Are All Care Homes Potential Cattle Markets? Interview with Steven Hawley

Steven Hawley’s novelette, Cattle Market, struck a chord with me as I reflected on the plight of my own mother and the difficult decision we made to place her in a care home. Before we moved her to a more ‘suitable’ facility I witnessed with my own eyes how the Matron, or whatever she was called, refused to let mum walk to the toilet. She also made her wear incontinence pads so mum was not a nuisance. When a kind Romanian carer tried to fight the Matron’s decision, she was met with a steely glare and total indifference. Fortunately it was only a temporary home but poor mum never regained control of her bladder or her dignity. I feel so strongly about the plight of the elderly and intrigued by Steven’s novelette I tracked him down and he kindly agreed to be interviewed. Thank you Steven.

Steven, please tell us a little about yourself?

I currently work within an NHS Trust supported living home. Slightly different to your stereotypical rest home in that I support 3 clients, not 30+ which means they generally receive a better quality of care. I’ve been in the industry for about 8 years now and have worked in a variety of different settings. My first job was in a residential care home where there were 4 staff delivering care to 40 residents. My interests are obviously writing. Ideally I would like to be able to write as a full time occupation, I’ll get there one day! Other than that I just live my quiet little life with my other half and dog in a quiet little house in the English countryside.

What inspired you to write “Cattle Market“?

I once supported a mid forties lady in a care home who had Huntington’s. She used to be a care worker and would often try to lend her services to us as we worked the shift. Unfortunately we couldn’t take her up on her offers but it got me thinking, one day we might all be in her position. That’s when I really started to notice how shit the care practices of most people were. I shamefully hold my hands up and admit that I was one of the less than decent carers, not that I did anything wrong mind you, but when I first started care I failed to see the person behind the backside I was cleaning. It was how my colleagues were, so it was how I became. It wasn’t until I got employment in a supported living environment I realised how dehumanising care homes can be and made efforts to get to know the people I was looking after. At the time I wasn’t mature enough to handle the situation any other way than to remove myself from it, but now that I’m able, I felt fictionalising my experiences is a good way forward. I’m pleased I got out of the care home because some of the most interesting people I’ve ever met have been people I’ve supported… I never would have been able to see that if I was still in that first job.

What is the novelette about?

Cattle Market is mostly based on my experiences at that first care home. Fictionalised, of course, for confidentiality reasons but still pretty accurate. It’s a novelette which tracks one young man’s experiences from 1960 and throughout his working life in an English “Institute” where abuse, neglect and the dehumanisation of life are commonplace. It goes right up to modern day where some stark realisations are made about the state of the care industry. The protagonist is loosely based on myself and my experiences. And Helen is the only true to life character I decided to keep. I have her to thank for teaching me to be a decent person. Unfortunately some other gentleman beat me to the privilege that the protagonist was afforded.

Please can you include a short extract from Cattle Market?

“What’re you doing?” Helen asks when she returns. She’s brought an electric iron. “Giving him a wash,” I reply. I have Mr Walsh on his side and I’m scrubbing his back, wetting the flannel in a porcelain bowl filled from the sink, like I was shown. He takes a sharp intake of breath whenever the cold cloth touches a dry patch of skin. “Can you pass the razor?” Helen asks as she plugs in the iron and leaves it to warm up on the bedside table. I turn to fetch the safety razor from the basin. My breath catches as the frigid contents of the wash bowl cascade down my back. I look over my shoulder, Helen is holding the now empty bowl. “If you like I can give you an idea of what a shave with that razor might feel like too,” she says. I look at the razor in my hand. Old skin and beard are compacted into the blade and the edge looks about as keen as a beaten dog. “There aren’t any other blades. They don’t get changed ’til the end of the month,” I protest. “Another apostle of the great Amanda in the making. Go to the laundry room and get a dry tunic for yourself. Bring a mop and bucket back with you and I’ll show you how to behave like a decent human being.”

From your research, how has the care industry changed since the 1960s?

It hasn’t changed by much, I’m afraid to say. Care homes are still the over populated, foreboding prisons they’ve always been. I’ve yet to find a care home that doesn’t treat their clients like detainees. Just recently there was a second world war veteran who had to escape his care home just to make the D-day celebrations. There’s locks on the main exits and no one leaves without a truck load of red tape being put up first. The carers are under paid in care homes so you generally get what you pay for. The meal times are institutionalised and regimented. They’re just horrible, controlling old fashioned institutes. There’s no place for large care homes in this day and age if you ask me. Supported living, however, is a different bag of tricks. There are some services better than others, but generally they all support their clients out in the community. The staffing levels are high and the staff generally receive a better rate of pay (though still not enough in my not so humble opinion). The clients often get many hours of one to one interaction with staff. And their lives are lived like any other persons. They have input over their finances, shopping, clothing. All the simple choices we all take for granted. Supported living still has faults, but it’s certainly the way forward. Care homes, by comparison, appear barbaric.

If you could wave a magic wand, what changes would you implement to make residential care homes for the elderly more comfortable and why?

I would destroy them and build a 5 building complex on the land they’re built on. Four of the buildings would be two bed houses, one client per bed (or even doubled up if they come as a pair!). The remaining house would be a staff base of operations. That way the staffs belongings, filing, mission notes and hostages would be separate from the clients which would give the illusion of minimal interference in their lives. One of the problems with supported living is there’s often a homely feeling about the house until you find bits of paper work laying around, or staff backpacks tucked into a corner.

Based on your ‘insider’ knowledge if you could offer three top tips for choosing a care home what would they be?

If the staff are wearing a uniform, don’t bother with that home. It’s a clear sign that the home is a business and run like one. In my experience, a uniform is more than just clothing… it’s a reflection on the type of care a person might get: sterile; generalised; not person centred… uniform. If you’re going to visit a care home to see if it’s right for a family member, try to do so at or just after the main meal. If you can visit while the clients are eating you can see what the staffs attitudes are like when it comes to one of the most important times of the day. If all the clients are crammed into one dining room eating the same slop, it’s a good sign that there are many other institutional practices happening within that service. Also, arriving 20 minutes after the main meal, you can see if the staff have bothered to clean up their clients or just left them with food all down their front. Ask for a list of the activities the home encourages. If they provide a list of things they like to do in house (crafts, karaoke, needlework etc.) it’s a dead give away that bugger all activities actually get accomplished. Looks good on paper but the reality is the staff employed will be too busy to actually spend any time co-ordinating those activities. If the provider waxes lyrical about day trips out for those who want to go… ask to tag along. While not all homes are guilty of this… some will bullshit you to fill a bed. I’ve seen it happen. I’m going to give you a fourth tip: Try to avoid large care homes in general. Anything over 15 clients is too many unless there are as many staff on each shift. In my previous working environment, we had 4 staff for 6 clients. They received good quality person centred care. In many large care homes there have been 4 staff for 30+ clients. They received minimal basic care and very little staff interaction.

What social media platforms do you use to promote your book?

Twitter mostly @PottyWhite. I try to avoid Facebook if I can, I’ve been stalked on there once too often!

I love the cover of your book did you design it yourself?

Designed yes, created, no. I had a rough idea of what I wanted as my cover, an oversized cow being washed by a care worker wearing an above mentioned uniform. But I have no ability when it comes to drawing. My sister, Jo, on the other hand does. I sheepishly rang her up one day and pitched my idea. She was kind enough to get on board and together the cover was created.

What are your plans for the future?

The release of a Science Fiction novel, as yet untitled! Then I might try my hand at world domination.

Where can people buy Cattle Market?

Amazon.co.uk it’s available in both kindle and paperback formats.

Steven Hawley, author of Cattle Market (Available for download on Amazon.co.uk) and Thanks For The Memory (First prize winner of Writers’ Forum magazine’s national short story week competition and later adapted for internet radio), lives just outside of Stratford-Upon-Avon and spends what little free time he has putting pen to paper. He enjoys science fiction, fantasy and occasionally dabbles in the darker side of writing. You can follow Steven on twitter @PottyWhite.

Last year we made the agonizing decision to move mum to a care home. Not only did she have mobility problems but she also suffered with dementia and therefore unable to look after herself in the comfort of her own home. My sister and I viewed twenty-six care homes before finding the little gem where Mum would end her days. It was a heart wrenching decision as we clung to memories of Mum before the dreaded dementia stole her mind. We soon discovered the common theme to all the homes, bar one, was that the residents sat around the outside of a communal lounge so they could only talk to the person either side. The focal point was usually a TV which muttered away to itself and was barely audible to us, yet alone those with hearing difficulties. There is a good reason why residential care homes are called “God’s Waiting Room”: These poor souls wore the resigned expression of those who had lost their dignity and were just waiting to die. We realised the whole care home industry was nothing more than a money-making enterprise and a “Cattle Market”. What is your experience of care homes and how were your loved ones treated? If you have any questions, Steven has kindly agreed to share his ‘inside’ knowledge. Thank you Steven…

Please don’t forget to order your copy of Cattle Market

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