This is a good week for residents of England s care homes. The Commission for Social Care Inspection is producing a guide to all 4,000 of them. It will be essential reading for anybody with a relation already in a home or who is looking for one. It shoul

This is a good week for residents of England's care homes. The Commission for Social Care Inspection is producing a guide to all 4,000 of them.

It will be essential reading for anybody with a relation already in a home or who is looking for one.

It should also be compulsory for Westminster's Directors of Adult Services and Procurement when existing contracts with care homes come up for renewal.

Unfortunately, Westminster has few local nursing home places and those in need of such care sometimes have to go far away where it is difficult for their friends to see them.

In Neighbourcare St John's Wood and Maida Vale we are trying to get out to these homes so as to keep in touch with our older friends.

The CSCI claims that 248 English homes do not meet its basic safety standards and records horrifying discoveries - a resident who had her fingernails ripped out, another covered with cigarette burns. If that is what a visitor to a care home was likely to find it would be dreadful but at least it would be easy to decide that a report needed to be made. Hopefully the police or the council would investigate, although amazingly it seems that under the present law they are not obliged to do so.

More often there is nothing you can quite put your finger on. Recently an old Neighbourcare friend was judged unfit to return home after hospital and was sent to an out-of-borough home.

At first she seemed happy, but last time I found her slumped in her chair. It was hard to wake her and when she did she cowered in panic. She apologised for sleeping in mid-afternoon explaining that she couldn't sleep at night because of the noise.

This wasn't just the cries of wakeful residents - the night staff themselves were noisy. How did the staff treat her? Some were nice, some less so. It was hard to get them to come to take her to the loo and when they did they were sometimes quite rough. They often knocked her feet, which are very painful. Was that deliberate? She thought it sometimes was.

Is there a case to answer? The only way to be sure is surveillance. Rooms in care homes need to be bugged. If that is against the law, then the law needs to be changed.

Another home that Westminster uses is the Heritage Care Centre in Tooting. Here again the person I visit is a new arrival.

She isn't happy but that is because of her loss of independence. The staff don't like her to pull herself around in her wheelchair using her heels, as she used to do, and she has to go to bed when they want.

But there is no suggestion that they are unkind and I had independent evidence of this, having been asked to wait in a room next to the common room. An older resident was being abominably rude and the staff member on duty incredibly restrained - neither was aware that I was in earshot. The room itself was a little bar and everywhere that I saw looked pretty and cared for - especially the dining room.

There was a visitors' book and I was pleased to see that Westminster Social Services had been in to check up quite recently. But nobody else had been there.

If any reader would like to go and visit Neighbourcare's older friends in homes - in or out of the borough, please ring me on 020-7586 5153. It would mean a Criminal Records Bureau check.

David Hogarth

Westminster Older People's Action