Letter #3 to the Police about Care Failings

Here is the third letter to Greater Manchester Police (G.M.P.), along with various other relevant persons/agencies, sent approximately two months after letter #2 (see previous post). Again, neither my advocate nor myself received any responses.

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Colin-Roy Hunter B.Ed.(Hons.) Esq.

[Redacted]

Chief Inspector of Greater Manchester Police

Stephen.Watson@gmp.police.uk

Cc. Graham Brady MP for Altrincham & Sale West

altsale@parliament.uk

Cc. Sara Todd, CEO Trafford Council

sara.todd@trafford.gov.uk

Cc. Dr. [redacted], Consultant at [redacted, hospital]

Cc. Dr. [redacted], G.P. at [redacted, medical practice]

Cc. [Redacted], housemate

VIA Email

[Redacted] February 2023

Dear Chief Inspector,

Breaches of Care Act, Assault & Trespass

SECOND REMINDER

Further to my letters to you dated [redacted] December 2022 and emailed on [redacted] December, entitled “Urgent Safeguarding Needs”, and my follow-up letter dated [redacted] December 2021 (sic - 2022) and emailed on [redacted] December, I note I have not had the courtesy of a response.

CURRENT SITUATION

I have had no medications since [redacted] December, i.e. for 64 days (2 months; 9 weeks), including anxiety, circulation and ulcer medications.

I have had 3 hydration-system refills (needed daily at least) in 64 days, each time during a visit by my ex-boyfriend; thus effectively 61 days without the hydration-system. In that time it has not been washed nor sanitised.

I have had no meals (due to no-one available) on 7 out of the past 64 days; only one meal per day on 51 of the last 64 days (usually after 20.00 when housemate returns from work &/or hospital visits); two meals on 5 out of the past 64 days; three meals on 1 out of the past 64 days (Christmas Day).

I have had no snack-bowl (fruit & cereal-bars) - a daily requirement - on 61 of the past 64 days.

I have had to survive on a single cup of water for some 20-22 hours/day over the majority of the past 64 days.

I have had no heat-pads for 64 days, which combined with no circulation meds, means I have been and am suffering from cold in my extremities. Sporadic bleeding has now returned to my toes

I have had no face-wipes over the past 64 days; no washes over past 64 days; no showers over past 64 days; but I have had 9 baths (6 supervised by housemate; 3 by ex-boyfriend - I usually average one bathe each week).

I have not brushed my teeth on 63 out of 64 days. The single occasion was supervised by my ex-boyfriend. I recall to mouth-wash occasionally (once or twice per week) when in the en suite.

Etc., etc.

My weight dropped from 68.2kg to 65.0kg in the first 10 days due to lack of food & water. However, due to Yuletide, housemate gave me lots of confectionery, cakes, pastries, bread, cheese, etc., I am currently 66.0kg. Housemate has been adding butter to almost everything, e.g. atop potaoes, veggies, meat. This kind of diët is not sustainable as it is too high in sugar & fats, and lacks fruit & veggies, so can only be viewed as a short-term stop-gap.

NAUSEA

“Chronic Nausea” continues on an almost daily basis. Recall that the NHS advice advises to: “take regular sips of a cold drink” & “eat smaller, more frequent meals”.

MIGRAINES

A couple of days ago I came out of a 13 consecutive day cluster of migraines. Migraine is item [redacted] on the Carer FAQ document and is covered by items [redacted] on my Conditions etc. list. Migraines are aggravated by lack of hydration.

ANXIETY

Almost anything is now triggering anxiety- or panic-attacks. It is increasingly difficult for me to remain calm. I now invariably wake from sleep in the midst of an attack.

INSOMNIA

The anxiety is having a knock-on effect on my sleep. For the past few weeks I have not been getting anywhere near average sleep. Mostly I have been sleeping in 2-3 hour spurts. Per Fitbit almost all my sleep quality - when it has enough time to calculate - is poor or fair (not good nor excellent). This is demonstrably worse since the carers were withdrawn.

LEGAL LETTER

I have still not received the letter from Trafford Council’s legal department, promised by the manager of Trafford’s Re-ablement Team - see first letter for details.

COMMUNICATION

On [redacted] January I sent an email to Trafford Council containing a letter dated [redacted] January 2023 for Trafford ASS in relation to my “Issues with Communication”. Receipt was confirmed same day. It is becoming increasingly difficult for me to communicate with the outside-world, let alone face to face. I am appending a copy for your records and attention.

SAFEGUARDING

A safeguarding-review ought to have been carried out after each complaint to Trafford Council/Trafford Re-ablement Team/Trafford social-workers/Trafford Councillors/etc. Instead my complaints about failings were not acted upon - had they been, my health may not have deteriorated so drastically! Obviously, we are well past Trafford Council acting with regards any safeguarding-review. Furthermore I should not trust them to act objectively at this point based on their in/actions thus far.

I have lodged complaints with you, Chief Inspector, and thus should appreciate you taking action to safeguard my health & wellbeing, as bodies & individuals that/who ought to have done so have failed and continue to do so.

Housemate’s mother sadly passed away on Saturday gone. He is even more distrait than ever.

My health & wellbeing will continue to deteriorate until appropriate measures are put in place.

I look forward to hearing from you, Chief Inspector.

Yours,

Colin-Roy Hunter

Continuing Failures to Care

Whilst this blog-post can be read without reading my previous post, “Crime, Death or Asylum”, the reader may wish to read it for background. This previous posting details some of my health conditions and the ramifications of the change in care-provider including loss of weight, severe dehydration, some quite severe reäctions to change in medication and care, and the over-all deterioration in my health since the council-owned care-agency took over in April 2021 and changed my care-regimen in August 2021.

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For some nine weeks I have been resident in my home’s guest-room. It is by far the snuggest room in the house, for some reason we have never quite figured out.

Normally I work my way through at least one whole box of mansize-tissues per week; but since the change of room I have only used up two boxes. I am allergic to dust - something which is rather difficult to avoid. My usual bedroom must have been extremely dusty and hence my constant sneezing and running-nose!

Normally we clear me out of the bedroom once per year so that it can be deep-cleaned. Alas, last year I was just not well enough to leave my room for any useful length of time. Indeed, this year, simply moving to the guest-room caused me to be almost totally bedridden for some three weeks, excepting using the lavatory for defecating and the occasional urination.

When I was finally able to rise from my bed to attend to practical chores in my usual bedroom, I discovered as I picked up objects, books, etc. just how dusty the room had become. Dust-balls rolled across the hard floor-surface like tumbleweed! The tops of books had the finest dust-coatings I have probably ever seen. However, when one reälises that there were five tubs-worth of books in my room, that adds up to a heck of a lot of contaminants!

My housemate has nearly completed the deep-cleansing. Most of the room plus its en suite have been vacuum-cleaned, mopped and hard-surfaces disinfected. There are just a couple of chores remaining. Then I may start moving some of my things back into my personal bed-cell.

[Image description: the writer in his usual bedroom]

Carer Duties

I have to say that the standard of care since my move, some nine weeks ago, has probably deteriorated. Remember: whilst mostly my long-term memory is fine, my active-memory is shockingly poor (and this is typical of someone with my chronic-illnesses); I have to be prompted with precise, closed-questions (to which a yes/no response can be given).

Personal Hygiene:

Number of times carers prompted me to shower - ZERO

Number of times carers prompted me to brush my teeth - ZERO

Number of times carers prompted me to mouthwash - ZERO

Number of times carers prompted a change of bedding - ONCE (M)

Number of times carers prompted to use a face-wipe - ONLY J1

Number of times carers prompted a change of clothing - ONLY J1, J3 & M

Food & Drink:

Number of times carers enquired as to what, if anything, I had eaten - ZERO

Number of times carers enquired as to what, if anything, I had drunk - ZERO

Number of times carers checked on water-consumption (water-cup & hydration-system) - DAILY

Number of times carers failed to fill water-cup - J2, J3 & J4 usually forget

Number of times carers failed to replace snacks - J3 & J4 usually forget

Number of times carers failed to enquire whether I wanted something to eat - most of the time, all carers forget.

Medication & Support:

Number of times carers failed to provide medication - ONCE.

Number of times carers enquired whether I needed a heat-bag - ONCE (M)

Trafford Adult Social Services (Trafford ASS) have been over the years repeatedly provided with detailed lists of carer duties, as has the Trafford Council-owned care-agency (or previous care-agencies) and as has my social-worker (and previous social-workers - yes, they are constantly changed). None of these agencies has ensured these lists are actually used, despite reminders and complaints from myself.

After more than a year of being under this selfsame care-agency I only recently discovered that nothing is provided in my file as to what duties are required of carers. Carers have been relying on my housemate (not always at home and anyways gets really annoyed at being constantly asked for the same information over and over) or myself - a person with appalling active-memory.

One carer advised me that due to the care-agency usually only retaining clients for circa three weeks, they have never bothered with duty-lists. However, I have been with this council-owned provider for some fourteen months. This is indicative of a failing to ensure continuity of care and appropriate care. How many other Trafford residents are being failed or have been failed by this deliberate recklessness?

Over a ten-day period I had six visits from a new carer. Trafford ASS etc are well aware that I will not undress with newbie carers until I have developed trust. Put yourself in my position by asking yourself how comfortable or not would you be with undressing or being undressed by a total stranger? Apart from the fact this newbie (J4) had not been mentored through what is needed here, her unwillingness to read through the file to find out her duties and thus her consequent failures in care, there was her lying in the notes after her very first visit. This really does not help me trust someone.

On J4’s first visit the care-agency did not notify me that a new carer would be attending, so I could not ensure housemate was at home. On this occasion he was out. J4 arrived extremely late for a 16.00 first call of the day at 18.09. Apparently she had been training. This meant I had not been fed, watered or medicated for twenty-two hours. There was also a knock-on effect: one of my medications has to have a minimum four hours between doses. Taking this medication at 18.26 would have meant the next dose could not have been taken prior to 22.26. The carers official finish-time is 21.00. One can immediately see the issue. J4 tried to press me to take the medication earlier, but I quite correctly refused as the minimum elapsed time had not passed. J4 noted that this was an outright refusal to take medication. J1 the next day, added an addendum to confirm the facts.

Effectively this was a failure by the care-agency to medicate me. Furthermore, this has not been the first time this year. There have been at least three other occasions in 2022 when the agency has failed to give me my medications. This is a repeated failure to medicate and thus fulfil their contract. Recall this is the council-owned care-agency not some penny-pinching private-enterprise. Imagine how those with private companies are fairing!

Update on my previous blog-post

Despite sending the link to the blog-post to various bodies and organisations, including Nicola Sturgeon in Scotland, I did not receive one single response. I could have committed suïcide. I could be dead from dehydration.

As I commented on Twitter, once one becomes disabled &/or chronically ill in the UK, one become to all intents and purposes invisible and uncared for. The United Nations (they also failed to respond) has repeatedly condemned the UK’s treatment of its disabled population - some eleven million individuals. However, the ultra-right-wing ruling-party and indeed the neoliberal alleged Opposition, do absolutely nothing to ameliorate the on-going situation. Nor will they.

No-one actually genuinely cares…

What Does Housebound Mean?

 

For several months I have been attempting to determine from my G.P. (family-doctor) whether they recommend me having the Covid19-vaccination (taking into account my various health-issues), which type to have if vaccination is clinically appropriate and also to arrange for the jab to be given at home, due to my being mostly bed-bound or bedridden as well as mostly house-bound.

I received a reply, after several reminders over these past months, last week. The practice-manager wrote:

“I have reviewed you medical record and given that you are able to travel abroad for the winter this technically does not make you housebound.” (sic)

The reader may consider that the practice-manager’s perspective is valid. However, there is no legal definition of what constitutes being house-bound (ditto in re “bedridden” or “bed-bound”). Thus, there can be no technical breach of a non-existent definition.

I have replied to the message I received and below is the pertinent section.

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Now to the the very thorny issue of what constitutes being “housebound”. As you are no doubt aware, there is no English legal definition. However, there appears to be a working NHS definition (alas I could not track down), upon which the following seem to be based:

“An individual will not be eligible for a home visit if they are able to leave their home environment on their own or with minimal assistance to visit public or social recreational public services (including shopping)” [source]

“A Housebound patient is defined as being an individual who is unable to leave their home environment due to a physical or psychological illness. An individual is not housebound if they are able to leave their home with minimal assistance to visit, for example, Neighbours, Hairdresser, Supermarket, Bingo.” [source]

“A patient is considered housebound if… The patient cannot leave home without considerable and taxing effort.” [source]

I have thus far this year only left my home on three occasions, each time with carer-support: on 12th February for a 3 minute visit a mile away (via car) to my ex-boyfriend who has cancer and who has been in a bubble of one during lock-down periods (equipment: walking-sticks & portable stool) - it took approximately two days for me to recover from the exertion; (via car) to vote in May (equipment: wheelchair) - again, it took approximately two days for me to recover from the exertion; (on foot) to visit my next-door-but-one neighbours for a socially-distanced cold meal on 22nd May (equipment: walking-sticks) - it took approximately five days for me to recover from the exertion. None of these were appointments, as I am currently unable to specify an exact time when I can do anything due to the precarious state of my health. You will note I have not left my home even once per month. In fact, I have managed to leave my bed-cell (bedroom) less than once per week this year. And that is also the same sort of statistic for last year as well.

I am NOT able to leave my home without taking into account:

* carer support - to prevent accident incl. falls (inter alia dyspraxia, BP), to support when narcoleptic ([hospital specialist/consultant]’s term) and general assistance, incl. financial know-how (inter alia dyscalculia, dyslexia);

* wheelchair or walking-sticks [US canes] (e.g. to neighbours) depending on distance;

* pain medication prior to, during and after any journey, time/distance/purpose dependent;

* incontinence-pads, depending on distance/destination/purpose - if I am likely to become anxious, then the pads are needed;

* water-bottle for car-travel as I require frequent urination when nervous, and travel generally makes me anxious;

* rest - I save up energy prior to journeys and rest afterwards to ensure I try to remain within my energy-envelope.

* sunglasses - to prevent photophobic pain.

* ear-plugs/head-phones - to prevent pain due to hyperacusis.

Under no reasonable understanding can my personal situation be deemed to be outside the remit of needing more than “minimal assistance”. When travelling abroad I take one or two carers, depending on need, as I have to be pushed in my wheelchair (partly due to the chair being unsuitable for self-propulsion) and assisted to do almost everything. Remember, here in the UK, I have carers to ensure I eat, take medications, drink and to help with personal hygiene & dressing. I am wheelchair-ed throughout the æroport. I need assistance to use the æroport toilets. I am assisted on to aircraft either manhandled or via Ambulift, depending on the æroport’s facilities. Again this is not “minimal assistance”.

Additionally for the past couple of years or so I have been bedridden [aka bed-bound] just over 95% of the time, up from my previous 85% proneness.

My en suite w.c. is 3 metres from my bed. It typically takes me upwards of 8 seconds to reach it, depending whether I walk (shuffle) or quite literally crawl. The latter I only need to do when defecation becomes necessary (IBS, diarrhœa), as I have a water-bottle for urination.

Additionally, due to my frequent falls, when out of bed and when alone in the house I wear a pendant-alarm so I can call for assistance. Frequent falling is a sign of frailty.

I also have severe difficulties in mounting or descending stairs, so generally go down on my bottom and crawl up on hands and knees. The inability to use stairs is indicative of frailty.

It is my understanding that my gait speed would also indicate frailty. Indeed, using the Edmonton Frail Scale, I come out as having mild to moderate frailty, depending on the time of year/my state of health. And bear in mind, I am not yet even considered agèd!

Furthermore, were I to be taken in an ambulance to Addenbookes or a London hospital, it would take much longer than the journey to Spain, for example. Being able to leave one’s home with assistance does not lead to the conclusion one is not house-bound, but rather the opposite, that one is house-bound without assistance.

So, to sum, I am de facto both housebound and bedridden the vast majority of the time.

Your definition and understanding appears to be lacking in understanding of my personal situation (odd given you are aware that some years I travel to Spain under the advice of both my G.P.s and hospital consultants!) and everyman’s reasonable definitions of the terms “housebound” and “bedridden”.

In the circumstances, I must insist that you develop a thoroughly thought-through policy with clear definitions of what [the medical-practice] considers “housebound” and “bedridden”. It is then imperative that [the medical-practice] goes through its patient-records and appropriately corrects them as well as taking any pro-active actions to remedy any failures to support patients.

[Image description: the writer in his bed-cell]

 

Pain-Patches - a G_dsend!

About fours year ago I was prescribed pain-patches to help control my pain-levels, especially my spinal pain. Whilst never totally pain-free, the patches have massively reduced what I was suffering and reduced spinal pain to just occasional twinges.

So I have ten to eleven (the latter is my back so carer-support needed) locations around my body where I can place the patches - on a hirsute person like myself it is not easy to find skin without too much hair! Constantly revolving the spots where the patches are placed is to prevent skin issues.

Since puberty I have been reäcting to sticking-plasters and even micropore-tape. A couple of years back I incurred a burn from a certain pain-patch manufacturer’s adhesive. I notified my supportive G.P. and my friendly pharmacist. From then on, that brand has not been prescribed to me, barring one mistake by a trainee pharmacist after which I incurred a second burn.

Unfortunately, over Christmas-time, it has not mattered where on my body I place the patches (and I use patches from two different manufacturers) I have been burned every week. These wounds are extremely sore and difficult to appease. I started using burn/scald-cream and that really helped ease the severe discomfort and also helped the burns heal faster than without.

After chatting with my housemate who works in Pharma, I decided to immediately stop using the pain-patches, to give my skin a rest. These past few days have been quite unpleasant as I go through withdrawal-symptoms and incur a huge concomitant increase in pain.

My heavy-duty pain-killer is not generally prescribed by G.P.s, but in my case, because I only take as a last resort, my G.P. was and is willing to prescribe. Normally I take on average less than a tablet per week. At the moment I am taking them whenever the dosage time-span is up. I had quite forgotten how much pain I used to be in on a quotidian basis. At least I am now reminded how effective the pain-patch medication has been and indeed is.

I am thankful today for scientists, research-assistants, statisticians, folk who sign on to drug-trials, drug-manufacturers, truck-drivers, doctors & nurses, pharmacists, my housemate (who collects my prescriptions as they cannae be delivered due to “controlled drugs” status), and the carers who remind and help me change the pain-patches. We are so inter-related and inter-connected in our civilisation: no man is an island! I AM thankful. 

Visiting My Local Supermarket During Lock-Down

Well, what a morning - totally exhausted!

Breaking my quarantine:

After twenty-two days of self-isolation, my stores of foodstuffs have been depleted. Whilst I have succeeded for the past fortnight to get fresh aliments and some staples home-delivered, I have been unsuccessful in my attempts at obtaining a delivery-slot from local supermarkets, and this week I could only source a small, insignificant basket of goods from a farm. Many disabled folk who rely on home-delivery have been unable to get their usual slots and there are many who are going without food. The national government has been extremely ill-organised in its whole dealings with regards the pandemic, and appears to have had no contingency plans in place/ However, my local authority ,Trafford, is telephoning folk it believes may be vulnerable and need support to check whether they do so. I have been very critical of my local authority in the past few years, but it is good to be able to applaud them for acting so pro-actively in this instance.

Preparations:

I awoke really early so I could be ready to shop at my local supermarket, Waitrose, along with the other vulnerables during the first hour of the opening-hours set aside for us. My housemate, Rico, who often acts as my principle carer, helped me dress as it was way too early for one of my regular carer calls. I decided upon clothing that could be stripped and go straight into the laundry upon my return home. I donned a long-sleeved top over a T-shirt, gloves to keep my hands germ-free and a scarf, in case it was needed to wrap around my face. Rico loaded the wheelchair into the back of the car. I grabbed a load of bags and my wallet, and we set off a little after nine, store opening-time.

At the supermarket:

I was rather pleasantly surprised at how organised everything is. There are markers at two-metre intervals so shoppers queuing can ensure they retain social-distance. For the most part customers kept their distance bar one odd curmudgeonly old git. The queue moved quite briskly and we were less than five minutes outside. Staff were extremely helpful. They were also very polite and apologetic to the three sets of customers who complained (in that time-frame) at them because they were not permitted to enter until ten and were thus turned away. The first hour of shopping has been reserved for the past fortnight at most large shops for the elderly and other vulnerable folk; and this fact has been in the newspapers and on the news programmes. If individuals have missed a trick, then that is their problem and they ought to accept their oversight with good grace rather than taking out their frustrations on hard-working staff. Let’s face it: we are meant to be staying at home and not visiting others, so most would not have good reason to be in a rush to be elsewhere!

A manager taught me how to use self-scan. I don’t recommend it for big sprees when this is all over, but probably good for a quick grab-and-go shop. However, it meant only I was handling the shopping. I wheeled round the whole store, whilst Rico pushed the trolley and packed the bags as we went along the shelves.

All the counters (butchery, fishmongery & deli), the café and the self-serve coffee-maker were shut down; but the bakery is still churning out fresh loaves - ours was still warm when we picked it up. The flour area was devoid of anything other than bread-making flour, but with no yeast available it was standing untouched. I had a kind server hand me down a bread-mix containing its own yeast medium, so if necessary I can make some bread of my own - well, actually, Rico is the resident bread-baker, so it would be over to him.

Normally, at the point where we reach the café, we should have stopped for a cup of coffee and a snack, a short rest and then continue with the task at hand. However, the café has now been turned into an extended holding area for customers awaiting to be allocated a cashier to assist.

The freezer-zone looks as if locusts have passed through. Plenty of frozen spinach to be had though! Toilet-rolls are aplenty, but rationed to two packs per shopper. We have plenty from our BREXIT stores, but did buy another pack of kitchen-roll. There were hardly any tissues, but I succeeded in finding a double-pack of Kleenex on a low-shelf - one advantage to being in the wheelchair. Similarly, there were no general cleaning sprays.

Results:

Thankfully, barring a handful of items, I obtained everything on my extended shopping-list. I am thankful that This Easter I shall be able to have a traditional lamb-roast, even if the friends who may no longer attend are absent. I shall certainly raise a toast to absent friends and say a few prayers for them.

[Image description: kitchen-counter covered in shopping and food preparation.]

Afterwards:

One hour and fifteen minutes from leaving the house, we stepped back over the threshold. I immediately stripped off my outer-layers, gloves & shoes and went to wash my hands. After stowing the shopping and washing the fruit & vegetables, intermittently re-washing my hands after dealing with packaging, I returned to my room and had a hot soapy shower. Hopefully, I shall have managed to bypass the virus. I should not need. To go out again for another three weeks or so. Thus there is time to see whether I do develop any symptoms. Fingers crossed. And my prayers for all.