After watching his girlfriend suffer in a dementia home so poor that it faced possible closure, Donald Hedges reached a simple conclusion: “It’s a robbery of taxpayers’ money.”
As it does for about a quarter of a million others in England, the state paid for Lilian Williams’ care. She lived in the privately owned Forest Edge care home in Southampton.
“It was terrible in there,” Lilian used to tell Donald, he said. “She used to lose her temper with me and say things like, ‘How would you like to be in this dump?’”
The former nurse, 78, eventually fell and broke her hip.
She is now in a different home, but Forest Edge was bleak. Last September, Care Quality Commission inspectors found a mattress soaked with urine that had been left uncleaned for days, dirty bathrooms and broken tables. There weren’t enough staff, none had completed their basic care certificate training, people were left unattended for too long, and there were unwitnessed falls. Staff tried to confine people to their chairs using tables. They rated the 32-bed home as “inadequate”, “not safe”, “not effective” and “not well led”.
Another visit in late January saw some improvements in response to previous warnings, but it remained “inadequate”.
Yet the home’s owners, John and Linda Hughes, have been profiting handsomely. Lilian’s care was paid for by Southampton city council, but the Hughes’ company also received £1.2m from Hampshire county council to look after people in the last two years. Over a similar period, the pair withdrew £652,435 in dividends, loans and salary, according to company accounts. These do not appear to be rewards for good care.
In September 2022, inspectors heard a person with dementia crying out from their room: “I want to get out. I want to go home,” but staff repeatedly ignored them. Family visits were often blocked, and residents were seen wringing their hands and pacing – signs of unmet needs or untreated pain.
Linda Hughes said the CQC inspection report of Forest Edge care home “was not a true reflection of Forest Edge”. She said the regulator and Hampshire county council had since visited “with very positive outcomes on all issues raised”.
Asked about the owners’ withdrawals of cash, she said she had “no reason to dispute your figures”. During Covid, the home had grown “old and tired”, but upgrades were under way, she said.
“We are very proud of our home and confident that we will achieve our good rating back in the next few months,” she said.
Southampton city council said that when concerns are raised about a care home, “our aim is to support the provider to raise the standards of care and management and to work with residents to ensure they are in the most appropriate setting”.
Hampshire county council said its quality improvement team had been working with Forest Edge “to address the failures”.
A spokesperson said that when it comes to moving people out of homes, “continuity of care and familiarity with an environment” are important considerations. The council “will always take action when alerted to cases of abuse or harm”, the spokesperson said.
Forest Edge is not unique. It is one of hundreds of England’s worst-rated care homes that is funded at least in part by hundreds of millions of pounds coming from central government grants and council tax revenues. In England, care homes with the worst ratings have a significantly greater proportion of residents being funded by the state. Conversely, the best places are much more likely to be occupied by people who can afford to pay their own way. The crisis in England’s care homes bites deepest on the poorest.
Social services directors report little choice in where to send people as a workforce and funding crises combine with an ageing population to leave them struggling to find enough care home beds. The NHS and Steve Barclay, the secretary of state for health and social care, meanwhile, increase the pressure to accelerate discharge from congested hospitals into care homes.
Julie Jenkins has seen the consequences of poor care for her father, John O’Brien, whose stay at Silvanna Court in Essex was paid for by the county council until his death aged 79 in February.
Silvanna Court is operated by Runwood Homes, a chain owned by multimillionaire property developer Gordon Sanders, but it is rated “requires improvement” and Jenkins described elements of his care as “utterly disgusting” and “Dickensian”.
According to Jenkins, a CQC inspector discovered that O’Brien, a former roofer with dementia, was being given drugs to calm him down twice daily when they had only been prescribed for use as required. He wasn’t eating properly because carers weren’t monitoring him, Jenkins said, and “carers in the TV room were just slumped in their chairs on their mobile phones”.
An inspection report from June reported a staff member complaining: “[Residents] are always soiled, but we just don’t have enough of us to take [them] to the toilet.” Medicines were not always managed safely, and “insufficient staff were available, which placed people at risk of harm”.
On 4 February O’Brien was taken to hospital in an ambulance after falling unconscious and suffering breathing difficulties. His daughter saw that his trousers were filthy and he was soaked in urine.
Once admitted to hospital, she said, the nurse was shocked at his condition and moved to tears. His incontinence pad had disintegrated and it appeared he hadn’t been changed for 48 hours.
“It was so undignified,” she said. “It’s my dad. It’s wrong.”
Jenkins understands that Essex county council has been investigating conditions at Silvanna Court. The council said it does not comment on individual cases.
“ECC takes all safeguarding concerns extremely seriously and it has an established process in place to deal with such matters,” it said.
Again, the home’s private operator has been making good money regardless.
According to council spending records compiled by Oxygen Finance and shared with the Guardian, Essex county council spent £31.6m on contracts with Runwood in 2022. Its owner, Gordon Sanders, paid himself at least £21m in five years.
O’Brien’s experience was “raised as a safeguarding matter with Essex county council at the time, in line with the local policy”, a spokesperson for Runwood said. “The safeguarding case remains open and no outcome has been issued.”