I have worked in care homes as a qualified nurse for almost 20 years now. I have worked in numerous homes and spent 10 years working for a nursing agency, so I've been around
The one that I am currently employed in, is run by a charitable organisation and is probably the best of the bunch. The others have been very depressing to work in, and the managers totally uninspiring and many of them totally unsuited to working in elderly care.
The main problem is staffing levels. You simply cannot provide a decent standard of care with the staffing levels that most care homes have.
I am currently working on an early shift as the sole nurse with five care assistants and on the late shift with only three carers - that is to care for 31 frail elderly residents, many of whom require a great deal of care. The nightstaff have one nurse and only two carers. If people were not helped out of bed at 6am the daystaff would be on until lunchtime helping people up People are helped into bed mid afternoon and fed their tea in bed because it takes so long to help 30 odd people to bed and the nightstaff would be on until past midnight if everyone started going to bed at 8pm. To be fair, many of the clients are very tired by mid afternoon or need pressure area care, and bed is the only option.
No matter how inspiring or decent a manager you have, you cannot provide a good standard of care with these staffing levels. The care assistants barely have enough time to provide the basic levels of care and they are constantly running here and there trying to get everything done.
I am expected to: administer the drugs, supervise the carers, deliver personal care, answer the phone, sort out problems, deal with GPs/other health professionals, deal with visitors, do the dressings, make phone calls, update notes etc. Sometimes, I'm not able to get everything done. I hardly have any time to talk to the residents properly or give them my full attention I'm constantly having to do two jobs at once and my mind is constantly on the next problem to be solved.
People think that the care assistants don't actually care, but they do. However, it's exhausting working in that job 5 or 6 shifts a week receiving only minimum wage and absolutely no thanks, either from the manager or the clients/relatives. Many of the carers suffer from chronic health problems that they are struggling to cope with, and some have sick relatives that they must care for after work.
Working conditions are often poor and one woman I am currently working with has had to work whilst suffering from an injury sustained within the home (she was not at fault) because she simply cannot afford to go 'on the sick'.
My carers care a great deal, but I watch them struggle sometimes and tbh, I don't know how they work full time. I only work part time and that's enough for me, but full time is tough.
Shorter hours and better pay would improve things enormously for people working in this environment.
The managers in these places have very little say in how much staff are paid or how many hours they work.
Please don't think that we don't care because we do, but it's such a tough environment in these places. A good manager can help, but what is needed is more money, equipment that works and shorter hours.