The road goes ever on: evidence of the continuing abuse of older people in care homes

Abstract

Purpose The purpose of this paper is to present findings from a research project designed to enhance knowledge of the current extent and nature of abuse in contemporary care homes for older people. Design/methodology/approach A self-completion, postal questionnaire was used to elicit both numerical and textual data that were subsequently subjected to both quantitative and qualitative analysis. The questionnaire was distributed to newly appointed care staff in five participating care homes providing care to older people to determine the nature of any abuse they may have witnessed in the homes in which they had previously worked. Findings A significant proportion of respondents had witnessed numerous occurrences of primarily psychological and physical abuse and neglect, perpetrated against the older people living in the care homes in which they had previously worked. Research limitations/implications Although the research draws upon the experiences of only 197 anonymous questionnaire respondents, of whom 180 had witnessed abuse, data suggest that abuse continues to occur in some care homes for older people. Originality/value The research has revealed staffs’ recent experiences of a range of abusive acts and practices. When combined with two previous studies using the same or a similar methodology, the research also confirms the enduring presence of abuse in care homes. Findings again suggest that changes are required to current methods of external scrutiny and investigation of practices in care homes.

Of myths and markets: how marketisation of the care home sector contributes to circumstances where abuse is more likely to occur and continue

“…Confounding the issue of the efficacy of external regulatory oversight even further is the research of Moore (2018Moore ( , 2019a who found in repeated cross-sectional studies that plentiful reports of abuse and neglect emanated from within care homes that had been rated by the CQC as "good" and sometimes even from those rated as "outstanding". The earlier research of Killett et al (2013, p. 131) similarly concluded from a study of organisational cultures in ten care homes that an inspection report indicating compliance with prescribed standards did not necessarily mean that care was of a good standard.…”

“…In this way the negative image of care and nursing homes will probably be perpetuated and may well decline. To cement and fuel the negative perceptions promulgated by this particular medium research undertaken by Cooper et al (2018) and the research and accounts of the real life experiences of Moore (2016Moore ( , 2018Moore ( , 2019aMoore ( , 2019b have revealed and documented the detail of the many forms that poor treatment and abuse can take, including those spawned by ignorance, malice and even a perverse desire for entertainment that can sometimes manifest among members of care staff.…”

“…There is little doubt that the rising costs of meeting ever increasing demand for the care of older people will require either some means of containing costs or mechanisms to raise more money to pay for it, whether by means of local or national taxation or insurance mechanisms. Indeed, during 2017-2018 and 2018-2019 local governments were empowered to increase local taxation to pay for the care of older people in their areas, and in 2019-2020 to do so for their populations in general, though in terms of the number of older people subjected to abuse these levies have had no discernible impact (Moore, 2019a). The long awaited government paper on adult social care, be it green or white, when it finally appears, may have some or all of the answers to this continuing dilemma, but we can be sure that it will not address the fundamental and very wicked issue of the choices that people would make if they were given the chance about where and how their care is to be provided, and this is not to be cared for en masse in care and nursing homes.…”

Sharpening Occam’s razor: developing theory to explain the persistent abuse of older people living in care homes

“…As Darlington and Scott (2002) maintain, a greater number of decisions on whether to take a qualitative (interpretivist) or quantitative (positivist) approach to conducting research are based not on the particular philosophical beliefs of positivism or interpretivism (or others), but on the design and methodology identified as best suited to the purpose of the enquiry. So, for example, we have the repeated collections of numerical data about abuse by NHS Digital (2016, 2017, 2018) referred to above that constitutes a predominantly positivist orientation, and the research of, for example, Moore (2016, 2018, 2019a) that makes use of a combination of positivist and interpretivist approaches to determine both the numerical extent and the nature of the abuses to which older people in care homes are sometimes subjected. Irrespective of the research philosophies that influenced these researchers, the findings of both contribute significantly to the current understanding of the prevalence and the nature of abuse in contemporary care and nursing homes.…”

“…Given that the abuse of older people is known to have been occurring in care homes for decades prior to the availability of such reliable data, and it has become increasingly apparent that abuse is a common part of the institutional life that many older people experience (Jenkins et al , 2000; Action on Elder Abuse, 2006; Cambridge et al , 2006; Cooper et al , 2008; Post et al , 2010; Fyson and Kitson, 2012; Moore, 2016, 2018, 2019a; Cooper et al , 2018) it is clear that current interventions by the responsible agencies, such as health and local authority commissioners of care home services, the statutory regulator of the care home sector and the adult safeguarding functions of local authorities, are all failing to respond effectively to what is evidently a obstinate social problem.…”