Revealed: The care contract ripped up over institutional abuse of elderly

The Argus reported last week how East Sussex County Council was on the brink of pulling the plug on its £2million contract with MiHomecare - known as Mitie - because of poor standards of care.

The firm pledged to look after 700 elderly and vulnerable people through home and community care across Rottingdean, Lewes, Seaford, Newhaven, Peacehaven, Hailsham, Eastbourne and High Weald when it began its five-year term in October last year.

But just nine months after putting pen to paper, the contract has been ripped to pieces by council bosses, who have given Mitie six-months notice of their intention to cancel the agreement. The blow comes seven months after MiHomecare lost its contract with West Sussex County Council because the firm was “unable to provide safe and sustainable care to customers”.

East Sussex County Council bosses confirmed its deal with MiHomecare had been scrapped shortly after The Argus asked to speak about a damning report into standards of care at Margaret House residential home in Uckfield.

The internal council report, obtained exclusively by this newspaper, concludes MiHomecare was responsible for a wave of "institutional abuse" that saw one elderly dementia patient confined to a chair for hours on end without food or medication. Six other serious incidents were investigated by the council.

Quizzed on whether the East Sussex County Council would be dipping into its coffers to terminate the contract with MiHomecare early, a town hall spokeswoman said: “We can’t go into too much detail about the contract as much of the information is considered commercially sensitive.

“But the payment from the council to MiHomecare is based on the level of service provided, so there is no upfront payment nor additional cost to terminate the contract early.

“Our contracts are monitored and regularly reviewed taking into account quality, value for money and ongoing need for the service. These factors then inform any decision about our contracts with providers.”

The council also stressed the hundreds of elderly and vulnerable people currently receiving care services through MiHomecare would be given "all the support they need" following the company's departure.

The council spokeswoman added: "We will be using county council approved providers and, where appropriate, we will also offer clients the option of a direct payment."

What The Argus discovered when it obtained an internal report into standards of care at Margaret House, Uckfield

AN ELDERLY dementia patient was left in her chair for five hours with no food, drink or access to the toilet in one of a series of damning “institutional abuse” cases at Margaret House.

An exclusive Argus investigation has discovered the pensioner’s calls for help were ignored three times while she suffered through lack of food and medication.

The incident was one of seven safeguarding cases at the Uckfield home investigated by East Sussex County Council.

In another incident, staff failed to take action when problems arose with an elderly women’s catheter. She eventually needed medical attention because of urine retention.

A council spokeswoman said yesterday: “Following concerns raised by relatives of residents, as well as issues identified by our own quality monitoring staff, we undertook a safeguarding investigation into the care provided by MiHomecare at Margaret House.

“The investigation substantiated those concerns and MiHomecare were required to develop an improvement plan to bring their services up to an acceptable standard.

“We regularly monitor progress against the targets within the plan to ensure that the residents at Margaret House receive the high quality and consistent care that they are entitled to.”

As well as institutional abuse at Margaret House, a damning report obtained by The Argus also documents concerns about a lack of staff training, ineffective management and worries from elderly residents who said they often struggled to speak to staff.

When East Sussex County Council was looking for a home care provider for Margaret House in 2013, it stressed that an “onsite care team will be expected to provide 24-hour waking emergency cover” at the home.

But after winning the lucrative contract, MiHomecare ran an operation where relatives of elderly residents complained about getting hold of staff.

The critical report from reads: “Relatives have commented on the difficulties getting hold of staff, particularly out of hours.

“On one occasion a relative could not contact staff by telephone. When she asked why, she was told there were only two members of staff on duty. The system is supposed to ring through to workers’ phones – but that did not happen.”

Long hours and low staff numbers were also contributing to low morale among care workers.

The report said: “Shortage of staff has put pressure on staff and this had a negative impact on the quality of care. New staff and agency staff lacked understanding of residents’ needs, this was particularly problematic for residents with complex needs.”

The report concluded: “This investigation has highlighted that there have been concerns about the service provided by MiHomecare at Margaret House since its commencement in August 2014. The systems and processes in place have been found not to be robust or effective.

“Communication has been poor, recording, care planning and risk assessments have not been of a consistently appropriate standard.

“This has led to a lack of adequate or appropriate support and care to residents. They have been placed at risk of harm and in a number of cases harm has occurred. Senior management appear not to acknowledge or recognise that the systems in place are not adequate. There appears to be a lack of accountability; when things go wrong individuals are blamed. The allegation of institutional abuse is substantiated.”

The damning report is a world away from MiHomecare’s start to life in East Sussex in October last year, when it announced it would create 350 jobs as part of its home care contract with the council.

The company, known as Mitie, entered the healthcare market three years ago with its £112 million acquisition of Enara. But in March it warned its full-year operating profit would be below market expectations as its home care and social housing arm had been hit by “pricing pressures”.

Ruby McGregor-Smith, Mitie’s chief executive, has previously declared problems with staff retention. About half of the company’s care workers are on zero hours contracts.

She added: “We should pay carers above the minimum wage. We always offer a living wage option but it’s up to local authorities what they pay. Where we pay the London living wage, retention is not an issue.”

Commenting on the damning report into levels of care at Margaret House, Mitie said yesterday: “The quality of the care that we provide and the safety and dignity of our customers is our highest priority.

“We are working hard with the local authority to continually improve standards across the business and we are investing in our people and processes to achieve this.

"As you will understand, we can’t make any comment on confidential personal circumstances, including the names of individuals and on unsubstantiated comments.”