Recent revelations by the older people’s commissioner for Wales about poor standards of patient care in Welsh care homes must be heeded by all those involved in the delivery of care home services, including those across the border in England.
The commissioner’s review concluded that too many people in Welsh care homes have an “unacceptable” quality of life. Flagging staff shortages, the review revealed that some patients were left for days without social stimulation, making them feel useless. Clearly, urgent action is needed, but do we really think the problems in Wales are not happening elsewhere?
The Care Quality Commission (CQC) recently released its fifth annual report on the state of health and social care in England. It found that one in five care homes inspected had too few staff on duty to ensure patient safety and care standards were met. It seems the problems identified in Wales are not isolated. However, unlike the Welsh review, the CQC report stopped short of identifying specific issues to be tackled, so we are left wondering how much action will be taken.
Just last week, the CQC published the findings of its review of care homes in England under a new ratings system introduced in 2014. While some homes have been given an “outstanding” rating, concerns have been raised already about how consistent the findings can be across the health and social care sectors.
While it is early days for the new system, it is unsettling that concerns have come to light so soon. Could it be a sign that the CQC is spreading itself too thin?
Of course, the CQC’s new regime of inspectorates and the quality rating system are just the beginning and there are plenty of changes to come. From April there will be another round of reforms to social care inspection as well as the introduction of the “fit and proper persons” regulations and legislation surrounding the “duty of candour”. These aim to give service users and their relatives honest and accurate information about the standard of care provided.
These changes are intended to help to raise standards. However, an overall “good” or “outstanding” rating could hide some areas where standards are slipping or simply not good enough. Without annual inspections, the situation could get worse, bringing hardship for those who rely on the care home system in England.
Over in Wales, a separate bill is soon to be passed by the Welsh government. It aims to strengthen the regulation and inspection of social services in Wales and will hopefully help end the shocking practices revealed by the commissioner’s review.
To stand a chance of retaining our confidence, the CQC will need to take similar action in England. Indeed, some aspects of its regime may need to be fine-tuned to ensure that services provided by care homes in England don’t slip behind.
With increasing budget pressures on the NHS, it is important that elderly people do not fall through the net. Whatever happens, patient care must come first. As a starting point, it would be good to see a review undertaken in England equivalent to that recently completed in Wales.
The CQC can’t afford to get this wrong. As NHS resources come under increasing pressure, the end-of-life care delivered by care homes in England and Wales is even more crucial.
Robert Rose is a medical negligence expert and partner at Lime solicitors
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