Nearly 4,000 adult social services criticised over level of care provided

As many as 80,000 people are living in care homes or receiving services rated as only “poor” or “adequate”, according to a government inspectorate.

Eight local councils have also been named and shamed for their performances in looking after the vulnerable and elderly, the Care Quality Commission (CQC) reveals in a report today.

In its first detailed survey of the quality of adult social care in England, the commission told the councils – Bromley, Cornwall, Peterborough, Poole, Solihull, South Tyneside, Southwark, and Surrey – that they must make improvements as a priority.

Two of them, Peterborough and Poole, were designated as “poor” in terms of the dignity and respect shown to individuals dependent on their care. All eight councils will be subject to further scrutiny by the CQC.

Despite an overall improvement in ratings, the commission warns that there are around 400 regulated adult social care services rated as “poor” and around 3,500 only rated “adequate”. They are estimated to be looking after around 80,000 people.

Care homes that are rated as “poor” are required to produce an improvement plan and subjected to follow-up inspections. Among failures identified were problems surrounding planning for individuals’ care, how medication is managed, staff supervision and promotion and protection of people’s health, safety and welfare.

A fifth of all care homes for older people – both council run and private – failed to meet the required standard on social contact and activities. Performance on this specific standard, the CQC says, has improved the least.

The commission says it is worried about the impact of the recession on people’s access to social care. Councils’ eligibility thresholds for access to care services have remained largely unchanged since last year, but that followed two years in which the number of councils providing care to people with “moderate” or “low” needs fell significantly.

The inspectorate noted: “There are already some areas where only people assessed as having critical needs receive any public help, with damaging consequences for individuals and carers.”

Cynthia Bower, the chief executive of the CQC, said: “It’s good to see the steady improvements and this should be recognised. However, I am concerned that many care homes and agencies have more to do to deliver the quality of care expected of them.

“There are also serious issues for councils to address in areas such as giving people more control over their care [and] treating people with dignity. It is striking that many of the issues of most concern to the public – such as dignity – are not necessarily things that cost a lot of money to put right.”

During 2007/08 councils spent £16.5bn on adult social care, £7.5bn of which was on residential services.

The Liberal Democrat health spokesman, Norman Lamb, said: “It is shocking that so many care homes and services are rated as providing poor care. The owners of these homes and other services should be told that unless urgent improvements are made, then they will face closure. We cannot tolerate elderly and vulnerable people living in these conditions.

“It is scandalous that standards of dignity and respect for residents in care homes have fallen in the past year. There can be no excuse for such disgraceful shortcomings.”

Andrew Harrop, of Age Concern and Help the Aged, said: “While the overall standards of care have improved from last year, it’s not acceptable that ratings for care homes for older people are lagging behind homes for younger age groups.”

“The report clearly shows that many service providers are still not up to scratch on basic standards of care that are vital for the wellbeing and welfare of older people.”

Helga Pile, Unison’s national officer for social care, said: “It is good to see that more councils are getting a better rating for their adult social care services. But there is clearly work to be done to bring standards of care up to a decent level across the whole country.

“However, Unison does not want to see the CQC becoming a cheerleader for the expansion of the private market into home care and care home services. Councils should be providing more services directly for the elderly and vulnerable adults. The move towards privatised care is part of the problem, not the solution, to improving services.

“We have seen pay and conditions pushed down to rock bottom in privatised home care. Some workers are paid on piecemeal rates, rushing from call to call, with wages falling to below the minimum wage. There is a lack of training and a high turnover of staff. This can be very confusing and difficult for the elderly, who should be able to rely on a regular carer.”

Stephen Burke, of the charity Counsel and Care, said: “The report shows that despite some improvement overall, the standard of care experienced by many vulnerable older people living in care homes in England still remains completely inadequate.

“More work needs to be done by local councils and care providers to ensure that personalised services become a reality for all older people and carers regardless of whether they live at home or in a care home, including access to good information and advice.”