Tuesday 26 February 20087:30 Shadow two carers as they visit rooms to get residents up, strip-washed and dressed. They wear no gloves or aprons, but say they should do.
8:30 Breakfast.
10:00 Left on my own while carers take break. Take one of the 13 residents on my floor to smoking room.
10:45 Carers realise they have forgotten one resident who is still in bed, and has a urine infection. Another resident in the adjoining lounge complains about the strong smell of urine coming from the bedroom.
11:30 Two carers I'm working with give resident a bath, without gloves.
12:00 Lunch. I help one lady who can't feed herself.
1:45-2:30 Bingo in the lounge. I help two residents to play.
5:00 Dinner.
6:00 An old film in the lounge attracts half a dozen residents, before I help a carer put some of the residents to bed.
7:15 I help take out the "sluice bags" and get other residents ready for bed. One carer notices a bruise on a resident's wrist. After some coaxing, she complains about a staff member - who she won't name - being heavy-handed. The incident is recorded in a log book. One of the carers says the bruise is probably the result of someone failing to use proper lifting techniques.
8.15 Two carers discuss the continuing lack of gloves. A colleague on another floor has apparently refused to take residents to the toilet until new supplies arrive.
8:30 Home.
Wednesday 27 February 20087:30 There are no gloves again, although this time we wear aprons. The senior carer I am with stresses the importance of changing aprons after each resident, and putting dirty pads straight into the bin. This is not what happened yesterday. As we rush round, one resident's bed is re-made with stained sheets. I help to take one lady for a shower. She has to be moved from a wheelchair to another chair for the purpose as she can't stand up.
8:30 Breakfast. All 22 residents get their choice of breakfast on trays in their rooms. I take a 100-year-old resident to the toilet as there is no-one else to do it. As yet, I have had no training in how to move people, and this man can barely stand on his own. The carer says my first week should just be observation but she thinks it's better for me to get stuck in.
10:15-10:30 My break. A carer and nurse I talk to complain about the lack of a bath which disabled residents can be rolled into. "We just don't have the facilities," the carer says.
10:45 Morning tea/coffee. Another carer asks me to change one extremely frail resident's clothes, as she has been wearing the same ones since Monday. The underwear left for her is clearly too small. She says the carers usually dress her in it anyway, and seems to appreciate it when I go to look for something more comfortable. When I ask her how she is, she says she is bored, and no-one comes in to talk to her.
12:30 Lunch. Irish stew with mashed potato. The stew looks watery and unappetising to me. The nurse and one carer discuss the fact there is no separate soft-food option for those who cannot chew hard food. The cook, they say, has to liquidise the normal menu for those who require soft food.
2:00-2:30 Church service in lounge.
3:00-3:45 Toileting. The carers tell me that at this time every day they have to take all residents to the toilet. Less than half of the residents on this floor can take themselves to the toilet. One carer says there's no need to wear an apron, but a senior carer says I'm being taught bad habits. The carer I'm working with does not wear gloves as he moves quickly from resident to resident.
4:00-4:10 I was left in sole charge of the floor while the other carers go for their break. I have to abandon a lady who I have been told has a tendency to wander because another lady rings her buzzer to say she needs changed.
5:00 Dinner. Before dinner the carers discuss the lack of gloves. The carers say one lady, who is MRSA positive, has a supply of gloves in her room which are to be used when carers are changing her. They debate whether they can use those supplies, before deciding instead to send someone out to buy half a dozen boxes of gloves.
6:00 Songs in lounge with two entertainers.
6:30 Start putting residents to bed. My colleague wears gloves, but after changing a colostomy bag keeps them on while he tidies the room and makes the bed.
8:30 Home.
Friday 29 February 20087.20 One carer late, one off sick, and the nurse has to go on a course later in the morning. All members of staff seem concerned that there will not be enough of them on duty but the manager calls an agency for extra staff, while others are moved from other floors to make up the numbers. Once agency staff arrive there are enough carers on duty.
7:30 For the first time since I started we wear both aprons and gloves to get residents up.
8:30 Breakfast.
10:00-10:15 I am told to keep watch on one resident at all times. She has a tendency to wander and had tried to leave two other establishments she stayed in.
10:45 Toileting. Working with another new starter (her second day and my third), we take residents to toilets and change their pads.
11:30 Take residents to dining room for lunch. Carers are discussing staffing levels. An experienced carer tells me that the general ratio of carers to residents should be one to five. There are usually three staff to care for 22 residents on the Thistle floor where we are working in the morning, she said. This normally increases to four during the afternoon, she added. I am one of four currently on duty, although one carer says I should not be included in the ratio as I have only just started.
12.00 I notice a carer testing the temperature of the food before serving and record it on a wallchart, but there are many gaps on the chart where nothing has been recorded on previous days.
3:00-3:35 Toileting. One of the residents we change is MRSA positive. She has her own waste disposal bin in her room. The nurse I was working with tells me I must wear an apron and gloves when dealing with this lady and remove them and wash my hands afterwards.
4.30 Chatting to one resident who complains of being bored.
5:00 Dinner.
6:00 The nurse and I are in charge of putting residents to bed. We get five people ready for bed in an hour.
7:40-8:10 The nurse and I attempt to change one man for bed. He doesn't like to wear pads and so has to be left to wet himself. The carers have to change his clothes each time that happens. As a result, the room smells very strongly of urine.
8.15 Talk to one resident who seems distressed about doing nothing all day. She says she is fed up and bored.
8:20 Home.
Monday 3 March 20087:30 The supply of gloves from the previous week has run out so we don't wear any today. We don't even have gloves when changing, washing and dressing the lady who has MRSA.
7:45 A carer tells me the home used to provide protective sheets on the beds, but stopped because they were too expensive. Instead, the residents all have to wear pads at night.
8:00 Another carer tells me there are regularly staff shortages in the home. She said that last week she was in charge of a floor and was working with two agency staff who needed to be instructed on how they did the job in their home. She had been working there for five months and said that she did not feel that she should have been in charge of instructing two members of staff.
8:30 Breakfast.
11:20 One resident has an accident on the way to the toilet, but there is also a lot of blood. She is distressed, very pale and shaky. I am told to clean her up, and have to steady her with one hand the whole time. I'm concerned that no doctor is called, but the two experienced carers with me agree it is best to wait to see how she is throughout the day.
12:30 Lunch.
1:45 The principal carer is to take me and two other carers for a "moving and handling" course, despite that leaving only two carers in charge of the 22 residents on the floor. Most of the residents have some level of dementia, several require help eating, and two have colostomy bags.
2:00-3:00 "Moving and handling" course. Introduction to basic techniques for lifting and rolling residents so as not to harm ourselves or the residents. All feels quite rushed, but is useful and would have been good on day one. One carer on the course said she was only getting the training after five months in post.
3:00 Toileting. The manager is called after the resident from this morning has another accident. The doctor is called and says he will come tomorrow.
4:10-5:00 The nurse and I are the only ones on duty, leaving no-one free when we have to work together to change one resident's colostomy bag.
5:00 Dinner is chaotic. Although there are four of us, we can't keep up with the demands of serving meals to 14 residents in the dining room and six in their own rooms, as well as helping the four people who cannot feed themselves. We rush around, leaving some residents waiting while others around them eat.
6:00 Serve the residents more tea and coffee then start to put people to bed. There is only time for a ten-minute break at 7:15 tonight as there is so much to do.
8:15 Home.
Wednesday 5 March 20087:20 The overnight nurse complains that there were only two overnight staff in charge of 22 residents and says that it had been difficult as a few of the residents had been wandering around.
7:30 There is one box of gloves on the floor today and I wonder how long they will last. I have to give one resident a shower. It is difficult as she is unsteady on her feet and I have only watched a carer doing this once.
8:30 Breakfast. Serve up breakfasts and feed one resident.
10:25 Hand in my notice. Tell one of the other carers I was leaving and she says she wants to leave too.
11:00 Morning tea/coffee. Help two residents who are unable to hold a cup.
12:45 Lunch was late today because they had agency staff working in the kitchen. It was again chaotic trying to serve everyone in time.
3:30-4:20 Toileting. The carer I work with does not adhere to any of the "moving and handling" techniques I was taught. He rarely uses a stand-aid and encourages people to lift themselves out of their chairs and on to their commodes. He forgets to put the guard up on one resident's bed to stop her from falling out. Another carer spots this and puts it right later in the afternoon.
5:00 Dinner. After serving the meals I help one resident eat hers.
7:45-8:10 Talk to a nurse, who finds my induction pack which I apparently should have been given on my first day. I have not seen it before. It includes a blank criminal record disclosure form, two copies of my contract, which had been signed by the manager the day before I started work but had not been given to me to sign, a job description, a Scottish Social Services Council Codes of Practice booklet and a training sheet to be filled in by a member of staff once I had learnt how to do certain things.
8:10 Home.
The full article contains 2127 words and appears in Edinburgh Evening News newspaper.
