As Britain's biggest care home axes 3,000 jobs, a Channel 4 News investigation uncovers new evidence about the impact the Southern Cross financial crisis is having on the care it offers to residents.
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On Wednesday Southern Cross announced plans to cut more than 3,000 jobs in the latest blow to the company and its 750 care homes.
Southern Cross, which employs 44,000 staff, said the proposals to slash the workforce by nearly seven per cent were part of its programme of change launched 18 months ago.
But as the company fights financial crisis and cuts jobs, concerns have been raised over the quality of care provided to some 31,000 residents across the UK.
Southern Cross has insisted that despite growing fears for its future, it is adamant the quality of treatment at their care homes will not suffer.
However, a Channel 4 News investigation has revealed that the care home regulator has recently criticised staffing levels in some homes in the six months to April.
A number of families of Southern Cross residents have voiced to Channel 4 News concerns about the quality of care their loved ones received.
One resident, grandmother Ruby Pooley, was taken to hospital after being attacked twice by fellow residents - one of her attackers had been involved in two previous incidents.
Mrs Pooley moved into the Southern Cross care home of Briar House, Kings Lynn, after she was diagnosed with dementia.
At first Mrs Pooley's family were happy with the care she received, but towards the end of her life, she was attacked by another resident. The pensioner was hit her over the head with a metal object and a pillow was placed over her face.
At the time of the attack Mrs Pooley was already in fragile health. She was hospitalised and died seven days later of pneumonia and dementia.
Doctors and a coroner concluded Mrs Pooley's death was unrelated to the attack, but her family told Channel 4 News she should have been better protected while in the care home.
"She was obviously very distressed, very bruised and it had a noticeable effect on her - from that moment she never recovered", Mrs Pooley's grandson Gary told Channel 4 News.
"To know that another resident had taken advantage or got to the point where she went into my nan's room and assaulted her was quite difficult to take - but to see my nan in the state that she was after that was difficult for everyone."
An inspection report into the home in April 2010 questioned staffing levels at the home, and its ability to deal with residents who display so-called 'challenging behaviour'.
A former senior member of staff at Briar House - who worked at the home some time before the attacks - told Channel 4 News under anonymity that during her time at the centre, she wanted to dismiss poor staff who had reached the end of their disciplinary process. But she was told that the sackings would not be possible because it was too costly to pay temporary staff to fill the gaps in staff.
She claims she was asked to fill the care home to its maximum capacity, even though she felt staff could not cope.
Watchdog criticises provider
Data gathered by the Care Quality Commission (CQC), and seen exclusively by Channel 4 News, shows problems in half of the Southern Cross homes surveyed.
In the six months to April 2011, the CQC reviewed 49 homes and found concerns in 26.
Nineteen reviews questioned staffing levels and 16 raised concerns about whether residents were protected from abuse.
Channel 4 News has also seen research which shows that in 2010 a third of Southern Cross homes - 265 - did not have permanent, registered managers.
CQC warned Southern Cross last year that a third of its homes lacking registered managers would be a significant issue for the company, and one that it must address. Amanda Sherlock, CQC
CQC issued a warning to Southern Cross last year telling the company it must address the issue of the lack of managers.
CQC director of operations, Amanda Sherlock, told Channel 4 News Southern Cross must address its issues in order to safe guard its vulnerable residents.
"CQC warned Southern Cross last year that a third of its homes lacking registered managers would be a significant issue for the company, and one that it must address," Amanda Sherlock said.
"Southern Cross as a large organisation is able to put resources into failing homes and address immediate problems. This 'parachuting' in of teams however is a short-term fix and de-stabilising for staff and residents.
"We would like to see a focus on continual quality assessment that prevent crisis happening and provides stability and sustainable quality care."
Southern Cross told Channel 4 News it was the regulator delaying proceedings for taking on new managers.
"We submit registration applications to the CQC for all home managers who are eligible," Southern Cross said in a statement.
"Unfortunately, the process is frequently delayed at the CQC end. At present, we have 114 submitted applications awaiting the CQC’s confirmation of registration. Some of our Home Managers have been waiting for confirmation for over seven months.
"Additionally, I am sure that the CQC would agree, that when a home manager leaves their job, it is good practice to at least put in an experienced temporary manager until a permanent manager can be appointed. This ensures greater continuity of care which is the priority for Southern Cross in all of its homes."
Channel 4 News has also found that at another Southern Cross care home, Rose Lodge, Alzheimer's sufferer Dorothy White had a series of falls and in one incident broke her arm at night - but her family told Channel 4 News that staff didn’t appear to notice.
It wasn't until the next shift when a carer saw the break and called the paramedics who said it was so serious the bone was almost coming through her flesh.
Mrs White's family said if the break was that bad, it should have been picked up by the night shift.
Read more: Government plans for major failure of care home provider - C4News sees exclusive document
The family also raised concerns over shortages of staff on duty at the Rose Lodge home.
Mrs White's son Arthur Gash told Channel 4 News sometimes he would arrive at the home and find just one or two people on duty to care for 10 to 12 dementia sufferers.
Concerns from the family led to inspectors from the CQC criticising the home and staffing levels have now improved. Mrs White still lives at Rose Lodge and her family are satisfied with the care that she receives.
With more Southern Cross homes coming under the spotlight questions are being asked about the future of the company which recently warned it was in "critical financial condition".
Southern Cross says that despite the current difficulties it is committed to ensuring quality of care across its care home.
In a statement to Channel 4 News Southern Cross said:
"Since new management of Southern Cross took over in 2009, its priority has been, and remains, to improve the standards of care across all of its homes. The Company deeply regrets any incidents where its residents have not received optimum care and learns from any such events.
"Over the last 18 months, the Company's new management has introduced improved monitoring and training systems and increased investment across all of its homes, such that its care standards have improved along with its care quality ratings. A Group HR function has been introduced and a Directorate of Care established in the last 12 months to ensure that the continuity of quality care for all Residents is prioritised as the focus of the business.
"Southern Cross remains committed to ensuring that its care standards continue to improve through training and development for its staff and ongoing investment in its homes, which last year exceeded £70m.
"The Company’s current financial restructuring has not, and will not, affect this commitment as recent care quality ratings demonstrate. The Company will continue to work towards ensuring that the provision of care is never compromised for our 31,000 residents."
01 June 2011