:00:08. > :00:10.Tonight, I'm undercover in nursing homes were sometimes it seems they
:00:11. > :00:20.just couldn't care less. Were some old and vulnerable
:00:21. > :00:46.residents are left helpless. We ask, is the regulation of nursing
:00:47. > :00:48.homes working? There is a hard-core of unacceptable, and resourced
:00:49. > :00:54.practice going on and these places should be closed down. And I find
:00:55. > :01:03.out what life can be like in a failing nursing home. I can walk out
:01:04. > :01:19.of the door today, I'm lucky. But I feel for those that can't.
:01:20. > :01:26.There are more than 250,000 people in care and nursing homes in England
:01:27. > :01:32.and Wales. I'm of an age where I one day join them. I am about to go
:01:33. > :01:38.undercover in two homes, in a quiet corner of rural England. Homes which
:01:39. > :01:48.promised top-quality care. But we've heard a different story.
:01:49. > :01:53.This is St Theresa's. It is run by the Morleigh Group, the biggest
:01:54. > :02:09.private provider of nursing and care homes in Cornwall.
:02:10. > :02:17.They think I've got a memory problems and I am here to give my a
:02:18. > :02:24.break. They charged me ?750 a week to stay here. St Theresa's can
:02:25. > :02:26.provide nursing care for up to 45 people. Many of them are funded by
:02:27. > :02:34.the Council and the NHS. I would say there are between 20 and
:02:35. > :02:40.30 people staying here. Many of them seem to be permanently in their
:02:41. > :02:50.rooms and others spent virtually all day sitting watching television.
:02:51. > :03:00.There is an overwhelming noise of TV throughout the building.
:03:01. > :03:03.It is my first evening, and half of the lights in my room aren't
:03:04. > :03:17.working. St Theresa's promises residents
:03:18. > :03:21.dignity, independence and privacy. I've been here four days and it is
:03:22. > :03:22.not the impression I'm getting. A resident is calling out for the
:03:23. > :03:43.bathroom. At about 10:30am, I noticed that
:03:44. > :03:49.BLEEP was asking for the toilet repeatedly. It was only by about
:03:50. > :03:55.10:45am that people actually came and took into the toilet. As a
:03:56. > :04:02.resident, I can only see so much. We decide to send in another reporter,
:04:03. > :04:06.Alice. She gets a job some days later and is shadowing a care
:04:07. > :04:11.assistant when another resident asks to be taken to the toilet.
:04:12. > :04:25.Often, residents, even those that can walk with help, are left in
:04:26. > :04:33.incontinence pads, instead of being taken to the bathroom. Dr Peter
:04:34. > :04:37.Holden is an experienced GP whose elderly care has been rated as
:04:38. > :04:48.outstanding. The problem with being left on the incontinence pad is that
:04:49. > :04:52.hearing and faeces are chemicals, they are not designed to be left in
:04:53. > :04:57.contact with the skin. The skin will be damaged. It is a dignity issue.
:04:58. > :05:01.It is health and hygiene issues, it's a comfort issue. You wouldn't
:05:02. > :05:04.do it to your baby, why are we doing it to the elderly? The Morleigh
:05:05. > :05:08.Group says refusing to take a resident to the toilet or using
:05:09. > :05:12.incontinence pads instead would result in disciplinary action. I'm
:05:13. > :05:20.beginning to wonder what I'm getting for my ?750 a week room, that is
:05:21. > :05:24.?3000 a month. Bins that never get emptied. Soap dispensers with no
:05:25. > :05:33.soap. There is a light here, it doesn't work. The toilet seat, not
:05:34. > :05:37.fixed. It seems that staff are rushed off their feet, even though
:05:38. > :05:40.the Morleigh Group says staffing levels are adequate. Alison should
:05:41. > :05:44.not be left alone with residents because St Theresa's has yet to
:05:45. > :05:48.receive the results of a criminal records check. But the nurse on duty
:05:49. > :06:06.asks Alice to feed a resident on her own.
:06:07. > :06:18.Then the nurse arrives with the resident's medication.
:06:19. > :06:22.The nurse says she hasn't got time to give the medication and asks
:06:23. > :06:52.Alice to supervise instead. Later the same day, Alice asks I
:06:53. > :06:53.experienced member of staff about working without having her criminal
:06:54. > :07:33.records check. CQC, or Care Quality Commission,
:07:34. > :07:38.regulates nursing homes. It told St Theresa's more than a year ago to
:07:39. > :07:48.improve the screening of new staff. I have been here for nine days. I
:07:49. > :07:52.have had sleepless nights and seen people in distress. But I've heard
:07:53. > :07:55.that things are even worse at another home in the Morleigh Group,
:07:56. > :07:56.Clinton House in St Austell. That is where I am headed for some more
:07:57. > :08:12.respite care. Clinton House has a history of being
:08:13. > :08:16.given warning and improvement notices by the CQC, although the
:08:17. > :08:24.regulator had found some standards were improving. While I am checking
:08:25. > :08:30.in, another undercover reporter, Lucy, is starting work as a care
:08:31. > :08:32.assistant. Straightaway she hears reports of problems, this in the
:08:33. > :08:54.kitchen. It has been an absolutely shambolic
:08:55. > :08:58.morning. The kitchen flooded. Then it was cold. Although there seemed
:08:59. > :09:05.to be people coming around and feeling the radiators, they weren't
:09:06. > :09:09.on. It is late September and I'm not the only one feeling the cold. It
:09:10. > :09:22.seems it is a common complaint at Clinton House.
:09:23. > :09:28.The Morleigh Group says that Clinton House is heated all year round and a
:09:29. > :09:37.temporary problem with the heating system was fixed. The company, which
:09:38. > :09:44.runs six care homes in Cornwall, is owned by Patricia and Steven Juleff.
:09:45. > :09:52.This is where they live. The Morleigh Group reported ?1.5 million
:09:53. > :09:54.profit after tax in 2015. Last year, Cornwall Council paid more than ?3
:09:55. > :10:01.million to the Morleigh Group to take care of elderly people.
:10:02. > :10:08.Back in Clinton House, undercover care assistant Lucy discovers a
:10:09. > :10:12.serious problem. The alarm system used by residents to call for
:10:13. > :10:28.assistance is faulty. It directs staff to the wrong rooms.
:10:29. > :10:35.To confirm which room and resident they actually need to go to, staff
:10:36. > :10:39.have to check a list on the wall. The Morleigh Group says a new alarm
:10:40. > :10:47.system was ordered in August and they are still waiting for it to be
:10:48. > :10:53.delivered. Nursing homes, unlike care homes, dispense medicine and
:10:54. > :10:55.deliver nursing care. You would expect the way Clinton House handles
:10:56. > :11:02.medicines to be watertight. You'd be wrong. Lucy spots medication that
:11:03. > :11:28.has been left by the sink in a resident's room.
:11:29. > :11:34.This is just poor medicine management, it's a risk because
:11:35. > :11:37.somebody might not be getting the medication that they need, somebody
:11:38. > :11:44.might be getting medication that is not intended for them. Lucy is
:11:45. > :11:48.astonished to discover another resident being given a prescription
:11:49. > :11:54.supplement that is two years out of date. Worse still, it was actually
:11:55. > :11:57.prescribed for somebody else. Four days later, she finds the original
:11:58. > :12:04.prescription label has been peeled off. The out of date supplement
:12:05. > :12:13.relabelled for use by the current resident. Peeled, replaced.
:12:14. > :12:19.That is primary sin number one, two relabelled medicine and give it to
:12:20. > :12:23.somebody else. If that is the kind of thing they are up to, the risks
:12:24. > :12:31.that places patients and is enormous. Clinton House promises a
:12:32. > :12:33.warm, friendly environment. But while I have hot water in my room,
:12:34. > :12:56.many of my fellow residents did not. Lucy complained to a nurse about the
:12:57. > :13:05.water and was told that plumbers were supposed to be dealing with it.
:13:06. > :13:09.Lucy often had to go in search of hot water with a bowl, so that she
:13:10. > :13:20.could wash residents. At various points during her shifts
:13:21. > :13:25.she found at least nine rooms had no hot water.
:13:26. > :13:31.The Morleigh Group says there were some problems when a new boiler was
:13:32. > :13:37.installed, and that residents were provided with hot water throughout.
:13:38. > :13:43.Clinton House also promises residents dignity and independence.
:13:44. > :14:09.Lucy finds a resident has been left on a bed pan.
:14:10. > :14:44.If you leave somebody on a bedpan for a long length of time,
:14:45. > :14:49.eventually what happens is their skin through the body weight begins
:14:50. > :14:54.to push through down the orifice of the bedpan. They will get stuck. Not
:14:55. > :14:56.only is that undignified and uncomfortable, but it's a risk to
:14:57. > :15:23.the skin. It takes two care assistants to free
:15:24. > :15:48.the resident. We showed the footage to her
:15:49. > :15:54.daughter and grandson. I didn't expect that to happen, no. No. Not
:15:55. > :15:56.in this day and age. I don't think it's a very nice environment for the
:15:57. > :16:01.old people, because they don't really have a clue what's going on.
:16:02. > :16:05.The TV set is Blairing out. The -- blaring out. The staff is running
:16:06. > :16:08.round. It's like chaos really. A woman her age shouldn't be left on
:16:09. > :16:09.there for that amount of time. She's old, she's frail. It's not
:16:10. > :16:24.acceptable. Clinton House says staff are
:16:25. > :16:29.qualified to care for people with mild dementia. Our undercover
:16:30. > :16:30.reporter has no training at all and is still asked to lock after someone
:16:31. > :16:45.with dementia. The resident's dementia is severe.
:16:46. > :16:47.She needs 24-hour, one-to-one care. The home is paid around ?3,000 a
:16:48. > :17:12.week to provide it. With just a few words of advice from
:17:13. > :17:15.a care assistant, Lucy's left alone with the resident. Lucy notices a
:17:16. > :17:35.bedpan in the corner of the room. Then she sees the safety rail on the
:17:36. > :17:40.bed is loose. The resident becomes calm when Lucy holds her hand.
:17:41. > :18:13.Lucy's worried she might injure herself on the bed.
:18:14. > :19:15.Lucy notices the resident has a wound on her leg.
:19:16. > :19:36.Another care assistant comes to take over from Lucy.
:19:37. > :20:02.This care assistant won't hold the resident's hand.
:20:03. > :20:07.We asked Professor John Williams, one of the country's leading experts
:20:08. > :20:14.in adult social care for his opinion. I think my reaction is
:20:15. > :20:18.there was no care given at all. I think she was treated badly and I
:20:19. > :20:22.find the attitude of the staff really very disturbing. The
:20:23. > :20:27.conditions in which she was living were appalling. The bed was unsafe.
:20:28. > :20:29.There was a dirty bedpan there. She was clearly very, very, very
:20:30. > :20:46.distressed and understandably so. Few days later, Lucy finds out the
:20:47. > :20:51.resident is being described by staff as "end of life". It becomes clear
:20:52. > :20:55.they don't know how the resident's leg was injured. Even though she's
:20:56. > :21:28.supposed to have round the clock care.
:21:29. > :21:33.The Morleigh Group denies the bed rail was faulty and says a number of
:21:34. > :21:39.the staff received relevant training. But says any failure to
:21:40. > :21:45.treat residents with dignity and respect is unacceptable. I spent
:21:46. > :21:48.five days at Clinton House and even without seeing what was going on
:21:49. > :21:58.behind-the-scenes, I was relieved to go home. I can walk out of the door
:21:59. > :22:10.today, I'm lucky. But I feel for those who can't. Lucy stays on. She
:22:11. > :23:27.attends a resident who has a degenerative disease.
:23:28. > :23:32.The resident has a prescription for morphine as required, that shouldn't
:23:33. > :23:47.include keeping her quiet. I'm horrified. Morphine is not there
:23:48. > :23:54.to be a cosh on patients. There's so many issues there. If I read that
:23:55. > :23:58.clip rightly, they're using morphine as a liquid cosh. That won't have
:23:59. > :24:02.been prescribed for that and would never be so. We asked the nurse
:24:03. > :24:08.about what we'd filmed. She didn't respond. The Morleigh Group says
:24:09. > :24:16.she's been suspended whilst an internal investigation is carried
:24:17. > :24:22.out. During 14 shifts at Clinton House, Lucy uncovered a catalogue of
:24:23. > :24:25.poor care and neglect. She also worked there without a criminal
:24:26. > :24:31.records check being completed or referenced being taken up. What I
:24:32. > :24:35.have seen on here is scandalous. I would hate people to think this is
:24:36. > :24:39.every nursing and care home in the land. Because I don't believe it is
:24:40. > :24:48.for one minute. But I think there is a hard core of unacceptable,
:24:49. > :24:52.unresourced practice going on, financially driven and frankly,
:24:53. > :24:57.these places should be closed down. Three weeks ago, we alerted the Care
:24:58. > :25:03.Quality Commission, Cornwall Council and NHS Kernow to the results of our
:25:04. > :25:07.investigation. They suspended all new admissions to both homes and
:25:08. > :25:12.provided extra nursing staff. Clinton House is now being closed by
:25:13. > :25:17.the Morleigh Group. We had a letter from the Morleigh Group to explain
:25:18. > :25:20.that Clinton House would be closing and then another letter from
:25:21. > :25:27.Cornwall Council to inform us there would be a meeting, which I attended
:25:28. > :25:31.and many relatives attended as well. As far as I'm aware, and I'm pretty
:25:32. > :25:37.sure, there was no-one from the Morleigh Group that attended this
:25:38. > :25:42.meeting, which, that makes me angry. Clinton House had been regularly
:25:43. > :25:48.inspected by the CQC and told to improve. New admissions had been
:25:49. > :25:55.temporarily suspended in 2013 and 2015. So why weren't residents
:25:56. > :25:59.better protected? What this is ultimately down to is the provider,
:26:00. > :26:04.the Morleigh Group, making sure that they are doing the job that they are
:26:05. > :26:08.being paid to do. We were trying to get the service to make sure that
:26:09. > :26:14.was happening, that it hasn't happened and that they've allowed it
:26:15. > :26:17.to deteriorate so badly is just awful, is awful for the people that
:26:18. > :26:24.are affected and it's not something that we can tolerate. We've shown
:26:25. > :26:29.our findings to legal and medical experts. They've said the regulatory
:26:30. > :26:33.system just isn't working. The regulatory framework is a very
:26:34. > :26:39.important aspect of how we make sure that people get the care that they
:26:40. > :26:43.have every right to expect. If we say a service requires improvement,
:26:44. > :26:47.that's what it means. It also requires people who are
:26:48. > :26:49.commissioning those services, so the local council and clinical
:26:50. > :26:54.commissioning group, to think about what are they doing in terms of
:26:55. > :26:58.commissioning from a service that we've said requires improvement.
:26:59. > :27:02.Both Cornwall Council and NHS Kernow say they worked with the Morleigh
:27:03. > :27:06.Group to make improvements, but they weren't maintained. They have
:27:07. > :27:11.apologised to residents at St Theresa's and Clinton House.
:27:12. > :27:15.Residents at Clinton House are now being found alternative
:27:16. > :27:19.accommodation. But rehousing residents when homes close,
:27:20. > :27:23.particularly in rural areas, can be difficult. The market economy was
:27:24. > :27:29.supposed to introduce competition. There would be lots of providers.
:27:30. > :27:34.That hasn't happened. If the Care Quality Commission threatened the
:27:35. > :27:37.closure of a home, then local authorities and health authorities
:27:38. > :27:42.are faced with finding alternative accommodation for 40, 50 or maybe
:27:43. > :27:49.more older residents. That is the problem. It is not a market to some
:27:50. > :27:54.extent, it is a system based on monopoly suppliers. The Morleigh
:27:55. > :27:58.Group denies that it failed to give proper attention to the quality and
:27:59. > :28:03.safety of residents' care. It says it had already dismissed the manager
:28:04. > :28:08.of Clinton House before it became aware of our investigation. The CQC
:28:09. > :28:15.has now downgraded four Morleigh Group Homes to inadequate. They told
:28:16. > :28:21.us basically lessons will be learned. Will they? I've got my
:28:22. > :28:26.doubts. The regulator has said it will refuse to let the owners of the
:28:27. > :28:31.Morleigh Group open another home. But how worried should we be about
:28:32. > :28:35.the more than 3,000 other care and nursing homes in England that have
:28:36. > :28:43.been told time prove? -- told to improve?