CQC chief warns there are “no excuses to deliver poor care”

Today has seen England’s care regulator publish its ‘State of Care’ report, an in-depth study into the reasons why some care services are falling short of standards.

Results from Care Quality Commission inspections find that pressures are increasing on home care services, while recording a 3.3 per cent increase in the number of nursing home beds, although the number of non-nursing residential care homes is falling.

An ageing population is highlighted by the regulator as the chief reason that care services are coming under pressure, together with an increase in adults with more complex conditions, but chief executive David Behan warns against excuses being made because of demographic issues, saying:

“Our report highlights concerns we have that pressures on some services are leading to problems in the quality of care, keeping people safe, treating people with dignity and respect, and involving people in decisions about their own care. These pressures cannot be used as an excuse to deliver poor care.

“Health and care services need to rise to the challenge of responding to the increasingly complex conditions suffered by our ageing population. That means delivering care that is based on the person’s needs, not care that suits the way organisations work. It also means that different services need to work well together in an integrated way that meets the best interests of the people who use these services.

“CQC will use its increasing knowledge and understanding, gained through thousands of inspections of services, to spot growing trends that are directly leading to poor care. Where we find standards are not being met we require improvements and we will use our enforcement powers where necessary to tackle issues such as staff shortages or the failure of service providers to involve people in decisions about their own care.”

The ‘State of Care’ report records that 15 per cent of nursing homes inspected were found to be lacking in respect for service users, while 23 per cent were found to have inadequate staffing levels. Record-keeping and medicine management in NHS hospitals is also noted as a leading concern, with 21 per cent failing to meet required standards.

The CQC also admits to anxieties that person-centred methods are not finding their way through to service users, criticising providers who take a ‘task-based’ approach to care and warning against “a care culture in which the unacceptable becomes the norm.”

Bernard Walker chair of the adults faculty at The College of Social Work (TSCW) agrees with the Report’s conclusions and calls upon the Government to recognise that more funding for care services and the role of social workers is necessary, commenting:

“We urge the government to protect service users from the dual effects of increased pressure on services and financial cuts by providing the funding that social care desperately needs.

“As budgets are squeezed, there are very clear arguments for investing in social workers rather than cutting posts. Social workers are unique in providing the knowledge and skills that enable service users to live independently as part of their communities, potentially reducing the requirement for costly packages of care.

“Advocating for service users in a fast-changing service context and enabling them to manage their own person-centred care is extremely challenging. This skill is best delivered by social workers, whose training prepares them to work effectively in this way.

“Far from being an optional extra in adult social care, this report reaffirms our belief that social workers have a critical role to play as demand from people with complex needs grows rapidly and health and social care are increasingly integrated.”

Chief executive of advice and support charity Independent Age, Janet Morrison, has labelled the findings as “shocking and unacceptable” and calls for renewed urgency within Parliament to implement the funding cap on care costs recommended by the Dilnot Commission.

Ms Morrison comments: “It is also deeply concerning that the CQC suggests that pressure on care services is increasing the risk of poor or unsafe care. The report adds real weight to our calls for urgent reform of care for older people. The Dilnot proposals on reform of care funding need to be implemented immediately.

“Poor quality in care homes is partly to do with funding. Most older people in care homes have their fees paid in full or part by their councils, and councils are restricting the amount they pay to care homes. This can only put pressure on struggling homes. But good quality care is not necessarily more expensive than poor quality care, and councils could do much to improve quality by buying better. For all residents – whether council-funded or self-funders – homes need to improve management, working practices and staff attitude – many of which can be improved without extra cost. Better information for those choosing a care home would also help to reward good practice and drive out poor providers from the marketplace.”