85Having finished reading a blog entry by a care assistant in a private nursing home, who informs of her and one nurse having to attend to the needs of 25 elderly residents on a night shift, and of her thinking the food given to residents during the day was on par with what would go in the bin of very cheap boarding house (this as the homes’ administrator received a bonus for cutting costs), it occurred to me that all private nursing homes should be open to scrutiny by residents’ friends and relatives.

For this purpose, I have adapted an assessment form used in America, from the National Caregivers Library, by which friends and relatives can give scores on a 1-5 rating scale for a series of nursing home performances that impact on their loved one’s daily routine.

The assessment document, which I have named NURSING HOME ASSESSMENT BY RESIDENTS’ FRIENDS AND FAMILY, assesses the home’s performance in the areas of Quality of Life, Quality of Care, Nutrition, and Safety.

The nursing home is given overall score out of a possible 200 points. It is strongly suggested that any score of below 150 points should be a cause of concern regarding the overall care of a resident. Specific areas of concern can be highlighted, and the assessment form ends with an additional comments section, in which such concerns and more general impressions can be given.

The assessment form is not one so worded by a nursing home as to minimise any criticism, it asks probing questions.

There is a need for friends and relatives to become involved with assessment, in that they are often as isolated within a nursing home as their loved one, feeling that they have no one outside of the home that they can share their concerns with, with the CQC inspection regime only geared to investigate general concerns within a nursing home, effecting all residents, and not individual ones. Yet, if a number of residents’ friends and relatives within a nursing home complete the assessment form, with assessments all pointing to the same areas of concern, and these forms are posted (I advise by registered letter) to the local Contracts Compliance Department of the local council, this department will be legally bound to pass on these widespread concerns to the CQC, triggering an inspection.

Friends and relatives should be encouraged to photocopy the assessment form, and distribute it to others. Nursing staff who feel that the homes’ management are not responding adequately to concerns about residents’ care should be encouraged to inform residents’ friends and relatives about the assessment form. Permission could be given for a homes’ assessment forms to be viewed by those thinking of placing their loved one there.

Too many people believe that their loved one is being cared for as someone from whom a profit can be extracted. They see their concerns not being addressed by the head office of the multinational corporation that owns the nursing home, with concerns being repeatedly referred back to the care home manager, whose main remit is bed occupancy levels/low staff ratios/economical menus, that is, profit. People feel isolated and powerless under such a system, with (mostly announced) inspection visits by the CQC being nothing more than a theatrical production for an invited audience of friendly critics.

Combine as friends and relatives to protect your loved ones. Become militant on their behalf. Keep copies of the assessment form. (Assessments could be used as circumstantial evidence in any ensuing legal action). As groups of the concerned, go to your local M.P. and raise issues that have not been addressed.

The government and taxpayers are paying for what is all too often is a poor service. In America, this is treated as a fraudulent use of funds, a felony that attracts criminal proceedings, with fines of millions of dollars being imposed on nursing home groups, and the threat of imprisonment for owners. The business-friendly approach of the UK offers no more than a slap on the wrist. It is time this changed.

Residents’ friends and relatives – Combine with others to be strong in the protection of your loved one.

Nursing staff – do not stand idly by if your concerns are not met by management, combine with residents’ friends and relatives to distribute assessment forms and to give advise as to where to send them.

The UK approach, backed by the NMC/RCN cartel, of persuing concerns within the offending establishment, stinks. It is like going to a bully to ask for leniency. The form also asks friends and relatives to state whether a nursing home is managed by a qualified nurse. It is a national disgrace that many are not, with the only response of the CQC being to ‘wave their handbag’ at the business owners of nursing homes who do not meet the cost of employing a nurse manager. Would you want your loved one to get into a taxi driven by someone who had not passed their driving test? Then why put them in a nursing home run by an untrained manager?

I urge everyone to distribute this form.

I urge militancy on behalf of nursing home residents.

lenin nightingale and carol dimon 2015


A list of basic questions to ask when you and your loved one visit a nursing home.

Facility Name: ——————————-

Date Visited: ——————————–

Address: ————————————-

Nursing Home Information
1. The person in charge of the home is a registered nurse. YES NO
2. The home conducts background checks on all staff. YES NO
3. The home has Abuse Prevention Training. YES NO


1. Residents can make choices about their daily routine. Examples are when to go to bed or get up, when to bathe, or when to eat. 1 2 3 4 5
2. The interaction between staff and patient is warm and respectful. 1 2 3 4 5
3. The home is easy to visit for friends and family. 1 2 3 4 5
4. Friends and family are made welcome. 1 2 3 4 5
5. Concerns raised by friends and family (including those of potential abuse) are taken seriously. 1 2 3 4 5
6. The nursing home meets you cultural, religious, or language needs. 1 2 3 4 5
7. The nursing home smells and looks clean and is well lighted. 1 2 3 4 5
8. The home maintains comfortable temperatures. 1 2 3 4 5
9. The resident rooms have personal articles and furniture. 1 2 3 4 5
10. The public and resident rooms have comfortable furniture. 1 2 3 4 5
11. The nursing home and its dining room are generally quiet. 1 2 3 4 5
12. Residents may choose from a variety of activities that they like. 1 2 3 4 5
13. The nursing home has outside volunteer groups. 1 2 3 4 5
14. The nursing home has outdoor areas for residents use and help residents to get outside. 1 2 3 4 5

1. The facility corrected any Quality of Care deficiencies that were in the CQC Report. 1 2 3 4 5
2. Residents may continue to see their personal physician. 1 2 3 4 5
3. Residents are clean, appropriately dressed, and well-groomed. 1 2 3 4 5
4. Nursing home staff respond quickly to calls for help. 1 2 3 4 5
5. The administrator and staff seem comfortable with each other and with the residents. 1 2 3 4 5
6. Residents have the same caregivers on a daily basis. 1 2 3 4 5
7. There are enough staff during the day to care for each resident. 1 2 3 4 5
8. There are enough staff at night and on weekends or holidays to care for each resident. 1 2 3 4 5
9. The residents association is independent from the nursing home’s management. 1 2 3 4 5
10. Care plan meetings are held at times that are easy for residents and their family members to attend. 1 2 3 4 5
11. The staffing mix adequately reflects the culture of the local community. 1 2 3 4 5

• A good patient/staff ratio is important to good care, but you should also consider other care factors. Examples are staff training programs and how long staff stay at the home. If staff changes frequently, ask why. If excessive agency staff are used, ask why.

1. The home corrected any deficiencies in these areas that were on the recent CQC inspection report. 1 2 3 4 5
2. There are enough staff to assist each resident who requires help with eating. 1 2 3 4 5
3. The food smells and looks good and is served at proper temperatures. 1 2 3 4 5
4. Residents are offered choices of food at mealtimes. 1 2 3 4 5
5. Residents’ weight is routinely monitored. 1 2 3 4 5
6. There are water jugs and glasses on table in the rooms. 1 2 3 4 5
7. Staff encourage residents to drink if they are not able to do so on their own. 1 2 3 4 5
8. Nutritious snacks are available during the day and evening. 1 2 3 4 5
9. The dining room environment encourages residents to relax, socialize, and enjoy their food. 1 2 3 4 5

• Ask the professional staff how the medicine a resident takes can effect what they eat and how often they may want something to drink.
• Visit at meal time. Are residents rushed through meals or do they have time to finish eating and to use the meal as an opportunity to socialize with each other?
• Sometimes the food a home serves is fine, but a resident still will not eat. Like everyone, nursing home residents like some control over their diet. Can they select their meals from a menu or select their mealtime?
• If residents need help eating, do care plans specify what type of assistance they will receive?

1. There are handrails in the hallways and grab bars in the bathrooms. 1 2 3 4 5
2. Exits are clearly marked. 1 2 3 4 5
3. Spills and other accidents are cleaned up quickly. 1 2 3 4 5
4. Hallways are free of clutter and well-lighted. 1 2 3 4 5
5. There are enough staff to help move residents quickly in an emergency. 1 2 3 4 5
6. The nursing home has smoke detectors and sprinklers. 1 2 3 4 5
FACILITY TOTAL  —-  (out of a possible score of 200)






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