Over a year ago a directive came round the Bupa homes telling us not to use them without good cause and risk assessments in place and how to avoid this type of accident

LOL, one has to wonder if this directive was anything to do with the incident in question and its aftermath. Did your directive suggest you should not neglect to check/ supervise your residents???

I am sure it was in response – thats called learning from mistakes / learning the lessons / putting in place procedures to prevent reoccurance

it is a complicated issue for sure and TJ talks some sense her. Project it is an emmotive issue but clearly the only way to get good quality high standard care is to use trained professional staff. these are going to cost a lot of money. The issue is the cost of the care equalling the standard if care. It is the same reason that Mc Donalds staff care less than those in a top restauraunt.
I have worked with LD’s and mental healt and the quality of the care and the quality of the staff has varied a great deal.
Say you are faced with a person who refuses your help into bed and gets angry and stops you either verbally or physically. Perhaps you respect their dignity and let them do it themselves either that or you over power them and do it without thier . this I assume you would not class as high quality care rather than assault.
We had an elderly genetleman with severe mental health issues who would walk constantly till he fellover. He would then ask for your help in getting him up but that meant he would inevitably fall again. he had broken bones doing this and would still walk on broken legs and ankles. If you did not help he just crawled everywhere which was undignified but safe. What was the appropriate choice to make for hi sstandard of care? What do you do when he approaches a set of steps and wants to go up them and will just hit you if you try and stop this. He was doubly incontinet and would fight if anyone attempted to clean him /bath him as he thought you were trying to undress him for abuse purposes etc. Again how do you provide “dignified” care here?
One controversial dementia treatment involves telling people they will go home their loved ones are coming etc as they will just get distressed if you tell the truth and wont remember the answer later anyway. Is this dignified, appropriate and fair?
Many of these choices and decisions are not simple or easy to call
It really does not help that many of the staff have little to no training and no real interest in dealing with this for the minimum wage whilst working unsocial shifts and weekends. Good staff cost but the decisions are still difficult.

I still want to know how TJ is going to move certain patients safely if he won’t use a wheelchair with a seatbelt?

Woody – they don’t need a seatbelt when I am with them – I can stop them sliding out of the chair, If they are being left unattended then they go in a suitable armchair

Also I accept the IMO lower risk of them falling out of a chair to avoid the risk of the seatbelt strangling them. I can manage the risk of them falling out of a chair easily.

Can’t agree with your risk assessment there TJ. How are you going to stop them sliding…..a firm grip on their collar with one hand and the other hand pushing and guiding the ‘chair?

IMO the risk of strangulation is minimal, whereas the risk of a forward fall, should a foot slip off a footrest or a wheel hits an obstacle is much higher and not easily stopped from behind the wheelchair.

Yeah, I’m part of a learning organisation to, it makes talking about preventable deaths so much easier.

mmmmm Life seems to be getting cheaper by the minute

Woody – thats my view and my experience. Never used a seat belt in a wheelchair, never seen an accident preventable by one. My professional judgement.

Fair enough. I’ve used them regularly and can say with certainty they prevented accidents. I have also seen and treated the resulting injuries when they weren’t used. My professional experience.

edit – argumentative post removed

I don’t believe this is the best system but it really annoys me with ignorant ranters saying that people make huge profits out of misery. It is simply not the case.

I wanted to own and run my own nursing home which is why I worked in them to gain an insight. It soon became claer that actually it simply is not feasible to provide care of the standard I would want for under £500 a week per resdident

Maybe you just couldn’t see how?

Gerry Robinson seems to think its very easy to make a 30% profit at low scale “the business model for care homes is not too challenging for any half decent businessman or woman: it is akin to that of a hotel where the number of guests remains relatively constant and occupancy is continually high. He says homes are often making a 30% profit. “
http://www.communitycare.co.uk/blogs/adult-care-blog/2009/12/gerry-robinson-bbc-programme-on-dementia-care-homes.html

And larger operators seem to make about 5% at larger scales
http://investors.schealthcare.co.uk/uploads/cc343fffd01.pdf

5% profit is a small profit. But that is about what the large operators make with their economies of scale and ruthless cost control

The only homes I have seen making large profits are the luxury ones at the top of the market – even then 30% is hard to come by