Imagine being confronted with concrete evidence that your husband, who has dementia and lives in a nursing home, is being abused by those responsible for his care. Think how you’d feel as you switched on the small tape recorder you’d hidden behind a chest of drawers in his room and heard people “hissing with venom” and treating him so roughly that he cried out.
It hardly bears thinking about; it’s every relative’s worst nightmare – the stuff of double page features in the Daily Mail and Panorama exposés.
At a recent conference debate I found out that this is what happened to Zoe Harris, the founder of Care Charts UK, a simple, effective enterprise that improves the lives of those in care, based in West Sussex.
The most remarkable aspect of Zoe’s chilling discovery – and this may seem hard to comprehend – was not the abuse she overheard, but what happened next and how it has shaped her opinions of formalised care, and how overt audio recording could be used as a positive means to better it, something we all want.
For some hours later that same night, as Zoe’s hidden Dictaphone continued to whir, another pair of carers entered her husband’s room. This couple’s treatment of Geoff, by now traumatised and confused, was exemplary. Listening to the recording, Zoe heard compassionate professionalism at its best as the two calmed Geoff’s fears. Later still, a third couple entered; their care was adequate, but could have been better.
The following morning Zoe relayed her discovery to the home’s manager, who acted swiftly, suspending the abusive carers, launching an internal investigation and alerting Social Services. After careful consideration, and with her husband’s wellbeing uppermost in her mind, Zoe continued her covert audio recording for another 12 months, until he died, being careful to protect carers’ anonymity by transcribing what she heard and deleting the recordings.
In 50 hours of recording she never heard anything as bad as the first night; the tapes revealed a mixture of good and bad practice, most of it was adequate, bordering on poor.
Her blogs on the subject, written some years later, contain a thoughtful analysis, not just of the minute-to-minute treatment her husband was receiving behind closed doors, but of how our system of care – with its inadequately trained, badly paid, demotivated, often poorly managed and exhausted workforce, for whom society seems to have a low regard – reflects on us all.
My goodness, that struck a chord with me. I wrote a Thunderer column in the Times last year which ran under the headline “Whose really at fault over care for the elderly? We are”. It sounded shocking (even to me) but it was in fact a perfect summary of my piece, which suggested that instead of constantly criticising badly paid carers for failing our loved ones we should consider how we as a society treat them all.
Zoe – who had every reason in the world to rail against the failing care her husband Geoff had received, berate the home’s manager, contact the industry’s watchdog in the form of the Care Quality Commission (CQC), demand that the home be shut down – even, some might say, take her revelations to the press – did none of this.
Instead, she considered all that she’d discovered – the good, the bad and the mediocre – and the method by which she’d discovered it and let the knowledge gently simmer away in the back of her mind as she got on with developing her care charts, which today enhance the lives of 20,000 people in 800 care homes throughout the UK. I once heard Zoe say that she’s more a doer than a talker; I’d go along with that.
But now the subject of surveillance in care homes is in the news. This week the CQC has approved guidance on covert cameras for families worried about relatives in care homes. It is, in effect, giving its backing to the use of hidden cameras to catch abuse.
Zoe believes that this action misses the point – that the use of such cameras “will not have the slightest impact on the overall quality of care”. How so? Surely if a hidden camera catches abuse – such as at Winterbourne View hospital – this is a good thing?
In Zoe’s opinion such recordings will feed sensationalist headlines and keep the debate focussed on a handful of bad cases, while neglecting the vast majority of good practice. Again, I’m with her.
What is so refreshing about 53-year-old Zoe is that, having heard the worst (in the emotive form of cruel treatment being meted out to the now-vulnerable man she loved) she has chosen to focus on the positive. How many of us would have had the strength of character to do that?
She’s decided to use her experience positively to make a difference in a system that she and I agree is only part of the much larger, complex issue of how we as a culture treat our elderly and vulnerable.
So, how does she envisage overt audio recordings should be used? She concedes that any form of surveillance will probably be regarded with suspicion by staff but says if audio recording can be introduced as a training tool, discussed and operated openly it doesn’t have to be divisive.
“Recordings must be taken with the full knowledge of participants, and the results listened to with a view to using it as a way to learn and improve, not criticise. Long-term, it can be used on an ongoing and random basis, as a cost-effective and efficient method of staff training.”
Zoe believes that, over time, carers not interested in doing a good job would be driven out. “This is not an overnight fix. I don’t believe that such a thing exists, but I have yet to hear of a better way of reassuring a sceptical public that care can be monitored even behind closed doors, whilst motivating carers to do a good job in the knowledge that good care will be recognised and rewarded”.
The term expert by experience is in danger of over use, but in this particular instance, Zoe is just that. I heed her words on this subject and gently suggest that others might do the same.
Andrea Sutcliffe, chief inspector of adult social services, has an unenviable job that must keep her extremely busy. She attended the conference debate where Zoe made her powerful, personal revelation and on the very brief occasions I’ve met Andrea and from what I’ve seen of her in the press, she brings more than professional expertise to her post.
Her watchdog may have given the green light for families to use covert surveillance cameras but I hope that she’ll spare the time to listen carefully to what Zoe Harris has to say about the power of audio recordings as a positive tool for good. I think she – indeed, each and every one of us – owes Zoe that, and more.