dignity while hoisting???

Dear Nicola

It is not ok for people to be treated like this I agree with you it is totally degrading. Just because people do this does not mean it is correct. I'm an OT and I would never recommend that some one is hoisted and left suspended in mid air. Not only is it undignified but it puts people at an increased injury risk. It causes significant pressure on all areas around the sling and can cause pressure sores and also can be an indicator in prolapsed bowels. Hoists should be used to get people from one place to another as quickly as possible people should not be suspended in any way for any period of time other than during the time it takes to do the transfer. Also people should not be left sitting on slings they should always be removed.
I often get queries like this and most often it is down to pressures of time for the carers who are going in if this is the case you need to go back to the social worker and state that the allocated time is insufficient to meet the persons needs.
I think you have no choice but to whistle blow on this very dangerous practice and I realise that this puts you in a very difficult situation and that you probably fear for your job but you have to remember the service users in all of this and often they have no say. Maybe you can contact someone in your locality to support you such as the local social services who monitor all care agencies, or the community OT

Good luck

Carol

Nicola,
You must speak up. You have a duty of care to the clients you look after and
this is definately not acceptable. Speak to your manager, if the supervisor
thinks this is acceptable then she is in the wrong job. I am sure the client
must feel totally disrespected being treated in this manner.

Emma

hi
i am discusted with the behaviour and standards of the company you are working for. you have to make a stand for the client. this is not taking the clients privacy or dignity into consideration. speak out and be heard. you have to protect the client this is what your role is; good luck.

> From: [log in to view email address]
> To: [log in to view email address]
> Subject: [Dignity Champions Discussion Forum] - Re: dignity while hoisting???
> Date: Mon, 14 Dec 2009 19:40:01 +0000
>
> Nicola,
> You must speak up. You have a duty of care to the clients you look after and
> this is definately not acceptable. Speak to your manager, if the supervisor
> thinks this is acceptable then she is in the wrong job. I am sure the client
> must feel totally disrespected being treated in this manner.
>
> Emma
>
> On Fri, Dec 11, 2009 at 1:54 AM, nicola robinson <
> [log in to view email address]> wrote:
>
> > please help.....ive been a carer(dommicilary) for 12 years and i have
> > recently witnessed something at work that has worried me, i coverered a
> > morning round (i work in the community) i was with a younger girl, we
> > hoisted up a elderly lady from her bed...(i presumed we were hoisting her
> > from her bed to the commode as the lady needed the toilet) but NO to my
> > absolute disgust she got the commode bowl put it on the bed, the lady was
> > now hovering (still in the sling hoist) over a bowl??? I immediatly
> > questioned this as i found it very degrading and undignified for the service
> > user, she said the service user always emtys her bladder/bowels this way?
> > and that our superviser is aware and its been agreed that its ok to do
> > this???, there seems to be no reason this lady cant be hoisted onto a
> > commode chair,since this inncident i have realised that the staff in this
> > company do this to all the double handed calls, surely this is unexceptable
> > and bad
> > practice these people are hanging in the air, being watched by 2 carers, no
> > privacy,,this to me appears dangerous and unhuman am i write??? im new to
> > this company and am still on my 6 mths probation period, i can tell some of
> > the staff dislike me as i wont stand by and say nothing if i beleive
> > something to be wrong, is this wrong what they are doing????
> >
> >
> >
> >
> >
>
>
>
>
>

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There are several avenues open to complain about health care service, even when you are working in the service and prefer to make your complaint anonymously. One of the newest organisations available is LINk. The LINk is the Local Involvement Network, the objective of the LINk is to provide a channel through which members of the community, You and I, whether employed by a provider of a service or simply an individual, might make our voice heard over improving local health and social care. I have been careful here to avoid saying that the LINk will follow complaints - instead they may signpost you to who will, but the LINk will tackle issues where they fell it will lead to an improvement in the Health & Social Care service delivery.
While funded through the DH, the LINk is independent and typically has a steering committee made up of Volunteers who have statutory powers, to enter and view a Health & Social Care provider's premises to see and report on what is happening; or simply to write to senior managers and require an answer within twenty days.
There are 150 LINks across England so there will be one local to you. They are structured differently according to the local requirement so do check that your LINk will treat your enquiry as confidential. You should find your LINk listed at http://www.nhs.uk/NHSEngland/links/Pages/findingyourlink.aspx
I am not going to comment on this specific issue as reported here, but I would encourage the writer to put the matter before their LINk. My view is that improving the dignity of people receiving Health and Social Care would lead to an improvement in Health and Social Care, so the Dignity Champions and the LINk share synergous objectives.

Particularly when movement is limited or in a wheelchair, sitting yet again
on a commode is not helpful. The bladder/bowel is more stimulated when in a
sling. Sometimes, what inexperienced carers 'think' about a situation is not
necessarily the best way to handle this situation. If carers really need to
remain in the room, they obviously need to be discreet and sensitive. There
is nothing worse than a carer deciding not to allow something which is
beneficial to the 'patient', just because they don't like it. The person's
personal choice must be sought.

-------Original Message-------

From: nicola robinson
Date: 11/12/2009 01:55:03
To: [log in to view email address]
Subject: [Dignity Champions Discussion Forum] - dignity while hoisting???

please help.....ive been a carer(dommicilary) for 12 years and i have
recently witnessed something at work that has worried me, i coverered a
morning round (i work in the community) i was with a younger girl, we
hoisted up a elderly lady from her bed...(i presumed we were hoisting her
from her bed to the commode as the lady needed the toilet) but NO to my
absolute disgust she got the commode bowl put it on the bed, the lady was
now hovering (still in the sling hoist) over a bowl??? I immediatly
questioned this as i found it very degrading and undignified for the service
user, she said the service user always emtys her bladder/bowels this way?
and that our superviser is aware and its been agreed that its ok to do
this???, there seems to be no reason this lady cant be hoisted onto a
commode chair,since this inncident i have realised that the staff in this
company do this to all the double handed calls, surely this is unexceptable
and bad
practice these people are hanging in the air, being watched by 2 carers, no
privacy,,this to me appears dangerous and unhuman am i write??? im new to
this company and am still on my 6 mths probation period, i can tell some of
the staff dislike me as i wont stand by and say nothing if i beleive
something to be wrong, is this wrong what they are doing????

Particularly when movement is limited or in a wheelchair, sitting yet again on a commode is not helpful. The bladder/bowel is more stimulated when in a sling. Sometimes, what inexperienced carers 'think' about a situation is not necessarily the best way to handle this situation. If carers really need to remain in the room, they obviously need to be discreet and sensitive. There is nothing worse than a carer deciding not to allow something which is beneficial to the 'patient', just because they don't like it, even though it gives relief and prevents the use of medications. Personal choice must be sought.

I worked in a private Nursing Home, where things were happening which were unacceptable. We tried complaining but nothing changed. I knew that it would be made difficult for me if I tried to do more, and then I would have to leave, and the residents I loved would be without another caring person looking after them. I wrote anonymously to the Head of Social Services in the area, and they swooped in one day and sorted things out. I found it very difficult when they were all talking about it and saying how awful it was that someone had done that, but it was necessary as people were being bullied.

I applaud Mrs Temperton's action. Despite being apprehensive about whistle blowing, she took the right action by putting those she was caring for first. If Dignity Champions is to make an impact it will be through seeking to change things for the better and for that we need to voice our view - wherever we see perceived poor deliver. Your local LINk provides a vehicle for you to voice concerns over poor Health and Social care anonymously. You can find your LINk at http://www.nhs.uk/NHSEngland/links/Pages/findingyourlink.aspx

Firstly, you are right in recognising this as unacceptable and degrading because it most certainly is!

Secondly, well done for wanting to change it.

There's lots of issues here. One is the mis use of equipment. A hoist is designed to left people, not to suspend them as a toileting aid. So the practice may be breaking health & safety law in regard to the safe use of equipment, it is only safe to use equipment for the purpose it was designed for. see http://www.pcaw.co.uk - 0207404 6609

Trust you instints on this, you are right. But you can't possibly change it all on your own. Raise it with the apropriate people. Congratulate yourself that you did the right thing and the best for the people you care for. Then let others take the responsibility for addressing this and find yourself a job in a better company!

This is also very poor moving and handling practice. Does the organisation you work for provide moving & handling training? If so is their a handling trainer or back careor you could query this practice with?

You say you've been told the supervisor is aware and its been agreed. I wonder who with? And if this practice is documented in a care plan? Do the people you are caring for have care plans stating how they should be moved and handled, or how they should be supported with toileting?

Is there anyone in the company you feel you could share your concerns with? Do the people your working to support have care managers? Are they having care review meetings? Is it possible to discuss with the individuals if they would prefer to be hoisted on to a commode.

It is not good practice in any way to leave someone to open their bowels or pass urine whilst suspended in a sling. This would be completely unnatural and reduce abdominal pressure which is promoted by adopting a good toileting position of having both feet on the floor, knees slightly bent and leant slightly forward - thus making the process more difficult.

There is then the obvious issue of cleanliness and infection control of putting a commode pan on someones bed and expecting them to go to the toilet there. It pangs of the horrible old attitude of 'just go in the bed'.

You have the option to raise your concerns with whichever authority (such as the social services) is paying the company to provide the care. Is there any body that inspects the company such as the Care Quality Commision (CQC)?

There is also the organisation 'Public Concern at Work' who'd be able to advise you.

this paragraph should have come at the end of the post, not sure what happened then?

see http://www.pcaw.co.uk - 0207404 6609

Trust you instints on this, you are right. But you can't possibly change it all on your own. Raise it with the apropriate people. Congratulate yourself that you did the right thing and the best for the people you care for. Then let others take the responsibility for addressing this and find yourself a job in a better company!

Nicola, you really must speak up. This sort of practice can not be allowed to continue. The dignity of the service user is a must at all times and in the case it would appear that there has been no thought for the service users dignity. Just because "we allways do it this way" does not make it allright. I understand you not wanting to speak up, but you have a duty of care, and wouldnt you want some one to speak up for you if you were the situation that this service user is in, i know i would.
Good luck and dont be put off reporting this to the appropaite people .

I am a service user who has been hoisted at least twice daily for five years. I do not find it in the least degrading, but a very sensible and practical way of being moved without strain for myself or carers. For those who have a problem with hoisting, perhaps more training is required, In addition, those who seem to object to service users going to the toilet whilst in this position, are they more concerned about what they 'think' is good for the patient/resident rather than what the service user finds to be most beneficial.
I come across quite a few people who think 'they know best'. They are often just as responsible for taking away our independence. This is why I'm a Dignity Champion. Service Users should always decide on their own care - we are the experts by experience.

Ok I'm lost on that last one- so will ignore it. If someone you work with is being in any way " abused", you MUST report it to the Adult Support And Protection Unit ASP-(In Scotland) and the equivelant elswhere in the UK. They then have a duty to investigate. Posters should be displayed in any nursing home or hospital ward. I would still recommend talking things through with line management and if action is not taken, or things put immediatly right- then please go down the ASP route. With regard to hoisting, I think there is an assumption that clients/patients must be hoisted. For some moves, a good care-plan will indicate what other alternatives are to be considered. The care-plan should be followed. Unfortunately, most bad practice I have seen is when there is 1- when no quality careplan in place or 2-staff plainly ignore it! Both these examples could be seen as abuse. However in my many many years of practice I am still proud to say that there are some great practices and examples of high quality care which far outstrips bad practices But when witnessed- bad practice must be not only challenged, but stopped. regards- dstewart2

THE CHOICE BELONGS WITH THE CLIENT, I THINK THIS IS WRONG AND UNSAFE, WHAT WOULD THE CLIENT WANT.

I am a trainer I recently went to a company that had all these problems above hoisting and suspending over the bed to encourage bowel openings and watching
I whitnessed alot of different things as they asked me to be out with the carers employed internaly
I had no choice but to say something to the upper management as it went as far as placing a wheel chair against the service user to resrtict freedom
The carers because they resisted training then started to pick on me although they were not to know any better one carer told me they had had no formal manual handling training or any other for about 4 years
The owners of the establishment treated me like I was to blame yet It happened in front of me as it was local the carers picked on me and my family for trying to help them
they had a bad inspection from the local contracters this then became my fault although I knew nothing about it
scape goat could be the word needed
after what i saw within this care DCA I was traumertised and cried for weeks then felt the system had not helped to prevent this as I saw the inspection reports the issues had been there for years not known to me why cannt we all care from the heart and think it will be me one day
care for each other as you would have care for your self
less emotionaly I tell my carers to if in doubt shout too many try to dicourage whistle blowing and the repocussions are traumatic but it is vital in the scheme of drawing attension to issues why should others recieve poor care why should anyone silently suffer it still is happening behind the authoritys back but looks good in the office when they call i think about the service users i saw and regularly wish they could have a better care plan with real carers

Sarah
I agree whole heartly with your sentiments!
(why cann't we all care from the heart, and think it will be me one day, care for each other as you would care for yourself )
We do need to stand up fight for what we believe is right for the ones we care for because if we don't nobody else will.
We most all try to change the wrongs were possible however much trouble it may bring to us.

Marie Beasley Bury

Thankyou for your kind words It makes a difference to feel that there are like minded people within the care network
carers need our support to change thier ways
but sometimes you can lead a horse to water but you cannt make them drink

There is absolutely no dignity shown to the service user in this method of toileting.
I have thankfully never witnessed anything so appalling!!
It occurs to me that this is another way of saving time, at the cost of degrading the individual whome we should be caring for.
Imagine yourself in that situation...dangling over a bedpan whilst there are onlookers!! Disgraceful!!
Not only does dignity come into this, but i would note that this is a form of abuse!! Imagine the discomfort caused to an already frail body, by being suspended in the air by a hoist!!
I was taught that hoists were ment to be used for the most minimal ammount of time, surely the practise you witnessed here was quite the opposite!!
You clearly care, therefore i would challenge this procededure used by your company and strongly advice for the comfort and dignity of your service users that they/yourself refrain from putting it into practice again.

Goodluck

this was so not my company i was trying to assist to train a local provider and stumbled across this it left me traumatised and in need of councilling as well as persecuted by them whan they failed thier monitoring like there is no one to blame within thier comapny it has to be evryone else
I agree with you completely about it being safeguarding issues and i cried for weeks and weeks emotionally felt
Im glad they are being monitored and I have faith in the system to assist them with change and best practise advise
I have been working within the care profession for 22 years in all different roles this is the worst care i have ever been exposed to and the poor service users they thought it was how it was done
wearing a uniform is automatic trust and the elderly dont have enough information to know this isnt right
this is a thought surely we should ensure the service user has enough inforamtion about procedures without getting too oficial to know whaen things are not right?