Convictions for abuse in care homes are rising as CCTV, smart phones and hidden cameras capture incriminating evidence on video. The answer is not to stop cameras coming into care homes, but to stop abusing residents, argues BBC Panorama producer Joe Plomin in conversation with Care Home Professional’s Rob Corder.
Joe Plomin is not universally popular with care home owners. His investigations as a producer for the BBC’s Panorama into abuse and neglect in care homes have used secret filming to uncover what can happen to the country’s most vulnerable citizens when owners, relatives and inspectors aren’t watching.
His 2014 documentary, Behind Closed Doors: Elderly Care Exposed, shows the lives of elderly and vulnerable people blighted by poor care. The film has led to care workers being suspended and others convicted of assault.
Secret filming using hidden cameras captured shocking images of residents at the Old Deanery care home in Essex being insulted, roughly handled and even slapped.
Norman Lamb, care minister for the coalition government at the time, described the images as “absolutely disgusting” and said there “could be a role” for the use of CCTV in care homes.
Is installing CCTV in care homes the right response to Joe Plomin’s film, and should relatives reach for covert cameras to film the treatment that their relatives are receiving?
“I think it is important to be clear that there are two very distinct things: care home operators putting in CCTV and individuals concerned about the treatment of their relatives are two totally different things,” Mr Plomin tells Care Home Professional in a wide ranging interview about his experience of filming in care homes.
“They are totally different technology, totally different ethical considerations, totally different dilemmas, and produce totally different outcomes,” he adds.
Mr Plomin stresses that he is not an expert in CCTV technology. His specialty is the use of hidden cameras, including the ethical and legal issues that secret filming throws up. He has even written a book on the subject called Hidden Cameras: Everything You Need to Know About Covert Recording, Undercover Cameras and Secret Filming.
He may not be a technical expert in current CCTV technology, but Mr Plomin does know how much effort and expertise is needed to make it effective. Installing cameras that simply amass thousands of hours of footage that may never be studied is useless, he argues.
“It is key to know from the outset who is going to monitor all the CCTV; who is going to watch all that footage. It is a skill that requires knowledge, experience and expertise. If you stick in a camera without having properly thought through the assessment, monitoring and management, it can be worse than ineffective. It can actually be counter-productive,” Mr Plomin asserts.
“Good, judicious use of CCTV by care home operators that have thought through how it is going to be installed, how it is going to be monitored, how it is going to be stored, how it is going to be protected, how it is going to fit into a system of good care within a home – then it is a good tool in the box. Done badly, I think it is worse than useless, especially since it can be massively expensive to operators that are already working in an over-stretched industry,” he adds.
Panorama is not popular with care home owners who argue that it sensationalised instances of abuse and neglect that are incredibly rare. Mr Plomin hopes that most care home professionals work hard for the good of their residents, but adds that a single instance of abuse is one too many, and that shining a light on mistreatment is important to raise standards.
It is outcomes that matter to Mr Plomin, and he is clear in his mind that secret filming or CCTV should be used only if they contribute to better care. In fact, he suggests, if a care home reaches for CCTV or a relative feels to need to secretly film, the system may have already failed.
“I have a firm belief that, if you are inspiring good behaviour in staff, if staff genuinely know that poor practice will be acted upon and rooted out; if the staff know that if they raise concerns they will be supported and protected, not treated as a problem, then that, allied to CCTV, may give care home operators a certain level of security. The cameras, without the culture, without the confidence to complain, without the acting on poor practice, you might just drive the problems underneath the camera where they can’t be seen,” he says.
If the culture of a care home is abusive or neglectful, CCTV will not fix it. “If I have learned one thing during the course of my investigations, it is this: there are no technological or technocratic solutions to cultural problems. If you put up a camera, and all the staff know where it is and there is a bad culture, all you will do is move the abuse underneath the camera where the CCTV can no longer see it. Bad staff can get around CCTV,” warns Mr Plomin. “You can hide neglect, you can hide poor practice.”
As well as CCTV, the use of secret filming is increasing as families, worried that their elderly relatives are not receiving the care they need, have myriad technological options to monitor them. A spy camera built into a photo frame can be bought from Amazon for just £22.
“I can tell you this: secret filming is here to stay,” says Mr Plomin. “The prevalence of granny cams, nanny cams, etc, the toothpaste is not going back in the tube.”
Care home operators may be surprised to learn that Mr Plomin is not an advocate for secret filming. His wish is that it is never needed because problems with care are dealt with professionally when complaints are made.
“I have a huge concern about secret filming being used injudiciously, and before people having tried all other ways of getting better treatment for their relatives,” he reveals. “The people I respect most, who have reverted to secret filming, are the people that have engaged with the care home, have tried everything they can to complain and improve things. If you skip that first stage and don’t engage in that way, it makes no sense to put in all that effort to use secret filming. It can be a positive tool in the box, but only if all else has failed.”
As with CCTV, there is a massive amount of time and effort required to make secret filming worthwhile. Any relative who has gone to that much trouble is likely to have serious concerns that have not been addressed by the care home, Mr Plomin suggests.
Ultimately, Mr Plomin hopes he never has to use secret filming or review hundreds of hours of CCTV footage to bring abuse of old people in care homes to the public’s attention. He’d like never to return to the topic because care home operators never fail in their duty of care.
“If there are two take home lessons I can offer from my experience I would say this: first, the best protection against secret filming is to have a well run care home. Secondly, [while] there is no point shooting the messenger if they are right, there can be circumstance where secret filming cannot be justified. Run your care home well; speak out about other care homes where you know things are not being run well; and put guys like me out of business,” Mr Plomin urges.