Good is Not Enough for Milly
Care homes ranked as good don’t guarantee the care our loved ones deserve. Outstanding care takes immense effort, vision, courage - and money.
Theme: The Beauty, Broken and Burnout
Quick Take:
Outstanding care matters, but only a tiny fraction of care homes achieve it. Most are rated “good,” and that’s probably on the good days. What about average days?
Less posh, more pounds. Luxury surroundings don’t create dignity or safety - investment in training and understanding dementia, and fair pay does.
If social care doesn’t become a financial priority - which seems unlikely - then it falls to us to improve the lives of our loved ones. Simple changes and better understanding can ease the fear of dementia.
Campaigning and Learning
I think I’ll be waiting the rest of Milly’s life - and then quite a bit more of my own - before I see a treatment for dementia. The same amount of time applies to any chance of any of us seeing the changes that are so badly needed in our care systems.
Meantime, and Last and Found is all about this, there are things that can take away some of the fear and despair that dementia holds for us.
Firstly, campaigns for specific and realistic reforms in the care sector - including helping professional carers receive the status, training and pay that enables them to love what they do. Secondly, the more we educate ourselves about dementia, the better position we are in to help lift standards and enhance the lives of those living with this disease.
Realistic Reforms
I’m inspired to write this piece after hearing about a newly published book called What Would Maggie Do. Michael Maslinski spent fifteen years caring for his wife Maggie after she was diagnosed with dementia, and nine of those years were spent living together in a care home. As a result of his incredible and unique experience, he has written his story and he wants to help others benefit from his insights - he’s fighting for reform.
I’m keen to read his book, and I’ve also asked for more information on his reform ideas - I’d love to be a part of something that truly makes a difference. I want to be more optimistic than I often feel.
From what I’ve read, Michael himself readily admits it took confidence, connections, experience, and money to help Maggie receive the care she deserved. Most of us fight hard to achieve two of these requirements, never mind all four!
Ironic Twist
Any care home reforms will take a great deal of … something! I’m not sure what yet! Because many of the care homes in England are part of investment portfolios, sometimes funded as part of our pension schemes. That means one important thing - our overstretched and poorly paid professional carers, and our vulnerable loved ones, are supporting pensions. So unless a pension company’s mission is to prioritise quality over profit - ha! like that is going to happen - there’s always going to be a limit to any investment in improving our care homes.
Outstanding Care
One of the reasons I care for Milly at home, with her family, is because I want outstanding care for her, and sadly that is not readily available.
I know everyone wants the same and it’s about great staffing levels, warm and friendly environments, enriching activities including cooking and gardening, prioritising health and rehab, and leadership that constantly responds to needs and strives to improve.
Measuring Care
The CQC - Care Quality Commission - is an independent judge of health and adult social care in England. I don’t have the figures for the whole of the UK, but even looking at England alone, only a small proportion of care homes are rated as Outstanding - about 4%. That’s roughly 600 homes, out of around 14,700, that are good enough for Milly! Four of them are around here, but three were last inspected in 2019, so I’ve no idea if they’ve maintained that level of care.
I have to admit the homes rated as ‘Good’ are the majority - 75–80% - but I’m afraid I don’t have much faith in good. In fact, I know good is not enough for Milly. I’ve worked in care homes, I have many friends with family in care homes, and I know what good means. It easily becomes okay. I know this both from experience and anecdotally. Outstanding care will be good care on average days - none of us are outstanding every day! And good care needs improvement or becomes inadequate on average days.
Safe, Effective, Compassionate, Responsive, and Well-Led
The CQC measures - safe, effective, compassionate, response and well-led care are all linked. It’s hard work, it takes dedication and a lot of love for the job.
Less Posh, More Pounds
I know carers need to feel and act like the professionals we need for our loved ones. That doesn’t necessarily mean more money overall, but a change of focus.
Care homes don’t have to feel like hotels or serve cordon bleu meals. What really matters is that staff are well trained, properly supported, and understand dementia. That’s where dignity, safety, and contentment come from.
Less posh, and more pounds for the staff - spent on training, understanding dementia, and paying people fairly - would make a far bigger difference to the lives of our loved ones than luxury surroundings ever could.
Valued Staff
Professional carers need to feel valued and to be better trained so they understand and feel good about making a difference in a vulnerable person’s life. It’s a wonderful feeling, and it makes you want to get up in the morning when someone you care for is living their optimum life, feeling safe and content as much as possible.
The Beauty, the Broken, and the Burnout
Burnout is too common. I know because I’ve seen it time and again - the pressure, the lack of support, the emotional toll. I’ve written a song called “I’m Not a Cash Cow” for this very reason, to speak out about how our system undervalues those who care for our most vulnerable.
Family carers feel broken too easily as well. The relentless worry, the constant advocacy, the sleepless nights - it wears us down.
And yet, there is beauty. The beauty I see every day caring for Milly gives me the strength to keep going on this path. It’s in the quiet moments of contentment, the small smiles, the laughter, the moments we have together. It’s what reminds me why any campaigning, continually learning, and all the family effort is worth it.
This is what Last and Found is about: noticing what lasts, what can be found, and holding onto it - even when the system is broken and burnout is real.
Change is Up to Us
I hope on Last and Found I will be able to share some campaign ideas - to help with the broken and the burnout that I refer to regularly. In the meantime, the more we can educate ourselves about dementia, the more we can lift standards, and the more we as families can enhance the lives of our loved ones living with dementia.