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The Guardian - UK
The Guardian - UK
Politics
Robert Booth Social affairs correspondent

‘I will always hear her screams’: family tell of heartbreak over care home abuse

Richard Last and Clare Miller tending to their mother, Ann King, who has dementia.
Richard Last and Clare Miller tending to their mother, Ann King, who has dementia. Photograph: Sean Smith/The Guardian

Installing a hidden spy camera by their mother’s care home bed was not something Ann King’s children ever imagined would be necessary.

When their 88-year-old mother faced worsening dementia, they considered a dozen care home options and carefully picked Reigate Grange, part of the Signature Senior Lifestyle chain. The Surrey property reminded King’s son, Richard Last, of the five-star Mayfair hotel Claridge’s, where he had once worked as an electrician. The home marketed itself as being like “a luxury cruise ship”, with a cinema, spa and beauty salon, and a promise of “fantastic care”. It looked safe and stimulating. With annual fees close to £100,000, it appeared reassuringly expensive.

But their confidence collapsed within months as problems mounted, starting with difficulties accessing King’s records of her hospital admission with dehydration, and fears she was being neglected. Then, last autumn, Last walked in on a male carer kneeling down by her bed who quickly left. Something felt wrong.

Richard Last and his sister Clare Miller
Richard Last and his sister, Clare Miller: ‘We got the wool pulled over our eyes.’ Photograph: Sean Smith/The Guardian

“My mum was on the bed absolutely shaking,” Last said. “She grabbed my girlfriend’s arm and said: ‘Don’t let me go’. I thought: What have I just missed here? She looked like she had been chased by a pack of dogs.”

This moment prompted the plan to install a covert filming device on King’s bedside table that would later reveal harrowing footage of abuse.

“We had tried our best to do our homework and [Reigate Grange] seemed like the best place,” Last said. “We got the wool pulled over our eyes.”

Moving King into the home was relatively straightforward, although emotional. The plan had been for Don, King’s husband, to move in with her. The couple had been starting to struggle at home, in ways familiar to thousands of families with ageing relatives. There was a near miss with a medicine mix-up; food was going off in the fridge; then Don lost thousands of pounds to an online scammer. King’s life savings were going to pay the care home fees.

“We were pleased with it,” Last said. “But I was in a mess when I dropped Mum off. I was in bits. But they were together and they would be safe.”

The home was “good”, according to the latest rating by the Care Quality Commission (CQC), in January 2021, although inspectors had been sent in by the regulator the previous month after anonymous concerns about “people’s safe care and the management of the service”.

King, sitting 3rd from left, with fellow staff and Field Marshal Bernard Montgomery in 1947 at a Roehampton hospital where she was an occupational therapist nurse for children.
King, sitting third from left, with fellow staff and Field Marshal Bernard Montgomery at a Roehampton hospital where she was an occupational therapist nurse for children Photograph: /The Guardian

In the months after King’s arrival in January 2021, the problems began. She was moved from her shared room with Don to the dementia floor without her daughter, Clare Miller, being told. Last considered the food “atrocious”, and brought his mother soup to lubricate dishes for easier swallowing. In May, King was admitted to hospital twice, once after an unseen fall and the second time with dehydration. Miller said the family had frequently raised concerns about whether she was getting enough fluids.

Safeguarding experts concluded the hospitalisation was not the result of neglect, but Signature admitted to Last: “Oversight of the fluids given to your mother … was not sufficient”. There was confusion over medicines prescribed by hospital doctors, and King had cuts on her arms, which the home said it believed were the result of her own dementia-related distress behaviours. Alert mats to detect if she fell from her bed were not installed properly and smelled of urine.

By the middle of July, Miller, herself a care worker with 27 years’ experience, had written a seven-page letter of complaint to the care home manager detailing these problems and more, including complaining about carers’ physically handling of her mother. Last also made a formal complaint to Surrey county council.

Ann after her wedding to her first husband Martin Last, at St Marys Church in East Sheen.
Ann after her wedding to her first husband, Martin Last, in East Sheen, London. Photograph: The Guardian

The care home’s lengthy response to Miller included admissions that some things could be better. Like many people with dementia, King’s condition meant she could be awkward and rude and lash out, but Last was “getting more and more distrustful” of her care.

Signature’s management had engaged with the family, in writing and in calls, and shared their complaints with the council, but, Last said: “We felt we had exhausted our attempts to communicate.”

Last had started looking for other care homes but they were either full or closed to new admissions because of Covid. In the meantime, a friend who visited King became worried, too. The friend was hit by an angry resident in King’s room and was concerned for King’s safety. In October she found King soaked in urine to her waist and very cold because the window was open.

King’s dementia meant she was often confused, but what she said concerned Last: “Are you going to throw me out of bed? Are you going to throw me out the window?”

Installing a secret camera is not unheard of. The CQC even has guidelines for worried families. Any concerns should first be raised with the home, and possibly with the CQC and local council. The family had done all three. People being recorded “may feel it breaches their rights and could take legal action”, the CQC warns. If the resident cannot consent because of dementia, the family must be sure recording is “acting in their best interests”.

Having consulted the guidelines, Last found a £95 device online that recorded around the clock. He discretely swapped the memory cards as they filled up, but there was little time to look through the hundreds of hours of footage. Last and Miller were both working and wrestling with the care home and the authorities.

Their relationship with the home collapsed and in January 2022, the home gave the family notice for King to leave. She did so on 10 March, going to live in Sussex with Miller, who had left her home in Norfolk, where she worked as a carer, to care for her mother full-time. “We were absolutely relieved,” said Last. “She was out of that … awful place.”

Then, in spare moments Miller started viewing the hundreds of hours of footage from the memory cards. “That’s when I saw the abuse,” she said. “It’s something that will never leave my mind. I will always see and hear her screams.”

The carers in the video grabbed King by her wrists and moved suddenly. King cried out in pain and distress and said: “You’re hurting me”.

“I got straight up from the sofa and rang the police.”

In a statement, Signature said: “Throughout Mrs King’s stay with us we engaged at length with her family and with the council’s safeguarding team, who independently and individually reviewed every concern raised by Mrs King’s family. As a learning organisation, in the wake of the footage being brought to us we have further strengthened our complaints process and our safeguarding policy.”

It apologised to the family and said the conduct of its staff and the agency worker in the footage was “reprehensible” and that they were “rogue individuals”. It said it routinely uses its own covert cameras to monitor care.

“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,” it said.

Signature, which is ultimately owned by a Canadian pension fund, refuted any suggestion its ownership model had any bearing on King’s experience and said its owners allowed it to invest in its care teams with higher than average staffing ratios, pay and annual leave. “Signature Senior Lifestyle prides itself on building caring relationships, showing empathy, kindness and respect in everything it does,” a spokesperson said.

The footage also showed kind behaviour from other staff, and Last was keen to stress that other workers in the home were caring.

The ordeal has caused the family to reflect on the way care is provided in the UK. In a letter sent last month to her mother’s MP, Claire Coutinho, Miller wrote: “We have allowed these big investment companies to take over the care in this country, gone are the days of local care homes. All they care about is making the investors money … Homes cut costs in the quality of care to make money. This costs our loved one’s dignity and respect. We as a country should be better than this.”

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