Jayne Easterbrook, a nurse for 42 years who specialises in training care workers, examined the footage of Ann King’s care at Reigate Grange in Surrey, and gave her reaction to the Guardian.
King, 88, has dementia, and secret filming showed she was physically and mentally abused at the luxury care home that charged residents close to £100,000 a year. Signature Senior Lifestyle, which runs the home, has agreed the conduct was “reprehensible”, but said it was perpetrated by “rogue individuals”.
The footage also showed kind behaviour from other staff, and her son, Richard Last, was keen to emphasise that other workers in the home were caring.
Easterbrook said she was shocked by what she saw, describing it as “abuse, there is no other word for it”.
There are basic standards to consider. The Care Quality Commission (CQC) states people receiving care must not suffer, “neglect, degrading treatment or unnecessary or disproportionate restraint”. Also, people must consent before any care or treatment is given.
The Care Certificate, a basic qualification, requires care workers to maintain people’s dignity when they are moved and ensure “privacy and dignity” during personal care. Care workers must be able to describe how they would adjust care for people with dementia and “protect people from harm and abuse”, which may be “physical, sexual, emotional or psychological”.
Easterbrook, currently in charge of training at the Homecare Asssociation, which represents providers of domiciliary care workers, pointed to seven examples of abuse.
1. Rough handling during pad changes
“Straight away there seems to be no consent,” Easterbrook said. “Even if a person is late on in dementia, everyone has the right to consent and it doesn’t have to be verbal consent. The fact she is fighting them off shows she is not consenting. Instead of stopping and calming her down and trying to get her to interact, they have just carried on.”
King is hauled up by her pyjama top showing “there are no proper moving and handling techniques going on there. She is not consenting to that yanking.
“She has said: ‘I will do it myself’. What they should be doing is calming her down and helping her to get up by herself as much she can.”
Easterbrook said: “It’s more or less a wrestling match. They are trying to rush that care and you can’t rush someone with dementia. You have to have an interaction with her. Once she has become agitated and she is fighting them off, you shouldn’t carry on.”
2. Laughing as King is restrained
When King is woken by a giggling female care worker and held down by her wrists by a male colleague she shouts “no, no, no”. Looking at the force used, Easterbrook said it was “lucky he didn’t break her wrist”.
“She doesn’t care,” said Easterbrook of the female worker’s “inappropriate” laughter. “She’s got no empathy at all.”
The whole thing is “a video you would show people the worst way to provide care ever. It is absolutely distressing to watch.
“All of it is too violent,” she said. “None of it is person-centred care. If she is struggling like that you stop … you take a breath. You talk to her. The fact that she has been abused over a period of time, of course she doesn’t want anyone to touch her. It’s like a feedback loop.”
3. Carer ignores King’s calls for attention, tells her to ‘stop, stop, stop’ and drowns her out with music
“That is absolutely disgusting,” said Easterbrook. “Ann is trying to communicate with her. As a care worker, you love it if someone with dementia wants to communicate with you. She should have gone over, got to eye level and said: ‘What is it Ann? What have you got?’ And if she wanted some music on, she should have said: ‘Ann, do you want some music on?’ She was trying to drown her out.”
Asked if the care worker could be expressing reasonable frustration, Easterbrook was emphatic: “No, you don’t get paid to go to work and be frustrated. If you work on a dementia unit, you should have dementia training. These are not caring people and are in the wrong job.”
4. Care workers ignore King for 50 minutes as she lies on the floor of her room and calls ‘Don’, her husband’s name
“People with dementia do that. They are not necessarily calling for that person, they are calling for help. If [the staff] are trained in dementia they should know that. When dementia attacks the brain, the last thing to go is feelings. When you are lost for words to say, you still have the feelings. This is downright dangerous. They are not addressing her needs. Clearly she is someone for whom, when there is a problem she calls for Don. Imagine being on the floor for 50 minutes and you are frightened. That must seem like a lifetime.”
5. Care worker flicks through phone while King lies on the floor, then swears at her; another worker shoves her into a chair
“It’s just abuse, there is no other word for it. Their body language is very aggressive. They have recruited people with the wrong values. Even if you were tired and frustrated from a long shift … but to swear, push people around, and abuse people physically, verbally, emotionally is not acceptable on any level. There is something seriously wrong about the culture of this organisation.”
6. Care worker shakes her bed as King protests saying ‘it’s awful’
“Why would you do this unless you were trying to break the bed or upset the client,” said Easterbrook. “It’s saying: ‘We’re here and we can do what we want with you – you are totally at our mercy.’ Imagine living like that every day knowing you are at the mercy of these people. She is telling them to stop, she [the care worker] doesn’t and he just laughs. They should be prosecuted for the abuse that is going on.”
7. Cleaner taunts King with toilet cleaning rags, threatens to dump a bin on her head and makes sexually offensive gestures in her face
“It is gross,” said Easterbrook who briefly stopped looking at the video in disgust at this point. “Apart from the abuse, it’s [an] infection control [issue],” she said of his use of the toilet rag.
“He shouldn’t even be in there on his own with her,” she said.
“This is more than training, this is a cultural issue,” she said. “All the people in this video are abusing on a different level and they are enjoying being abusive. They are having a laugh. That is a cultural thing.”
In May, the CQC cut Reigate Grange’s rating to “requires improvement” and the inspection report found “risks to people’s safety and wellbeing were not always robustly monitored”. Leadership was “inconsistent” and “leaders and the culture they created did not always support the delivery of high-quality, person-centred care”.
Signature Senior Lifestyle said the actions in the videos “were committed by rogue individuals” and denied their behaviour was systemic or linked to the management of the home or organisation. It said it deployed an undercover supervisor and had used covert CCTV to check on care standards.
“We remain committed to doing everything we can to deliver the highest quality care, and to ensuring peace of mind for the residents who make their home with us, and their loved ones,” a spokesperson said.
Signature emphasised that the home was still ranked “good” in three out of five categories, and said the criticisms were minor and “easily addressable”. It said the CQC found staff “were aware of their responsibilities to keep people safe from the risk of abuse” and said “the actions of a few rogue individuals should not be construed as being representative of the wider staff team, or Signature as a whole”.
