
0:02:37 > 0:02:39She can no longer walk
0:02:39 > 0:02:42but getting to the toilet is really important to her.
0:02:42 > 0:02:44It's a matter of dignity. She needs help.
0:02:46 > 0:02:49CRYING:
0:03:06 > 0:03:10Yvonne started calling almost half an hour ago.
0:03:10 > 0:03:13She doesn't know her family has left a secret camera in her room
0:03:13 > 0:03:15to check on her care.
0:03:15 > 0:03:17She's now desperate.
0:03:18 > 0:03:21WAILING:
0:03:21 > 0:03:25Yvonne is just a short distance from the nurses' station.
0:03:25 > 0:03:28Staff should know she doesn't use her call bell,
0:03:28 > 0:03:29she calls out instead.
0:03:34 > 0:03:36But no-one is answering her.
0:03:39 > 0:03:42Another 18 minutes tick by.
0:03:42 > 0:03:43Still no help.
0:03:59 > 0:04:02Yvonne Grant lived her whole life in south London.
0:04:02 > 0:04:06She grew up not far from the care home.
0:04:06 > 0:04:09She always used to talk fondly of when she was living at home
0:04:09 > 0:04:12with her mum and dad, when she was younger, with her sisters.
0:04:12 > 0:04:16It's the area where she raised her family and worked,
0:04:16 > 0:04:18eventually becoming head of dress-making
0:04:18 > 0:04:21at one of Croydon's large stores.
0:04:21 > 0:04:24Always put her lippy on. She used to love looking smart.
0:04:24 > 0:04:26We used to say she looked like the Queen Mum,
0:04:26 > 0:04:27the way she used to have her hair and...
0:04:29 > 0:04:32She was as young on her 90th as what she was on her 80th.
0:04:32 > 0:04:35She just never seemed to age.
0:04:39 > 0:04:43Her granddaughter Vanessa and her family lived nearby.
0:04:44 > 0:04:47But when Yvonne required more medical help,
0:04:47 > 0:04:49doctors said they needed to find a nursing home.
0:04:50 > 0:04:53She was increasingly unable to walk.
0:04:54 > 0:04:58So she moved to the 61-bed Oban House,
0:04:58 > 0:05:02owned since 2011 by one of the country's biggest providers -
0:05:02 > 0:05:03HC-One.
0:05:05 > 0:05:09Soon, Vanessa began to feel things weren't quite right.
0:05:10 > 0:05:13Almost every visit she pointed out problems
0:05:13 > 0:05:15but felt things weren't changing.
0:05:15 > 0:05:18On the surface, it did look smart.
0:05:18 > 0:05:22But when you're in it for a while, you start to see the cracks.
0:05:22 > 0:05:24I'd go in there and she'd start crying.
0:05:24 > 0:05:27She'd say, "I just don't want to be here any more."
0:05:27 > 0:05:31I knew that something wasn't right. But exactly what, I don't know.
0:05:31 > 0:05:34Well, I didn't know until I put in the camera.
0:05:34 > 0:05:36In Yvonne's room,
0:05:36 > 0:05:39the unattended camera counts the minutes as she waits.
0:05:47 > 0:05:48On that Saturday night...
0:05:50 > 0:05:54..Yvonne calls out "nurse" 321 times.
0:05:55 > 0:05:58She pleads for the toilet 45 times
0:05:58 > 0:06:00and bangs her cup on 26 occasions.
0:06:10 > 0:06:14Finally, after more than an hour, a care worker appears.
0:06:14 > 0:06:17Her name is Sakovia.
0:06:21 > 0:06:23Despite Yvonne's long wait,
0:06:23 > 0:06:27Sakovia doesn't seem interested in helping her to the en-suite toilet.
0:06:39 > 0:06:41Sakovia and a colleague
0:06:41 > 0:06:44are telling her to defecate in her incontinence pad,
0:06:44 > 0:06:46the last thing Yvonne wants.
0:06:47 > 0:06:50She hated the fact that she couldn't walk to the toilet.
0:06:50 > 0:06:53She used to say it was so undignified.
0:06:53 > 0:06:57She would always make sure that she used the toilet.
0:06:57 > 0:06:59She wouldn't, you know, as she'd say,
0:06:59 > 0:07:01degrade herself with using a pad.
0:07:01 > 0:07:04Again, Yvonne has to wait.
0:07:13 > 0:07:16With that promise, Sakovia leaves.
0:07:17 > 0:07:2015 minutes later, there's no help
0:07:20 > 0:07:22and now, the light's switched off.
0:07:25 > 0:07:28YVONNE:
0:07:38 > 0:07:43Consultant nurse Lynne Phair is an expert on elderly care.
0:07:43 > 0:07:47She's advised the Government on protecting vulnerable older people.
0:07:47 > 0:07:50This lady, she probably, like most of us,
0:07:50 > 0:07:54hasn't had an accident since we were two or three years old.
0:07:54 > 0:07:58So you've got the dehumanisation, the emotional trauma,
0:07:58 > 0:08:00the physical pain.
0:08:00 > 0:08:03This is a type of assault.
0:08:03 > 0:08:05But not the type of assault people understand.
0:08:12 > 0:08:14After more than 20 minutes in the dark,
0:08:14 > 0:08:18an hour and three quarters after Yvonne started calling out,
0:08:18 > 0:08:21Sakovia returns with another care assistant.
0:08:28 > 0:08:29In the darkness,
0:08:29 > 0:08:33they try to make a desperate Yvonne, who hasn't walked for years,
0:08:33 > 0:08:34walk to the toilet.
0:08:43 > 0:08:45They should be using a hoist.
0:08:45 > 0:08:48When they realise she can't walk, they sound disgusted.
0:08:48 > 0:08:50GROANING
0:08:58 > 0:08:59I know.
0:09:03 > 0:09:05They drop her back on the bed
0:09:05 > 0:09:07and complain they're short staffed.
0:09:18 > 0:09:20That's not what Yvonne wants
0:09:20 > 0:09:22and she still hasn't been to the toilet.
0:09:25 > 0:09:28She's upset and again she's alone.
0:09:39 > 0:09:42Two and a half hours after Yvonne first called out,
0:09:42 > 0:09:45a different member of staff, a nurse,
0:09:45 > 0:09:46finally takes her to the toilet.
0:09:48 > 0:09:51The care worker that you see there,
0:09:51 > 0:09:53the one who does all the talking,
0:09:53 > 0:09:56she was prosecuted for common assault.
0:09:56 > 0:09:59- And was she found guilty? - She WAS found guilty.
0:10:00 > 0:10:03Last July, Sakovia was given a suspended sentence
0:10:03 > 0:10:05and community service.
0:10:05 > 0:10:08She's currently appealing against the conviction.
0:10:11 > 0:10:13The secret camera was in Yvonne's room
0:10:13 > 0:10:15on three occasions over two weeks.
0:10:15 > 0:10:18That night was by far the longest wait
0:10:18 > 0:10:19that she had for the toilet.
0:10:19 > 0:10:23Some care workers are also seen being kind.
0:10:23 > 0:10:24Pardon?
0:10:24 > 0:10:26GENTLY:
0:10:28 > 0:10:30But there is other poor treatment.
0:10:30 > 0:10:34There's nothing gentle about the way she's being handled here.
0:10:34 > 0:10:37YVONNE GROANS
0:10:37 > 0:10:40This care assistant was also convicted of common assault.
0:10:44 > 0:10:48Lynne Phair is regularly called in to investigate concerns over care.
0:10:48 > 0:10:52She says too often action isn't taken.
0:10:52 > 0:10:58I am very relieved to hear the police took that so seriously
0:10:58 > 0:11:00and the CPS took it seriously in that place.
0:11:00 > 0:11:02Because it doesn't get taken seriously everywhere.
0:11:02 > 0:11:07Sometimes in society we have to say enough is enough.
0:11:07 > 0:11:10Things only change because society finally says,
0:11:10 > 0:11:12"We will not tolerate this any more."
0:11:15 > 0:11:19Croydon Council's safeguarding team concluded Yvonne's treatment
0:11:19 > 0:11:22amounted to neglect and institutional abuse.
0:11:25 > 0:11:27What was the reaction of the management
0:11:27 > 0:11:29when you showed them the footage?
0:11:29 > 0:11:32Horrified. Absolutely horrified.
0:11:37 > 0:11:41HC-One, the company that owns Oban House, has told Panorama...
0:11:41 > 0:11:45"The failings in care from that period were totally unacceptable.
0:11:45 > 0:11:48"We apologised unreservedly to Mrs Grant and her family."
0:11:48 > 0:11:49And...
0:11:49 > 0:11:52"We always seek to deliver the kindest possible care."
0:11:55 > 0:11:58The home now meets all necessary standards.
0:12:00 > 0:12:04When Vanessa told her grandmother she'd put the camera in
0:12:04 > 0:12:07and knew what had been happening, Yvonne was pleased.
0:12:07 > 0:12:09She said, "Thank God for that.
0:12:09 > 0:12:12"It's going to stop now, it's not going to happen to others."
0:12:12 > 0:12:16The next afternoon was when her last days began.
0:12:16 > 0:12:20It's like she was holding on for it to be found out.
0:12:23 > 0:12:27Yvonne died in January 2013, aged 98,
0:12:27 > 0:12:30surrounded by the family she loved.
0:12:31 > 0:12:33Vanessa remains angry
0:12:33 > 0:12:35that the earlier complaints she'd made
0:12:35 > 0:12:36weren't listened to.
0:12:36 > 0:12:39It left her grandmother vulnerable to poor care.
0:12:39 > 0:12:44And she believes the secret camera was vital in getting heard.
0:12:45 > 0:12:48I wish it were actually in every room in every care home.
0:12:48 > 0:12:52That way maybe the care would just be given automatically
0:12:52 > 0:12:56because people are aware that they're being watched.
0:12:56 > 0:12:58She is part of a quiet revolution
0:12:58 > 0:13:01where worried families are putting in their own cameras.
0:13:01 > 0:13:05Many experts discourage the use of secret cameras
0:13:05 > 0:13:09but accept that's what happens when families lose trust.
0:13:10 > 0:13:14Putting in a secret camera does not sit comfortably with me.
0:13:14 > 0:13:16Things are being filmed that are very intimate.
0:13:16 > 0:13:20But I absolutely understand why the families are doing it,
0:13:20 > 0:13:22because no-one is listening.
0:13:25 > 0:13:29But how do you build trust so people don't put in cameras?
0:13:29 > 0:13:31Here at the University of Worcester,
0:13:31 > 0:13:34they believe better training for care staff is part of the answer.
0:13:36 > 0:13:38Those fundamental aspects of care,
0:13:38 > 0:13:41like the ability to maintain somebody's dignity...
0:13:41 > 0:13:44The aim is to teach the skill and understanding
0:13:44 > 0:13:48staff need when they move on to real people.
0:13:48 > 0:13:51You've got to have very highly skilled care
0:13:51 > 0:13:53but delivered in a kind and compassionate way.
0:13:53 > 0:13:55The two have to go hand-in-hand.
0:13:55 > 0:14:00Professor Dawn Brooker is a leading expert on dementia.
0:14:00 > 0:14:02She says there are many good care workers
0:14:02 > 0:14:04and in the best homes
0:14:04 > 0:14:07the culture reinforces the right way to do things.
0:14:08 > 0:14:11Everybody knows what good looks like.
0:14:11 > 0:14:14Everybody in that home matters.
0:14:15 > 0:14:20Most of the 17,300 residential and nursing homes in England
0:14:20 > 0:14:23meet the regulator's basic standards.
0:14:23 > 0:14:26Professor Brooker, who is against secret filming,
0:14:26 > 0:14:28has done ground-breaking research
0:14:28 > 0:14:31into the care of challenging residents with dementia.
0:14:32 > 0:14:35She says far too many have limited quality of life.
0:14:37 > 0:14:4030 years ago, it was relatively rare
0:14:40 > 0:14:43to see anybody with dementia in a care home.
0:14:43 > 0:14:47They were full of people who were pretty self-caring, really.
0:14:47 > 0:14:50And yet we've continued that model.
0:14:50 > 0:14:53Care homes now have become the home
0:14:53 > 0:14:57of people with really, really very complex needs.
0:14:57 > 0:15:00We are coping with some of the most challenging
0:15:00 > 0:15:03and vulnerable people within our society.
0:15:05 > 0:15:06But across the country,
0:15:06 > 0:15:09even basic standards of care for older people
0:15:09 > 0:15:13are not being met by a hard core of homes.
0:15:13 > 0:15:17Exclusive figures released to Panorama by the regulator
0:15:17 > 0:15:19show since 2011
0:15:19 > 0:15:231,260 homes have been given warning notices.
0:15:24 > 0:15:26This is serious.
0:15:26 > 0:15:29It means here, at the Care Quality Commission,
0:15:29 > 0:15:31they have started legal action
0:15:31 > 0:15:35because of failings in areas such as care, welfare and staffing.
0:15:36 > 0:15:40More than one third of the 1,100 homes that remain open
0:15:40 > 0:15:43still don't meet all standards.
0:15:43 > 0:15:48That's 406 homes, with more than 15,500 beds.
0:15:50 > 0:15:54The new Chief Inspector of Social Care wants change.
0:15:55 > 0:15:58There are organisations who are running care homes,
0:15:58 > 0:16:01they're getting paid to provide care and to provide support.
0:16:01 > 0:16:04We are expecting people who are running services,
0:16:04 > 0:16:07who are managing these services, to deliver.
0:16:07 > 0:16:10People shouldn't be getting into this business if they don't care.
0:16:13 > 0:16:17In the UK, more and more of us are living longer.
0:16:17 > 0:16:20One third of the babies born last year will reach 100.
0:16:21 > 0:16:25That is going to put care homes under even more pressure.
0:16:25 > 0:16:28We're only as good, in a society,
0:16:28 > 0:16:32as the poorest quality of care that we tolerate.
0:16:32 > 0:16:35We have to admit that we do have a lot of shortfall
0:16:35 > 0:16:37in quality of care
0:16:37 > 0:16:39and that it causes people a lot of misery.
0:16:39 > 0:16:41So unless we get care homes right
0:16:41 > 0:16:44unless we really raise the bar,
0:16:44 > 0:16:47actually all our futures are going to be really grim.
0:16:50 > 0:16:54Frequently, it's staff with poor or minimal training providing the care.
0:16:54 > 0:16:55And when that goes wrong,
0:16:55 > 0:16:58the consequences couldn't be more serious.
0:16:58 > 0:17:02'Next, elderly care home residents were left lying for hours...'
0:17:02 > 0:17:05'Her family say she was treated worse than an animal
0:17:05 > 0:17:07'in the care home she stayed in...'
0:17:07 > 0:17:12'A cleaner says she saw one staff member slap a patient...'
0:17:12 > 0:17:14Each of these cases
0:17:14 > 0:17:17which were investigated or reached court in the past year
0:17:17 > 0:17:21represented a failure to care for someone vulnerable.
0:17:21 > 0:17:24A failure to change, even when there are warnings.
0:17:33 > 0:17:36Lesley Lincoln is an experienced nurse
0:17:36 > 0:17:37who made numerous complaints
0:17:37 > 0:17:40about the nursing home where her mother lived.
0:17:40 > 0:17:44Enid Trodden was denied even the most basic care.
0:17:46 > 0:17:50She'd still be in bed, soaking wet, freezing cold.
0:17:50 > 0:17:51She wouldn't have had her breakfast.
0:17:51 > 0:17:55They would be lying on the table in her room.
0:17:55 > 0:17:56Her 86-year-old mother
0:17:56 > 0:18:00endured months of appalling care before she died.
0:18:00 > 0:18:04I probably wrote about six letters,
0:18:04 > 0:18:06possibly a dozen phone calls.
0:18:07 > 0:18:10I was desperate, really, because I just thought,
0:18:10 > 0:18:15I'm making all these complaints, nobody seems to be taking any notice.
0:18:18 > 0:18:22That home was Orchid View in West Sussex.
0:18:22 > 0:18:24'A coroner has ruled that neglect contributed to the deaths
0:18:24 > 0:18:28'of five elderly people at a residential home in Sussex.
0:18:28 > 0:18:32'Some residents were left dirty, distressed and unattended.'
0:18:32 > 0:18:34Lesley's mother, Enid Trodden,
0:18:34 > 0:18:38was one of the five whose death was hastened by neglect.
0:18:38 > 0:18:43Last October, a coroner ruled that 19 Orchid View residents who died
0:18:43 > 0:18:45had suffered poor care
0:18:45 > 0:18:48in a home riddled with institutional abuse.
0:18:50 > 0:18:54It just made me feel more guilty that...
0:18:54 > 0:18:57How could I have left her there in amongst that?
0:18:57 > 0:19:02How did I not know that this was more serious than what it was?
0:19:03 > 0:19:07Of course, the place looked fantastic. It looked marvellous.
0:19:07 > 0:19:11- We had no idea what was going on. - None of us knew what was going on.
0:19:11 > 0:19:14And all the families who had relatives there
0:19:14 > 0:19:17now live with the distress of what happened.
0:19:17 > 0:19:20Behind that facade of the new building,
0:19:20 > 0:19:23there was hell on earth going on.
0:19:23 > 0:19:25You're just thinking about your relative
0:19:25 > 0:19:28and you're literally living on a day-by-day basis,
0:19:28 > 0:19:30particularly there, because every day
0:19:30 > 0:19:32there seemed to be some new catastrophe
0:19:32 > 0:19:34or something that had happened.
0:19:34 > 0:19:37Southern Cross, the company that owned Orchid View,
0:19:37 > 0:19:39collapsed in 2011.
0:19:41 > 0:19:43My mother was the last person to go into that care home
0:19:43 > 0:19:47and I felt I was hoodwinked into her going into that place.
0:19:47 > 0:19:51They knew they were in dire straits.
0:19:51 > 0:19:54They just told you what you wanted to hear...
0:19:54 > 0:19:55and take the money.
0:19:57 > 0:20:01People died at Orchid View for lack of care.
0:20:01 > 0:20:05We can put men on the moon, rockets in space, reach Mars
0:20:05 > 0:20:07and we can't look after the elderly.
0:20:09 > 0:20:10That's what I feel.
0:20:14 > 0:20:17Lynne Phair was one of the investigators sent in.
0:20:19 > 0:20:22Despite our best efforts,
0:20:22 > 0:20:27we were unable to get the managers of that company
0:20:27 > 0:20:32to see the neglect that their staff were administering.
0:20:32 > 0:20:35It took an admin assistant turned whistle-blower
0:20:35 > 0:20:38to expose the full extent of what was going on in Orchid View.
0:20:40 > 0:20:42Morally I know that I did the right thing
0:20:42 > 0:20:45but personally I have not worked for two years
0:20:45 > 0:20:48and the case has had a huge impact on my life.
0:20:51 > 0:20:53Eileen Chubb has first-hand experience
0:20:53 > 0:20:56of just how difficult it can be to blow the whistle.
0:20:56 > 0:21:00She was a care assistant at a different private-sector home.
0:21:00 > 0:21:04She spoke out and lost her job as a result.
0:21:04 > 0:21:06I've been a whistle-blower.
0:21:06 > 0:21:09I've been there and I know the fear and, you know,
0:21:09 > 0:21:12the distress that people are put through.
0:21:12 > 0:21:14'I saw horrific abuse.
0:21:14 > 0:21:15'I reported it.
0:21:15 > 0:21:20'From that moment on, we were basically driven out of our jobs.'
0:21:20 > 0:21:22Yeah, I've got a copy of it, yeah.
0:21:22 > 0:21:27Her experience led her to start a charity called Compassion In Care.
0:21:27 > 0:21:28In the past 14 years,
0:21:28 > 0:21:33she's had more than 1,600 calls from whistle-blowers working in care.
0:21:33 > 0:21:34Across the country,
0:21:34 > 0:21:38she finds some homes are complained about over and over.
0:21:38 > 0:21:42Every day cases are coming in where there's been, you know,
0:21:42 > 0:21:47sometimes up to 15 staff, 20 staff raising concerns.
0:21:47 > 0:21:51Six years later, more staff raising the same concerns.
0:21:52 > 0:21:58One call she received in March 2013 was from a woman called Karis.
0:21:59 > 0:22:01She was really nervous.
0:22:01 > 0:22:03Just said that she was a care worker
0:22:03 > 0:22:05and there was a number of others, as well,
0:22:05 > 0:22:07and that she'd blown the whistle.
0:22:08 > 0:22:10Karis was upset
0:22:10 > 0:22:14by how she'd seen elderly and vulnerable residents treated.
0:22:14 > 0:22:16When people beg to go to the toilet
0:22:16 > 0:22:19and then they're sitting in their own faeces
0:22:19 > 0:22:20and people think it's fine...
0:22:23 > 0:22:26This is the care home where she used to work.
0:22:26 > 0:22:29The Old Deanery overlooks the Essex countryside.
0:22:29 > 0:22:31It's a residential home
0:22:31 > 0:22:35which sits alongside St Mary's Court nursing home.
0:22:35 > 0:22:39Together they make a 183-bed care village,
0:22:39 > 0:22:42set in beautiful gardens.
0:22:42 > 0:22:46The brochure says, "Care is at the heart of everything we do."
0:22:47 > 0:22:51But during more than two years as a housekeeper at the Old Deanery,
0:22:51 > 0:22:54Karis says she saw care workers shout at, goad
0:22:54 > 0:22:58and even pull some elderly residents about.
0:22:58 > 0:23:00You get the people mocking them, winding them up...
0:23:02 > 0:23:05..to being downright abusive, some of the shouting.
0:23:05 > 0:23:08What went through your mind when you saw that happening?
0:23:08 > 0:23:11It's shocking and really upsetting.
0:23:11 > 0:23:15What makes you say those kind of things to people?
0:23:16 > 0:23:20Karis and ten other staff put a long list of complaints
0:23:20 > 0:23:23about pay, staffing levels and poor care
0:23:23 > 0:23:26to their then bosses in August 2012.
0:23:29 > 0:23:32Amy, a care assistant, was one of them.
0:23:32 > 0:23:34Like the others, she was concerned
0:23:34 > 0:23:37about not having enough time to do all that was needed
0:23:37 > 0:23:41and people being left soaked in urine.
0:23:41 > 0:23:43There were so many residents there.
0:23:43 > 0:23:45How was you supposed to do all of them?
0:23:45 > 0:23:48And with the amount of carers there were,
0:23:48 > 0:23:50it was just physically impossible.
0:23:50 > 0:23:51It was horrible.
0:23:51 > 0:23:52There was one resident
0:23:52 > 0:23:54and there'd be a massive puddle on the floor.
0:23:54 > 0:23:57And the amount of times that people used to walk past
0:23:57 > 0:23:59and shrug it off.
0:23:59 > 0:24:00You wouldn't want to be treated like that,
0:24:00 > 0:24:03so why do you treat them like that?
0:24:04 > 0:24:07They also complained to the local authority
0:24:07 > 0:24:09and the national regulator.
0:24:09 > 0:24:10That September,
0:24:10 > 0:24:14the Care Quality Commission made an unannounced inspection.
0:24:14 > 0:24:16Staff levels at the Old Deanery that day
0:24:16 > 0:24:19were described as woefully inadequate by an inspector.
0:24:19 > 0:24:21And some residents were waiting too long
0:24:21 > 0:24:23for call bells to be answered.
0:24:23 > 0:24:26Essex council's safeguarding team
0:24:26 > 0:24:30also stopped new residents moving into the home for three months.
0:24:31 > 0:24:35It should have been a clear marker that things needed to change.
0:24:35 > 0:24:36So did they?
0:24:41 > 0:24:43Alex Lee is about to find out.
0:24:43 > 0:24:46She will see what the inspectors don't see.
0:24:48 > 0:24:52She's going undercover as a care assistant at the Old Deanery.
0:24:54 > 0:24:57I am worried and I feel really daunted by it.
0:24:57 > 0:25:00I just hope I can do a good job.
0:25:00 > 0:25:01I really, really do.
0:25:11 > 0:25:16Alex, an experienced journalist, has never worked in care before.
0:25:16 > 0:25:18But Panorama arranged training
0:25:18 > 0:25:20in addition to the three days mandatory training
0:25:20 > 0:25:23the home provided before she started work.
0:25:23 > 0:25:25She'll soon discover the pressures
0:25:25 > 0:25:29that care assistants face for £7.16 an hour.
0:25:29 > 0:25:32ALARM SOUNDS IN THE BACKGROUND
0:25:32 > 0:25:33'Doors closing.'
0:25:34 > 0:25:36Well, this is my first day.
0:25:36 > 0:25:38I'm wearing the cameras at the Old Deanery and
0:25:38 > 0:25:41I'm just going up to the first-floor care station to start my shift.
0:25:44 > 0:25:46We've got pasta, tuna and cheese.
0:25:46 > 0:25:48It's like a bake.
0:25:48 > 0:25:49Like a maze!
0:25:50 > 0:25:54This 93-bed residential home is one of the largest in the country.
0:25:56 > 0:25:59Alex finds she's pitched straight into the job,
0:25:59 > 0:26:00with limited guidance.
0:26:00 > 0:26:03At first, it's a struggle.
0:26:03 > 0:26:05Did you say through the middle?
0:26:05 > 0:26:07She wants to go for a wee.
0:26:07 > 0:26:10- Whereabouts do I need to take her? - Um...
0:26:10 > 0:26:12'Doors closing.'
0:26:20 > 0:26:22Yeah, I'm just finding it slightly chaotic.
0:26:22 > 0:26:24Nobody really tells you anything.
0:26:24 > 0:26:27Nobody explains what's going on, you know.
0:26:27 > 0:26:28It's frustrating to say the least
0:26:28 > 0:26:31because the problem is you could make a mistake,
0:26:31 > 0:26:34you could probably end up hurting someone.
0:26:34 > 0:26:37The home says employees are well-supported.
0:26:37 > 0:26:39It has told Panorama there are...
0:26:39 > 0:26:42"A large number of staff on duty at any time
0:26:42 > 0:26:44"who can provide guidance.
0:26:44 > 0:26:47"Detailed care plans exist for every resident."
0:26:53 > 0:26:57# Que sera sera!
0:26:57 > 0:27:01# Whatever will be will be... #
0:27:01 > 0:27:06Which star was the theme song from The Wizard Of Oz?
0:27:06 > 0:27:09At the Old Deanery, Alex finds many good things,
0:27:09 > 0:27:13like comfortable rooms, a cinema,
0:27:13 > 0:27:17hair-dressing and these daily activities.
0:27:17 > 0:27:19MAN CROONS
0:27:19 > 0:27:21Would you like a cup of tea?
0:27:21 > 0:27:23Most residents fund themselves.
0:27:23 > 0:27:26Some pay roughly £700 a week.
0:27:31 > 0:27:33Yeah!
0:27:33 > 0:27:37'I really enjoy spending my time with the residents.
0:27:37 > 0:27:40'Experiences they've had, what they've done with their lives.
0:27:40 > 0:27:41'They've all had such a rich history
0:27:41 > 0:27:43'and they've got so many stories to tell.'
0:27:43 > 0:27:45Very good!
0:27:45 > 0:27:48But there just never seems to be any time
0:27:48 > 0:27:51to sit down and just listen to them.
0:27:54 > 0:27:56THEY LAUGH
0:27:56 > 0:28:01Alex's job is to help many residents to eat, drink, dress...
0:28:01 > 0:28:03Let's get you to the toilet first.
0:28:03 > 0:28:06..to clean them and help them wash.
0:28:06 > 0:28:09It's also about being sensitive to their needs.
0:28:09 > 0:28:11Let me just tuck that down.
0:28:11 > 0:28:13That's brilliant.
0:28:13 > 0:28:15Many residents only need a little support.
0:28:15 > 0:28:17Others need a lot.
0:28:17 > 0:28:19ALARM GOES OFF IN BACKGROUND
0:28:19 > 0:28:22'Residents that are there just for residential needs have no problem.
0:28:22 > 0:28:24'They've got a social life there,'
0:28:24 > 0:28:27their food is provided, they can get around.
0:28:27 > 0:28:29But there are also a lot of residents there
0:28:29 > 0:28:32that have much more complex needs.
0:28:32 > 0:28:35Those residents need a lot of skilled help.
0:28:38 > 0:28:41And Alex does meet many care workers who are trying their best.
0:28:50 > 0:28:52ALARM GOES OFF
0:28:57 > 0:28:59But from day one,
0:28:59 > 0:29:02Alex hears call bells ringing for a long time.
0:29:03 > 0:29:06When a resident presses a button or pressure pad,
0:29:06 > 0:29:07their room number flashes.
0:29:08 > 0:29:11If no-one answers within six minutes,
0:29:11 > 0:29:13the system goes into emergency mode.
0:29:13 > 0:29:15The bell sounds so everyone can hear.
0:29:17 > 0:29:19I'm just with somebody.
0:29:19 > 0:29:21I can't come at the moment, I'm afraid.
0:29:21 > 0:29:23Sometimes delays are because
0:29:23 > 0:29:26care assistants are busy looking after other people.
0:29:26 > 0:29:28'The alarm's going quite often
0:29:28 > 0:29:30'cos the problem is there's just so much to do'
0:29:30 > 0:29:33that you physically do not have the time
0:29:33 > 0:29:37to go and get to all the buzzers that are sounding.
0:29:37 > 0:29:42Sometimes staff are doing handovers or writing care notes.
0:29:42 > 0:29:45ALARM SOUNDS
0:29:45 > 0:29:46Whatever the reason,
0:29:46 > 0:29:49there are several hours in most shifts
0:29:49 > 0:29:52when Alex notices call bells sounding almost constantly.
0:29:52 > 0:29:56ALARM SOUNDS Are you OK?
0:29:56 > 0:29:59And some residents are clearly distressed
0:29:59 > 0:30:01by how long they have to wait.
0:30:01 > 0:30:04This woman was sadly in the final months of her life.
0:30:04 > 0:30:06She rang her call bell a lot.
0:30:06 > 0:30:08On this day, she called ten times,
0:30:08 > 0:30:10twice the home's average.
0:30:12 > 0:30:14WEAKLY:
0:30:14 > 0:30:15You need the toilet?
0:30:15 > 0:30:16Let me turn your buzzer off.
0:30:18 > 0:30:21But without help, she couldn't go to the toilet safely.
0:30:21 > 0:30:25She fell twice trying to get there on her own.
0:30:25 > 0:30:27CRYING:
0:30:42 > 0:30:44ALARM SOUNDS
0:30:44 > 0:30:46Until a call bell is answered,
0:30:46 > 0:30:49there is no way of knowing if the resident is wet, dirty
0:30:49 > 0:30:52or more worryingly has had a fall.
0:30:54 > 0:30:57Even so, this care worker called Lorna
0:30:57 > 0:31:00is saying she put a call bell behind the back of a man
0:31:00 > 0:31:04whose movement is so limited he has the button hung around his neck.
0:31:08 > 0:31:10LAUGHTER
0:31:12 > 0:31:15We can't know if she really moved the bell
0:31:15 > 0:31:17but three times she says she did.
0:31:22 > 0:31:23Lorna could be joking
0:31:23 > 0:31:26but he can't do anything for himself
0:31:26 > 0:31:28and that call bell is his lifeline.
0:31:31 > 0:31:35The company which runs the home says while a bell does ring audibly
0:31:35 > 0:31:37once a resident has waited six minutes...
0:31:37 > 0:31:41"It does not at all follow that if a call is answered after six minutes
0:31:41 > 0:31:44"there is a failure of care.
0:31:44 > 0:31:47"The vast majority of calls are answered within minutes."
0:31:52 > 0:31:54Alex also sees the consequences
0:31:54 > 0:31:57of people not getting help when they need it.
0:31:57 > 0:32:01She regularly sees people sitting in their own mess for lengthy periods.
0:32:01 > 0:32:04Often it's the same three or four people.
0:32:08 > 0:32:10THE MAN MOANS
0:32:23 > 0:32:26'I've lost count of the times I've gone in'
0:32:26 > 0:32:29and found people lying in urine-soaked sheets,
0:32:29 > 0:32:33that have got pads with poo in
0:32:33 > 0:32:35that, you know, they've been sitting in.
0:32:35 > 0:32:39'It's stuff like that that I find really frustrating.'
0:32:41 > 0:32:44Alex is heading to a resident's room
0:32:44 > 0:32:46to move his possessions to a new room.
0:32:46 > 0:32:50His serious medical condition means he relies on staff completely
0:32:50 > 0:32:53and will need care for the rest of his life.
0:32:53 > 0:32:56To respect his privacy, we're not using his voice.
0:32:59 > 0:33:02He says he needs someone to clean him.
0:33:02 > 0:33:05He's already rung his call bell twice
0:33:08 > 0:33:11Two care workers have been in. Both cancelled the bell.
0:33:14 > 0:33:16They went without helping him.
0:33:16 > 0:33:19It seems that was being left to someone else.
0:33:21 > 0:33:25He tells Alex he's been lying in his own faeces for more than an hour.
0:33:25 > 0:33:27She cleans him.
0:33:31 > 0:33:35Even so, he says it doesn't matter. He's not complaining.
0:33:44 > 0:33:47This is one of the care workers, who left without helping him.
0:33:47 > 0:33:50She was in the room just minutes before Alex.
0:33:50 > 0:33:54Her name is Anita and a year earlier the whistle-blowers complained
0:33:54 > 0:33:56she had a bad attitude.
0:33:56 > 0:33:59She was later promoted and supervises some staff.
0:34:02 > 0:34:04There were a number of care workers the whistle-blowers
0:34:04 > 0:34:07complained about in 2012.
0:34:07 > 0:34:11But they only made their written complaints after weekend pay
0:34:11 > 0:34:12and hours were cut.
0:34:12 > 0:34:15The home said that was to bring it in line with other
0:34:15 > 0:34:16local care providers.
0:34:18 > 0:34:22There was no morale left. You'd been pushed so far.
0:34:22 > 0:34:25Pushed to the point where you break or you have to fight back.
0:34:27 > 0:34:30And what did fighting back mean in your terms?
0:34:30 > 0:34:34It was to stand up and say, "Things are going on and it's not acceptable
0:34:34 > 0:34:37"and we can't deal with this."
0:34:40 > 0:34:44In 2012, Anglia Retirement Homes Ltd, the company that
0:34:44 > 0:34:48runs the Old Deanery, was owned by a local property developer.
0:34:48 > 0:34:51He insists it was properly run, delivering good care,
0:34:51 > 0:34:55and the behaviour of the complainants during negotiations
0:34:55 > 0:34:58showed the dispute was about money, not care.
0:35:00 > 0:35:04After a messy argument, six of the care workers were suspended,
0:35:04 > 0:35:09including Karis, partly for not raising concerns earlier.
0:35:09 > 0:35:11Amy was among three who left.
0:35:11 > 0:35:14Just two continued to work at the Old Deanery.
0:35:14 > 0:35:18The home says the complaints were investigated, but...
0:35:18 > 0:35:21"The allegations were, in the vast majority of cases,
0:35:21 > 0:35:23"denied by the accused.
0:35:23 > 0:35:25"The incidents were old
0:35:25 > 0:35:27"and no verifying evidence could be obtained."
0:35:32 > 0:35:36Whatever the motivations behind the dispute, investigations by
0:35:36 > 0:35:39the CQC and the local authority that followed
0:35:39 > 0:35:43identified problems around staffing, answering calls,
0:35:43 > 0:35:45training and the treatment of some residents.
0:35:50 > 0:35:54A year later, when Alex is working at the home, there is change
0:35:54 > 0:35:56of a different kind.
0:35:56 > 0:35:59Anglia Retirement Homes, which runs the Old Deanery and St Mary's Court
0:35:59 > 0:36:04next door, is sold to a private equity firm - August Equity.
0:36:04 > 0:36:06And it's noticed.
0:36:06 > 0:36:08So you say this place is being sold, then?
0:36:13 > 0:36:14Yeah? On what?
0:36:17 > 0:36:19Oh! LAUGHTER
0:36:21 > 0:36:27Providing care for the UK's ageing population is an expanding business.
0:36:27 > 0:36:29And it's attracting private investment companies,
0:36:29 > 0:36:31like August Equity.
0:36:32 > 0:36:36In the last financial report, the two homes made more than £1 million
0:36:36 > 0:36:38in trading profits pre-tax.
0:36:38 > 0:36:41CALL BELL RINGS
0:36:44 > 0:36:48At the Old Deanery, the new owners and new chief executive seem
0:36:48 > 0:36:51to be trying to deal with call bells not being answered.
0:36:54 > 0:36:58care workers are given pagers, which tell them who's ringing for help.
0:37:12 > 0:37:14But Alex doesn't notice much change.
0:37:19 > 0:37:22And now she finds some call bells unplugged.
0:37:25 > 0:37:28She finds the bells of three different residents
0:37:28 > 0:37:30unplugged on five occasions.
0:37:30 > 0:37:33The three are known for asking for help a lot.
0:37:51 > 0:37:53Alex can't know who left it unplugged,
0:37:53 > 0:37:57but she hadn't noticed it happening before.
0:37:57 > 0:38:00Call bells for residents are a lifeline.
0:38:00 > 0:38:02Without those call bells they're imprisoned.
0:38:02 > 0:38:06They have no way of communicating with the outside world.
0:38:06 > 0:38:12It could be that there's not enough staff, it could be that the staff
0:38:12 > 0:38:16do not appreciate the importance of the call bell to that resident.
0:38:16 > 0:38:19Anglia Retirement Homes say they take allegations of call bells
0:38:19 > 0:38:24left unplugged or not answered extremely seriously.
0:38:24 > 0:38:26They continue...
0:38:26 > 0:38:29"Frequent audits of the call bell log are carried out
0:38:29 > 0:38:32"and any such incidents are examined and investigated."
0:38:35 > 0:38:39But Alex is also seeing the sort of rough treatment of some residents
0:38:39 > 0:38:42the whistle-blowers complained about more than a year before.
0:38:42 > 0:38:45Here, Lorna, the care worker we saw earlier,
0:38:45 > 0:38:47has showered this elderly lady.
0:38:47 > 0:38:50She appears to be rushing to dress her.
0:38:50 > 0:38:52Pulling on her nightie whilst she's still wet.
0:39:07 > 0:39:08The resident's not impressed.
0:39:24 > 0:39:28And another lady is clearly upset by how she's treated
0:39:28 > 0:39:29by a different care worker.
0:39:48 > 0:39:51She's already made it clear who she's talking about.
0:40:05 > 0:40:07She's talking about Anita.
0:40:07 > 0:40:09The care worker who earlier walked away from a man
0:40:09 > 0:40:11who needed to be cleaned.
0:40:13 > 0:40:16Separately, Alex sees some residents, like this woman,
0:40:16 > 0:40:17with large bruises.
0:40:27 > 0:40:29Older people can bruise easily,
0:40:29 > 0:40:33so it doesn't necessarily mean anything sinister.
0:40:33 > 0:40:36But this should be recorded on a body map, to keep a check
0:40:36 > 0:40:38on what may be happening. It isn't.
0:40:39 > 0:40:43Another lady is clear in her own mind how she got her bruises.
0:40:58 > 0:41:03We can't know how they were caused or why they weren't documented,
0:41:03 > 0:41:06but with an incomplete record, there's no way to keep a check
0:41:06 > 0:41:07on what's going on.
0:41:09 > 0:41:14Over 36 shifts with cameras, Alex saw at least seven large bruises.
0:41:14 > 0:41:16Only two were recorded.
0:41:16 > 0:41:18What I've been shown in the training that I've been given
0:41:18 > 0:41:22is that with old people, you do it like that.
0:41:22 > 0:41:26Paws not claws. So why has she got almost like a grab mark?
0:41:34 > 0:41:37During her time at the home, as well as worries over how people
0:41:37 > 0:41:41are handled, Alex sees some care workers who mock
0:41:41 > 0:41:43and goad residents.
0:41:43 > 0:41:45The sort of behaviour the whistle-blowers
0:41:45 > 0:41:47warned about a year before.
0:41:49 > 0:41:53Remember Lorna, who gestured she'd taken a call bell away from one
0:41:53 > 0:41:55resident and was rough with another.
0:42:02 > 0:42:05The man she's lifting in a hoist swears at some staff,
0:42:05 > 0:42:07usually when he's agitated.
0:42:07 > 0:42:10He seems better when people explain what's happening.
0:42:10 > 0:42:13Here his private parts are being washed,
0:42:13 > 0:42:14but Lorna gives him no warning.
0:42:23 > 0:42:24This is really intimate care
0:42:24 > 0:42:27and the way it's done here clearly upsets him.
0:42:29 > 0:42:30Then Lorna has her say.
0:42:47 > 0:42:48KNOCKING
0:42:55 > 0:42:57The test of any home and its staff is how
0:42:57 > 0:43:00they look after residents with the most complex needs.
0:43:00 > 0:43:02People like Joan Maddison.
0:43:08 > 0:43:10Alex is told she is one of the Old Deanery's
0:43:10 > 0:43:12more challenging residents.
0:43:16 > 0:43:20I didn't quite know what to make out in terms of the personality
0:43:20 > 0:43:23and how they treat this woman. Cos I see this lady, you know,
0:43:23 > 0:43:27and she's very quiet going around the care home in her electric wheelchair.
0:43:31 > 0:43:33I think he's been naughty, don't you?
0:43:33 > 0:43:38- No, never naughty. - Don't you?
0:43:38 > 0:43:42Joan's brought up five children, including her daughter Gill.
0:43:44 > 0:43:49That's Mum at about 15. That's her at 17. Beautiful.
0:43:49 > 0:43:53- She is stunning. - They're how I think of my mum.
0:43:53 > 0:43:57I'm very aware of how different she is these days.
0:43:57 > 0:44:00She also looked after others as a social worker.
0:44:00 > 0:44:03But now she has early-stage dementia
0:44:03 > 0:44:07and is paralysed down her right side from a stroke in her 50s.
0:44:09 > 0:44:12She's got this fierce independence.
0:44:12 > 0:44:15She thinks she still gets herself up and gets herself washed
0:44:15 > 0:44:17and gets herself dressed.
0:44:17 > 0:44:20She cannot do any of those things, though in her mind she thinks
0:44:20 > 0:44:21she still can.
0:44:23 > 0:44:26In the behaviour notes written by staff,
0:44:26 > 0:44:29Joan is often described as aggressive.
0:44:29 > 0:44:34She can lash out if frustrated, and Gill has been increasingly worried.
0:44:35 > 0:44:40There are definitely ways of dealing with her where she's a pussycat,
0:44:40 > 0:44:43and ways of doing it wrong and all hell breaks loose.
0:44:43 > 0:44:47I'd had the home ring me to say they'd been experiencing problems
0:44:47 > 0:44:52with Mum being very difficult, quite obstructive with her care
0:44:52 > 0:44:56and kicking out and hurting staff.
0:44:56 > 0:45:00And I said, "Well, that's very unlike my mum."
0:45:00 > 0:45:04She can kick off, but it's usually when she's been hurt
0:45:04 > 0:45:07and I'm saying you need to look at the reasons why.
0:45:08 > 0:45:12It was Lorna who first took Alex in to help with Joan's morning care.
0:45:26 > 0:45:28Joan needs to be washed and dressed.
0:45:34 > 0:45:38Lorna is physically restraining Joan and asks Alex to help.
0:45:53 > 0:45:55Lorna should be defusing the situation.
0:45:55 > 0:45:57Instead she's winding Joan up.
0:46:16 > 0:46:18Alex doesn't know what to think.
0:46:19 > 0:46:22Lorna asked me to hold her arms or her hands
0:46:22 > 0:46:23to stop her from hurting her.
0:46:23 > 0:46:26I didn't feel very comfortable doing it.
0:46:26 > 0:46:29I think because Lorna was taunting her almost, reciprocating
0:46:29 > 0:46:33the insults that she was throwing at her, it was just escalating things.
0:46:34 > 0:46:40We asked consultant nurse Lynne Phair to review Joan's care.
0:46:40 > 0:46:43They didn't talk to this lady, they didn't tell her what was going on,
0:46:43 > 0:46:45they didn't anticipate what her problems were,
0:46:45 > 0:46:51and all that lady's got is to resist what they're doing to her.
0:46:53 > 0:46:55The home told Panorama...
0:46:55 > 0:46:58"These incidents involved a small number of staff
0:46:58 > 0:47:01"and are not reflective of the high standards of care
0:47:01 > 0:47:05"which we expect and demand from all of our team."
0:47:08 > 0:47:11But increasingly, staff need the skills to cope with residents
0:47:11 > 0:47:14who can no longer explain what's wrong.
0:47:20 > 0:47:24On 28 mornings, our unattended camera in Joan's room
0:47:24 > 0:47:26shows how care assistants start her day.
0:47:30 > 0:47:32Joan's paralysed right side is painful.
0:47:33 > 0:47:37But on too many days, she's pulled roughly and she reacts.
0:47:45 > 0:47:49Joan's a determined woman who's overcome disability,
0:47:49 > 0:47:50but she's treated like a child.
0:47:52 > 0:47:54Treated spitefully.
0:47:57 > 0:47:59Her knuckles rapped.
0:48:02 > 0:48:03She's told she smells.
0:48:11 > 0:48:14Joan can be difficult, but this shouldn't be happening.
0:48:16 > 0:48:18Hello. Nice to meet you, Gill.
0:48:18 > 0:48:22After reviewing Joan's care, consultant nurse Lynne Phair
0:48:22 > 0:48:24is meeting her daughter Gill.
0:48:25 > 0:48:28She says the home should've been asking questions
0:48:28 > 0:48:32about the reactions different care workers get.
0:48:32 > 0:48:35The organisation have not been looking at the evidence that they've
0:48:35 > 0:48:38actually got. The evidence would be there.
0:48:38 > 0:48:42I say there's obviously something going on because of when she
0:48:42 > 0:48:46expresses her dissatisfaction through aggression. At what times
0:48:46 > 0:48:48and who were the care staff that were involved?
0:48:49 > 0:48:52And there is a clear difference in the way Joan behaves
0:48:52 > 0:48:55when she's with care assistants who show more understanding.
0:49:00 > 0:49:04As requested in the family's care plan detailing her needs,
0:49:04 > 0:49:05they involve her...
0:49:07 > 0:49:09..chat to her...
0:49:09 > 0:49:11..and she is much more relaxed.
0:49:18 > 0:49:22But with Lorna and Anita the battle with Joan is predictable.
0:49:24 > 0:49:27Lorna throws the bag strap at Joan's head...
0:49:30 > 0:49:32..and she's left to struggle on her own.
0:49:35 > 0:49:39We needed to show Gill what the secret camera had picked up.
0:49:39 > 0:49:43It's an insight into what can happen when she's not there.
0:49:46 > 0:49:51I've had inklings, gut feelings. I'm bitterly disappointed.
0:49:51 > 0:49:55I spent two years with my sister looking for somewhere for Mum to go.
0:49:55 > 0:50:01I've let her go there and have that happen to her.
0:50:03 > 0:50:07This type of abuse is very insidious.
0:50:07 > 0:50:11This is hidden, this is like psychological domestic abuse.
0:50:16 > 0:50:19Panorama hasn't shown the undercover film to the Old Deanery,
0:50:19 > 0:50:22but has provided it with details.
0:50:22 > 0:50:24It says...
0:50:24 > 0:50:26"We are shocked and saddened by allegations made by
0:50:26 > 0:50:30"the BBC's Panorama programme of inappropriate behaviour
0:50:30 > 0:50:34"by some staff at the Old Deanery Care Home
0:50:34 > 0:50:37"and apologise unreservedly for the failings.
0:50:37 > 0:50:40"We care passionately about our residents
0:50:40 > 0:50:42"and will not tolerate this kind of behaviour."
0:50:45 > 0:50:50Last November, CQC inspectors gave the Old Deanery Residential Home
0:50:50 > 0:50:53a clean bill of health for the first time in 18 months.
0:50:55 > 0:50:58But 11 days later, Alex is on shift.
0:51:00 > 0:51:04She sees the senior care worker, Anita, with another assistant
0:51:04 > 0:51:05about to get Joan up.
0:51:11 > 0:51:15I needed the hoist so I went to look for it in Joan Maddison's room.
0:51:15 > 0:51:19The hoist was in there and Anita and another care assistant were trying
0:51:19 > 0:51:20to get her ready.
0:51:20 > 0:51:23I could tell there was a lot of aggression in the room at that stage
0:51:23 > 0:51:28and I couldn't stay, so I decided to leave a secret camera in the room
0:51:28 > 0:51:29before I left.
0:51:40 > 0:51:45Anita seems increasingly exasperated by Joan as they start to dress her.
0:51:54 > 0:51:56And Joan appears to have scratched her.
0:52:03 > 0:52:05The situation is escalating.
0:52:05 > 0:52:06She threatens Joan.
0:52:15 > 0:52:17Then Anita does this.
0:52:20 > 0:52:21She slaps Joan.
0:52:23 > 0:52:25Did she just slap her? Can I see that bit again?
0:52:29 > 0:52:32She did. I mean, that's assault.
0:52:32 > 0:52:36She's just assaulted that lady, but who would believe Joan?
0:52:36 > 0:52:40Because Joan is labelled, by everybody that I've seen so far,
0:52:40 > 0:52:44as someone who's aggressive, she's nasty, she's an alley cat.
0:52:45 > 0:52:49I feel like I've let her down, I've let everybody down that trusted me.
0:52:49 > 0:52:53I begged, I pleaded, I fought like a tiger to get the funding
0:52:53 > 0:52:54to get her in there.
0:52:56 > 0:52:58The care home says that Anita...
0:52:58 > 0:53:00"Has been summarily dismissed
0:53:00 > 0:53:03"and other disciplinary proceedings will be completed shortly
0:53:03 > 0:53:06"after the Panorama broadcast."
0:53:08 > 0:53:12The home told Panorama as soon as they were informed of our evidence
0:53:12 > 0:53:14they took immediate action.
0:53:14 > 0:53:17They suspended eight staff and...
0:53:17 > 0:53:22"Hired an independent law firm to carry out a full investigation.
0:53:22 > 0:53:26"Our priority remains the health and well-being of our residents
0:53:26 > 0:53:29"and we have more than 200 dedicated members of staff
0:53:29 > 0:53:32"who remain committed to the highest standards of care."
0:53:39 > 0:53:43Gill visits her mother at the Old Deanery several times a week.
0:53:45 > 0:53:47If things aren't going to change,
0:53:47 > 0:53:49I'll have to look for somewhere else for her.
0:53:49 > 0:53:51Where will my mum end up?
0:53:52 > 0:53:55But the Old Deanery is her mother's home.
0:53:56 > 0:53:59There's an element of hope, because I have to have hope.
0:53:59 > 0:54:01I don't want to move her, Alison.
0:54:01 > 0:54:04I believe that they could change things.
0:54:04 > 0:54:08They've got some amazing staff that need good, strong leadership.
0:54:08 > 0:54:12It isn't adjustment needed, it's fundamental change.
0:54:14 > 0:54:18The Old Deanery emphasises the good care it provides.
0:54:18 > 0:54:22Its new owners say they've increased the number of senior staff
0:54:22 > 0:54:26on shift and introduced an independent whistle-blowing service.
0:54:26 > 0:54:29The home told Panorama it's...
0:54:29 > 0:54:32"Very concerned that any broadcast of what is likely to be
0:54:32 > 0:54:37"highly-emotive material will give a wholly false view of the home."
0:54:37 > 0:54:40And they told us to consider...
0:54:40 > 0:54:43"The many positive views that have been expressed about the home."
0:54:46 > 0:54:50However, two months ago, after we informed it of our findings,
0:54:50 > 0:54:53the CQC carried out an early-morning inspection.
0:54:56 > 0:54:59This time it found too few staff.
0:55:00 > 0:55:04And some residents waiting too long for call bells to be answered.
0:55:04 > 0:55:07They discovered one person "crying and distressed" because
0:55:07 > 0:55:10they couldn't find a care worker to help them to the toilet.
0:55:12 > 0:55:18In less than two years, the CQC has visited the home six times.
0:55:18 > 0:55:23We have inspected the Old Deanery, we have identified concerns that
0:55:23 > 0:55:25we've had, we've issued a warning notice.
0:55:25 > 0:55:29They improve but then they fall back on other areas,
0:55:29 > 0:55:33and particularly because of the issues around staffing,
0:55:33 > 0:55:35that's where you get the problems.
0:55:35 > 0:55:39The CQC gets eight serious legal challenges a week
0:55:39 > 0:55:42from places unhappy with inspection reports.
0:55:42 > 0:55:47It finds some homes seem to resist change.
0:55:47 > 0:55:50But it's introducing ratings to make it clear which homes are doing well.
0:55:52 > 0:55:55And new legislation will mean company directors could be
0:55:55 > 0:55:57prosecuted for failings in care.
0:56:02 > 0:56:05But as Alex finishes her time at the Old Deanery,
0:56:05 > 0:56:09she knows inspectors won't see all that happens in homes.
0:56:11 > 0:56:16I've just come off my last night shift at the Old Deanery.
0:56:17 > 0:56:20I'm absolutely shattered, if I'm honest.
0:56:20 > 0:56:25What these residents are getting is just the basic level of care,
0:56:25 > 0:56:28and sometimes even that's not happening
0:56:28 > 0:56:30and it's just not good enough.
0:56:31 > 0:56:35For too many people like Joan, we aren't getting the basics right.
0:56:35 > 0:56:38So what will it take to change that?
0:56:40 > 0:56:43At the Department of Health, the minister with responsibility
0:56:43 > 0:56:46for care in England agrees there's a problem.
0:56:47 > 0:56:52There's a stubborn minority of care providers who do not meet
0:56:52 > 0:56:56acceptable standards and those are the ones that we have to tackle.
0:56:56 > 0:57:00We have to send out the message that there should be no place
0:57:00 > 0:57:04in our care services for providers of that sort.
0:57:05 > 0:57:08With pressure on funding and growing need,
0:57:08 > 0:57:12he accepts change will take more than fine words.
0:57:12 > 0:57:16This has to be a big collaboration between Government,
0:57:16 > 0:57:21the regulators, local authorities and providers.
0:57:21 > 0:57:25I think collectively we can drive up standards and ensure that
0:57:25 > 0:57:29our loved ones get access to the best possible care that's available.
0:57:31 > 0:57:35The families who've experienced poor care say that means all homes
0:57:35 > 0:57:37need to measure up to the best.
0:57:38 > 0:57:42For Lesley Lincoln that's the only way to protect others
0:57:42 > 0:57:45from the neglect her mother suffered at Orchid View.
0:57:47 > 0:57:51As a society we need to say, "This has got to stop."
0:57:51 > 0:57:53All the basics are basics.
0:57:53 > 0:57:56You shouldn't have to be complaining about that sort of thing.
0:57:56 > 0:57:58It should be top-notch.
0:58:08 > 0:58:12And each time the cries of someone like Yvonne Grant go unheeded,
0:58:12 > 0:58:14the question for us all is,
0:58:14 > 0:58:17do we have the will to stop this happening?