Behind Closed Doors – why do older people still experience such poor care?

Sadly, through working on a campaign like Care in Crisis at Age UK, I’ve heard plenty of horror stories of older people experiencing poor levels of care at a time when they are most vulnerable. But even I was shocked at what BBC’s Panorama uncovered in their programme on care homes, Behind Closed Doors, this week.

Neglect, bullying and taunting, being ignored, rough treatment and even outright assault: this is what was found during secret filming in more than one care home. It left me feeling upset, distressed and angry. How is it that this sort of thing can still take place in 21st-century Britain?

Before going any further, I feel it’s important to point out that there are some fantastic examples of great quality care taking place in care homes, where vulnerable older people, some with very complex needs, are able to live the final months and years of their lives with the dignity they deserve.

But every example of bad quality care is one too many.

Everyone has a right to expect good quality care

At Age UK, we have been calling for wide-ranging reform of the social care system through our Care in Crisis campaign.

As well as ensuring older people are able to access the care they need, we believe that everyone should be able to expect good quality care, whether that’s in their own home or a care home, via the local authority or as a self-funder.

Most recently, we have been campaigning to ensure that all older people in receipt of care are covered by the Human Rights Act, and we are delighted that we have made some big progress on this.

Because it was quite clear in this Panorama investigation that human rights were not in the mindset of the carers committing those abuses, they forgot they were dealing with real people who have families, personalities and characters. Many of whom survived the Second World War, raised children, worked hard and contributed to their communities throughout their lives.

The care that some received was, at best, treating them like children, and at worst, completely dehumanising. No one should ever have to expect to wait over an hour to be taken to the toilet and then be told to just use an incontinence pad. Nor should anyone be ridiculed, sworn at or slapped while supposedly being cared for.

The programme was distressing because it could have been our mum or our dad, our partner or another loved one – even ourselves – in that situation. All of us want to be able to live our final years with dignity and a good quality of life.

One man on Panorama, whose loved one had experienced neglect in Orchid View care home, put it aptly when he said that: ‘We can put a man on the moon, rockets in space, reach Mars, but we can’t look after the elderly.’

Why neglect is still taking place

Why is it then that abuse and neglect are still taking place? The answer is a complicated one.

It involves poor staffing levels in some homes, inadequate training and support, not listening and learning from complaints and care homes remaining ‘behind closed doors’ – cut off from the community.

The Care Quality Commission remains under-resourced and unable to adequately inspect every care home. There also needs to be more support for whistleblowers to come forward about poor care and their complaints to be investigated swiftly and properly.

The Government will point to the Care Bill and the measures contained within that will improve the quality of care, and rightly so. There will be minimum standards for training, a new principle of wellbeing at the heart of the care system and improved safeguarding.

But there is still a long way to go before this problem is properly addressed and at least some of it can still be attributed to the chronic underfunding of social care and the impact that cuts to local authority budgets have had.

There was a rallying cry in Panorama from Lynne Phair, an independent consultant nurse, who said: ‘Things will only change because society finally says we will not tolerate this anymore.’

And change they must, or we can expect to see more Panorama-style investigations in the near future. That, we should all agree, is utterly unacceptable.

Find out more about Care in Crisis.

If you are concerned about poor quality care for you or a loved one, contact Age UK’s advice line on 0800 169 65 65.

24 thoughts on “Behind Closed Doors – why do older people still experience such poor care?”

  1. because these Care Homes do not bother to properly vet their Care Assistants before they employ them to ascertain if their approach to the elderly needing care is one of empathy and compassion and not just for a salaried income like for a cleaning job..

  2. I think it comes down to this: when some people look at you, they think ‘old’ but don’t know the amazing and valuable things you’ve achieved in your life, and therefore don’t know your value at all! Whereas family, neighbours, friends, people you network with, do know your worth, strangers don’t.

  3. Poor management – poor training – poor pay – just for starters. My Mum is fortunate and in a superb home – the owner manager is always available and the buck stops with him – he always knows what is happening – and is always available. For those in poor care who have no visitors – who is to pick up on bad care – it is very frightening. That programme should be a wake up call for all who work in the care system – be it in the home or in residential care.

  4. Pay peanut money you get what you deserve these company’s
    Are there to make money and peoples welfare is the last thing on their

    1. Yes I agree with the minimum wage as in peanut money but still not all Care Assistants treat their elderly residents with mental or physical abuse, the Care Home managers or their recruitment staff need to be far more selective in their interviews, using whatever psychology tests that commercial firms use to get the best employees suitable for the job and of course pay a LIVEABLE wage as there should be no minimum wage. And how come £700 or much more a week [that’s £2800 upwards a month] – justify the abuse and neglect seen in this series that represents shamefully on a national scale. There should be more governmental control on the way Care Homes run.

  5. i have been studying a introduction to health care with the open university I have read much about poor practice. I have also read a article the bedroom work where much of care of the elderly is unseen. I think that there is little jobs now and some people do actually enter into care purely for financial reasons rather than having empathy for the job itself. There is training in this line of work but its what you take out of it and i have heard many comments such as what a load of rubbish after such training’s.

    I work as a carer myself and have done for some years there is a fast number of Yong people in this sector now who are very good carers however there are still some very inexperienced carers that just don’t grasp the commitment to the work.

    Caring for the elderly is very hard work indeed and there are some care homes that just run either understaffed or untrained.We now have the care inspectorate. I feel much is hidden from them to, and that they themselves just don’t have the resources to check everything.

    Visits from the care inspectorate all seem to run on a numbering point system for the homes if the homes are downgraded on this it seems that meetings are held after their visits,its then that the care workers themselves feel demoralized in their duty.This then seems to have a impact on the care.

    I can understand why some relatives would put in cameras because of poor care they see on TV. This is completely understandable .There is much talk about having this implemented, if this was so then I think that we would then have a shortage of care staff as many people wouldn’t work under such condition.I don’t have all the answers.However for such a responsible job carers need more of a incentive. I hear all the time carers are very poorly paid for such a responsible job this is indeed a fact.The answer always seems to be then don’t do it that’s really not the answer professional carers want to hear. we want change and want to help but we need more support.The fact is that many carers are not supported in their job role.This is actually down to a management team.There are some good and some bad there has to be something done now about care of the elderly before it gets totally out of hand but the care staff do need general public support

    I my self will continue in this line of work helping and doing what i can for the elderly. I am a moving and handling trainer as well in my job role.Therefor i can help other carers to do their job a little better We will all get old one day and we need to remember that.

    I think that we need to all have a understanding on dementia care as well and feel that some carers don’t know how to cope with this and this has a impact on poor care

    take care

    Steven jamieson


    1. I think CCTV in Care Homes might be a way of tackling abuse and can understand it would put people off working under such conditions, still if care is provided as it should be in a caring, thoughtful way then there’s is not much to hide but bringing in personal surveillance by way of gadgets is the next best choice especially when there is good cause to do so,

  6. I agree with Diane, the care assistants should be vetted and I think should have much more training than what they have now. That goes for the Carers who go out to the homes as well. The homes seem to be employing any moron who only take the job because they have to.

  7. I think the pay should be a lot better. This job should be taken by someone who have a of understanding of the human race and have sympathy and empathy. Just cos someone is old does not mean they should be badly treated. Those old people can and have contributed a lot over the years. Not young people who only take the job because it is a job. Seems to be a lack of training all round. We treat our animals better than we do our aged people.


  9. Care Homes need to have higher levels of staffing and they need to be much more open and connected to the community. Staff are too scared to whistleblow as they fear losing their jobs. Some managers are ruthless in their treatment of staff.

    1. those ruthless greedy managers or Care Home owners need to go, restrict them by having this kind of business but how, that’s a good question!

  10. When abuse is publisised everyone shouts & jumps up & dowm about it. Some of us have been whistleblowing for 20 years and have suffered because of it. I have reported abuse to Health Authority NH inspectors, CSCI, CQC and safeguarding units and AEA. I have been threatened with being reported to GNC & NMC. I have lost numerous jobs since 1994. Whistleblowers must have protection. I am hoping to start a new job after WB about a home in Co Durham. Will I speak out again? I dont know as it is me and my family who will suffer again

    1. yes agree there must be laws to protect whistle blowers in these Care Homes anywhere where the vulnerable are, this issue should be lobbied at government level especially in 2015 when hopefully there is a change in government.

  11. I know of a home that has been inspected twice by CQC and still not up to the standard that it should be ( not my words) I have just done a shift in another care home and pointed out some very poor practice, and I’m the one who has now been told I can’t go back! I don’t want to go back that home has just been inspected and passed. I would love to work under cover but what’s the point of reporting it if they don’t do anything

    1. …never give up with ‘under cover’ work because as with anything in our society it takes time before changes are realized and made good. If a Care Home repeatedly accumulates a poor reputation in its elderly care, should it be abuse and/or neglect, it will be the Care Home that will eventually suffer financially be it in change in ownership or.eventual closure..

  12. Furthermore the Care Home and a specified number of staff in question that were highlighted in ‘Behind Closed Doors’ – is now under investigation by Essex Police which in itself is a good result because when in the future it becomes well known nationally that perpetrators of abuse, physical or mental against the elderly in Care Homes will be deemed as ‘an assault’ offense against the individual, like with any other young or old. That realization should make those inclined to have that approach think twice about their actions or the job they pursue. More whistle blowers need to come forward and make this public as even prisoners these days are usually not subjected to unmitigated assault so why should the vulnerable, the frail and sick be on an every day basis should they have the misfortune to be in one of these Care Homes.

  13. One of the biggest obstacles in improving care and stamping out poor practice is not just management but with owners / service providers not liking it one bit when management flag up concerns. If you have a weak or poor manager that just takes it lying down, nothing will change and many think that without the backing of the owners or in cases of larger providers, the regional managers etc – they’ve essentially done all they can. Then there are the poor managers that don’t even make it as far as discussion with anyone else when someone raises concerns.

    There needs to be more support services for care home staff and managers so they can go directly with concerns they either can’t flag up with senior managers or have already flagged up but find themselves getting nowhere fast. Also an obstacle is the number of care staff that submit complaints anonymously to either CQC or the local authority because not giving their details or providing specific evidence means most complaints will be unsubstantiated. Having spent several years working with a safeguarding team, one of the most frustrating things I found was the number of staff that only disclosed concerns as a result of unrelated disciplinary action and / or after they’d left their jobs. I’m keen to stress to all the staff I manage that they mustn’t sit on any worries or concerns and if they can’t come and speak to me directly for whatever reason, to alert the local safeguarding team or CQC and then it can be properly investigated but sooner rather than later.

    I take issue with people implying that young or inexperienced staff tend to be the worst culprits for neglecting and abusing because in actual fact, newer, inexperienced carers are by far the most likely to spot and report what they don’t feel is right. Much of the time, the staff that are alleged or found to be neglecting or abusing are long-standing, so called “senior” staff.

  14. This is such a frustrating topic to read. Its pretty obvious that in a society where people live for the weekend, they will pretty much do anything for a job as long as it pays well. I’m not saying everyone in care is simply after the money as there some genuine carers who do it for the rewarding aspect of helping others.

    From personal experience I have seen and know of many people who are in the job for the money and have an absolutely terrible attitude towards those that they look after e.g. lack of patience, tolerance and morals.

    In this day and age where technology is fast evolving and the world is becoming to fast for the elderly, we need to ensure that carers actually want to help and not just pick up a wage check. they should be monitored for certain psychological aspects and be under supervision for a long period of time.

    Private and public care organisations don’t care who they employ a lot of the time and this is obvious due to the high staff turnover.

    A company created a map of all the worst CQC scores in all the counties in England (, this should be used to tackle the poor care issues and a structure should be implemented to ensure that standards don’t slip.

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