"Tonight, I'm undercover in nursing homes, where sometimes it seems they just couldn't care less." "Where some old and vulnerable residents are left helpless." "And others are put in danger." "We ask - is the regulation of nursing homes working?" "There is a hard core of unacceptable, unresourced practice going on, and these places should be closed down." "And I find out what life can be like in a failing nursing home." "I can walk out of the door today, I'm lucky." "But I feel for those who can't." "There are more than 250,000 people in care in nursing homes in England and Wales." "I'm of an age where I may one day join them." "I'm about to go undercover in two homes, in a quiet corner of rural England." "Homes which promise top-quality care." "But we've heard a different story." "This is St Theresa's." "It's run by the Morleigh Group, the biggest private provider of nursing and care homes in Cornwall." "Hello." "Come in." "They think I've got a memory problems, and I'm here to give my relatives a break." "They charged me £750 a week to stay here." "St Theresa's can provide nursing care for up to 45 people, many of them funded by the Council and the NHS." "I would say there are about 20 to 30 people staying here." "Many of them seem to be permanently in their rooms, and others spend virtually all day sitting, watching television." "There is an overwhelming noise of TV throughout this building." " The switch on the side of your bed..." " Yes..." "It's my first evening, and half the lights in my room aren't working." "St Theresa's promises residents dignity, independence and privacy." "I've been here four days, and that's not the impression I'm getting." "A resident is calling out for the bathroom." "At about 10.30 this morning, I noticed that BLEEP was asking for the toilet repeatedly." "It was only by about 10.45am that people actually came and took him to the toilet." "As a resident, I can only see so much." "So, we decide to send in another reporter, Alice." "She gets a job some days later and is shadowing a care assistant when another resident asks to be taken to the toilet." "The two care assistants ignore her." "Often, residents, even those who can walk with help, are left in incontinence pads instead of being taken to the bathroom." "Dr Peter Holden is an experienced GP whose elderly care has been rated as outstanding." "The problem with being left on the incontinence pad is the urine and the faeces are chemicals." "They're not designed to be left in contact with the skin." "The skin will be damaged." "It's a dignity issue." "It's a health and hygiene issue, and it's a comfort issue." "Summarised, you wouldn't do it to your baby, why are we doing it to the elderly?" "The Morleigh Group says refusing to take a resident to the toilet, or using incontinence pads instead would result in disciplinary action." "I'm beginning to wonder what I'm getting for my £750 a week room." "That's £3,000 a month." "Bins that never get emptied." "Soap dispensers with no soap." "The light here doesn't work." "The toilet seat, not fixed." "It seems to me that staff here are rushed off their feet, even though the Morleigh Group says staffing levels are adequate." "Alice should not be left alone with residents because St Theresa's has yet to receive the results of a criminal records check." "But the nurse on duty asks Alice to feed a resident on her own." "Then the nurse arrives with the resident's medication." "The nurse says she hasn't got time to give the medication and asks Alice to supervise instead." "Later the same day, Alice asks an experienced member of staff about working without having her criminal records check." "The CQC, or Care Quality Commission, regulates nursing homes." "It told St Theresa's more than a year ago to improve the screening of new staff." "I've been here for nine days." "I've had sleepless nights and seen people in distress." "But I've heard things are much worse at another home in the Morleigh Group, Clinton House in St Austell." "So that's where I am headed for some more respite care." " Hello." " Hi." " Nice to meet you." " Welcome to us." " Thank you." "Clinton House has a history of being given warning and improvement notices by the CQC, although the regulator had found some standards were improving." "While I'm checking in, another undercover reporter, Lucy, is starting work as a care assistant." "Straightaway she hears reports of problems, this time in the kitchen." "It's been an absolutely shambolic morning." "The kitchen flooded." "Then it was cold." "Although there were people coming around and feeling the radiators, they weren't on." "It's late September, and I'm not the only one feeling the cold." "It seems it's a common complaint at Clinton House." "The Morleigh Group says Clinton House is heated all year round, and a temporary problem with the heating system was fixed." "The company, which runs six care homes in Cornwall, is owned by Patricia and Steven Juleff." "This is where they live." "The Morleigh Group reported" "£1.5 million profit after tax in 2015." "Last year, Cornwall Council paid more than £3 million to the Morleigh Group to take care of elderly people." "Back in Clinton House, undercover care assistant Lucy discovers a serious problem." "The alarm system, used by residents to call for assistance, is faulty." "It directs staff to the wrong rooms." "To confirm which room and resident they actually need to go to, staff have to check a list on the wall." "The Morleigh Group says a new alarm system was ordered in August and they are still waiting for it to be delivered." "Nursing homes, unlike care homes, dispense medicines and deliver nursing care." "You'd expect the way Clinton House handles medicines to be watertight." "You'd be wrong." "Lucy spots medication that has been left by the sink in a resident's room." "This is just poor medicines management, and it's a risk because somebody might not be getting the medication they need, somebody might be getting medication that is not intended for them." "Lucy is then astonished to discover another resident being given a prescription supplement which is two years out of date." "Worse still, it was actually prescribed for someone else." "Four days later, she finds the original prescription label has been peeled off..." "SHE WHISPERS" "..and the out-of-date supplement relabelled for use by the current resident." "'Peeled off.'" "That is primary sin number one, to relabel medicine and give it to somebody else." "That has..." "If that is the kind of thing they are up to, the risks that places patients under is enormous." "Clinton House promises a warm, friendly environment." "But while I had hot water in my room, many of my fellow residents did not." "Lucy complained to a nurse about the water and was told plumbers were supposed to be dealing with it." "Lucy often had to go in search of hot water with a bowl so she could wash residents." "At various points during her shifts she found at least nine rooms had no hot water." "The Morleigh Group says there were some problems when a new boiler was installed, and that residents were provided with hot water throughout." "Clinton House also promises residents dignity and independence." "Lucy finds a resident has been left on a bed pan." "LUCY GASPS" "The resident is in her nineties." "If you leave somebody on a bedpan for a long length of time, eventually what happens is their skin, through the body weight, begins to push through down the orifice of the bedpan." "And they will get stuck." "Not only is that undignified and uncomfortable, but it's a risk to the skin." "It takes two care assistants to free the resident." "We showed the footage to her daughter and grandson." "'I'm going to get one more person to come back and help.'" "I didn't expect that to happen, no." "No." "Not in this day and age." "I don't think it's a very nice environment for the old people, because they don't really have a clue what's going on." "The TV set is blaring out, the staff are running round, it's a bit like chaos really." "A woman her age shouldn't be left on there for that amount of time." "She's old, she's frail." "It's not acceptable." "ALARM BLEEPS" "Clinton House says staff are qualified to care for people with mild dementia." "Our undercover reporter has no training at all and is still asked to look after someone with dementia." "Yeah." "Yeah, sure." "But the resident's dementia is severe, and she needs 24-hour one-to-one care." "The home is paid around £3,000 a week to provide it." "Hello." "OK." "All right, then." "With just a few words of advice from a care assistant," "Lucy's left alone with the resident." "Lucy notices a bedpan in the corner of the room." "Then she sees the safety rail on the bed is loose." "Lie down." "The resident becomes calm when Lucy holds her hand." "But Lucy's still worried she might injure herself on the bed." "HE CHUCKLES" "Oh, really?" "OK." "RESIDENT SHOUTS" "RESIDENT WHINES" "Lucy is left to cope on her own." "Lucy notices the resident has a wound on her leg." "I'm sorry." "Help me!" "Help me!" "Another care assistant comes to take over from Lucy." "Yeah, she's..." "This care assistant won't hold the resident's hand." "RESIDENT MOANS" "I can't..." "We asked Professor John Williams, one of the country's leading experts in adult social care, for his opinion." "I think my reaction is there was no care given at all." "I think she was treated badly and I find the attitude of the staff really very disturbing." "The conditions in which she was living were appalling." "The bed was unsafe." "There was a dirty bedpan there." "She was clearly very, very, very distressed, and understandably so." "INDISTINCT RESPONSE" "A few days later, Lucy finds out the resident is being described by staff as "end of life"." "It becomes clear they don't know how the resident's leg was injured, even though she's supposed to have round-the-clock care." "The Morleigh Group denies the bed rail was faulty and says a number of the staff received relevant training." "But says any failure to treat residents with dignity and respect is unacceptable." "I spent five days at Clinton House, and even without seeing what was going on behind the scenes," "I was relieved to go home." "I can walk out of the door today, I'm lucky." "But I feel for those who can't." "Lucy stays on." "KNOCK ON DOOR" "She attends a resident who has a degenerative disease." " Hello?" " Hiya." "The resident has a prescription for morphine as required, but that shouldn't include keeping her quiet." "I'm horrified." "Morphine is not there to be a cosh on patients." "There's so many issues there." "If I read that clip rightly, they're using morphine as a liquid cosh." "That won't have been prescribed for that and would never be so." "We asked the nurse about what we'd filmed." "She didn't respond." "The Morleigh Group says she's been suspended whilst an internal investigation is carried out." "During 14 shifts at Clinton House, Lucy uncovered a catalogue of poor care and neglect." "She also worked there without a criminal records check being completed or references being taken up." "You've been stuck in here?" "What I have seen on here is scandalous." "And I would hate people to think this is every nursing and care home in the land." "Because I don't believe it is for one minute." "But I think there is a hard core of unacceptable, unresourced practice going on, financially driven, and frankly, these places should be closed down." "Three weeks ago, we alerted the Care Quality Commission," "Cornwall Council and NHS Kernow to the results of our investigation." "They suspended all new admissions to both homes and provided extra nursing staff." "Clinton House is now being closed by the Morleigh Group." "We had a letter from the Morleigh Group to explain that Clinton House would be closing and then another letter from Cornwall Council to inform us there would be a meeting, which I attended, and many relatives attended as well." "Um, as far as I'm aware, and I'm pretty sure, there was no-one from the Morleigh Group that attended this meeting, which..." "That makes me angry." "Clinton House had been regularly inspected by the CQC and told to improve." "New admissions had been temporarily suspended in 2013 and 2015." "So why weren't residents better protected?" "What this is ultimately down to is the provider, the Morleigh Group, making sure that they are doing the job that they are being paid to do." "We were trying to get the service to make sure that was happening." "That it hasn't happened and that they've allowed it to deteriorate so badly is just awful, is awful for the people that are affected, and it's not something that we can tolerate." "We've shown our findings to legal and medical experts." "They've said the regulatory system just isn't working." "The regulatory framework is a very important aspect of how we make sure that people get the care that they have every right to expect." "If we say a service requires improvement, that's what it means." "It also requires people who are commissioning those services - so the local council and the clinical commissioning group - to think about what are they doing in terms of commissioning from a service that we've said requires improvement." "Both Cornwall Council and NHS Kernow say they worked with the Morleigh Group to make improvements, but they weren't maintained." "They have apologised to residents at St Theresa's and Clinton House." "Residents at Clinton House are now being found alternative accommodation." "But rehousing residents when homes close, particularly in rural areas, can be difficult." "The market economy was supposed to introduce competition." "There would be lots of providers." "That hasn't happened." "If the Care Quality Commission threaten the closure of a home, then local authorities and health authorities are faced with finding alternative accommodation for 40, 50 or maybe more older residents." "And that is the problem." "It is not a market." "To some extent, it is a system based on monopoly suppliers." "The Morleigh Group denies that it failed to give proper attention to the quality and safety of residents' care." "It says it had already dismissed the manager of Clinton House before it became aware of our investigation." "The CQC has now downgraded four Morleigh Group Homes to "inadequate"." "They told us, basically, lessons will be learned." "Will they?" "I've got my doubts." "The regulator has said it will refuse to let the owners of the Morleigh Group open another home." "But how worried should we be about the more than 3,000 other care and nursing homes in England that have been told to improve?"