23 Nov 2012

Some care providers ‘struggling’ – care regulator report

Vulnerable people are at risk of receiving “poor or unsafe care” as pressures on care services take their toll, according to a new report by the Care Quality Commission.

Some care providers 'struggling' - care regulator report (Getty)

The ageing population and the rising tide of patients who suffer from complex or multiple illnesses mean that some care providers are struggling to provide “person centred” care, according to the CQC.

Pressure on the care system is having an impact on the respect that patients are receiving in some areas, according to the State of Care report.

The report, based on evidence found from 13,000 CQC inspections, found that one in ten NHS hospitals did not meet basic respect and dignity standards.

And at 15 per cent of 2,500 nursing homes there was a lack of respectful care. Inspectors noted that 20 per cent of 1,362 nursing homes and residential care homes and 15 per cent of 258 NHS hospitals failed to ensure that the people in their care were given the food and drink they need or helped them to eat or drink.

It is extremely worrying that some organisations are still not getting the basics right every time. NHS Confederation

The CQC also raised concerns about staff numbers. It found that 16 per cent of 250 NHS hospitals did not have adequate staffing levels and a quarter of nursing homes failed to meet the CQC staff standards.

Increased pressure on care providers is leading to slip-ups in basic care practices such as record keeping and medicine management, the CQC said.

More than one in five NHS hospitals failed to meet standards in medicine management and 22 per cent had poor record keeping, inspectors found.

“These are challenging times for providers,” the report states. “CQC continues to see many examples of organisations that meet these challenges and deliver an excellent quality of care. But it also sees others, across both health and social care, that are failing to manage the impact of these pressures effectively.”

Read more from Victoria Macdonald: Care versus 'cuts' in the NHS

Dignity and respect

The CQC, which regulates health and social care in England, said that when it witnessed poor care, there were three main underpinning factors – a care culture in which the “unacceptable care becomes the norm”, an attitude to care that is “task-based”, not person-centred, and providers who try to manage with high vacancy rates or poorly deployed staff.

David Behan, chief executive of the CQC, said: “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 can not 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.

“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.”

No hiding place

Health Secretary Jeremy Hunt said: “While there is much to praise about the NHS and social care today we still need to do much more to raise standards of care across the board.

“I’ve made it absolutely clear that quality of care needs to be valued as highly as the quality of treatment. And that there can be no hiding place for those providing poor care or sub-standard practice.”

Katherine Murphy, chief executive of the Patients Association, added: “At the heart of this report are a number of serious issues: unsafe discharges from hospitals to care homes, the exploitation of vulnerable residents and the fear that many have of raising concerns.

“The basics of good care, such as dignity, compassion and respect, cannot be delivered in a conveyor belt approach which is task orientated or lacking in empathy and human care.”

NHS Confederation chief executive Mike Farrar said: “It is extremely worrying that some organisations are still not getting the basics right every time.

“In every part of the health service, we must make it a priority to get the cornerstones of good care right every time, including providing the right food and drink, treating people with dignity and respect, and co-ordinating arrangements to support people when they are ready to leave hospital.”