Private care homes must face the same level of scrutiny as the NHS and be required to provide information to the public when concerns are raised about their standards, according to a review into a scandal-hit facility.
The report into the Orchid View home where residents suffered “institutionalised abuse” which led to the deaths of five people made more than 30 recommendations to overhaul the way care homes operate and are supervised.
An inquest last year heard multiple accounts of maltreatment of often immobile elderly people which led to the home near Crawley, West Sussex, being labelled “Britain’s worst care home”. Residents received medication overdoses, were left on soiled bed sheets or locked in their rooms.
A Serious Case Review (SCR) published yesterday said privately-run care homes need to face the same requirements as the Health Service for declaring investigations into potentially serious failings as well as other measures, including the formal provision of proof that they can sustain a trained and skilled workforce.
Relatives of 19 elderly people whose deaths at Orchid View were examined by an inquest had highlighted the lack of information about problems at the home as a key failing at the home, which was shut down in October 2011.
Southern Cross, the now defunct owner of Orchid View, was allowed to continue advertising for self-funding residents despite the raising of “safeguarding” concerns which had led to the local authority suspending its placement of people at the home.
Despite investigations into the home, current and potential residents had to rely on the owner’s publicity material and a previous inspection by the health and social care watchdog, the Care Quality Commission, which rated Orchid View as “good”.
Ian Jerome, whose uncle Bertram died while at Orchid View, said: “The key question we still have is why Orchid View could appear from the outside to be one of the best care homes in the country, when in fact it was clearly one of the worst. There needs to be a much better system for sharing information about care home standards and about the people who are working in and running them.”
The SCR, commissioned by the West Sussex Adult Safeguarding Board, said the failure to provide full information to people making “crucial decisions” about care was one of a number of significant failings that placed an onus on private providers and regulators to prove they are up to the task of caring for an ageing population.
Nick Georgiou, the review chairman, said his 33 main recommendations included the provision to relatives of a named contact inside each home and a contractual requirement for care providers to hold open meetings with residents and relatives.
He also welcomed proposals to apply to the social care sector a new “duty of candour” placed on NHS staff to volunteer information when a patient may have been harmed while receiving treatment.
He said: “As the role of independent sector care businesses has grown, the number, frailty and vulnerability of people dependent on their care has increased. It is critically important that these services demonstrate that they can provide the quality of care necessary.”
West Sussex coroner Penelope Schofield said the £3,000-a-month home had been “an accident waiting happen” with poor management and under-staffing leading to a culture of “institutionalised abuse” under which residents were routinely left in bed, ignored and medical needs left unaddressed.
The deaths of five residents - Wilfred Gardner, 85, Margaret Tucker, 77, Enid Trodden, 86, John Holmes, 85, and 77-year-old Jean Halfpenny - were found to be at least partially attributable to neglect.
The CQC acknowledged it had not responded to early warning signs about Orchid View and had been “too easily reassured” by Southern Cross, which collapsed in 2011 under £1bn of debt.
Laura Barlow, a solicitor representing families of victims, renewed calls for a public inquiry into the scandal. She said: “For real change to occur, these recommendations must be delivered and there are questions over who will now drive these improvements and who is ultimately accountable not only for the neglect at Orchid View but at other care homes across the country.
Since Jean Halfpenny’s death in May 2010, her family have asked why her condition and that of other residents of Orchid View were allowed to deteriorate so dramatically before the authorities stepped in.
Mrs Halfpenny, who was 77, died after she was given an overdose of three times the correct level of the blood-thinning drug Warfarin.
She had also been left unattended in her room and found on at least one occasion by a social worker crying and naked in her bed.
The problems at Orchid View finally came to light when a whistleblower at the home in Copthorne, near Crawley, called in police over claims that medical records were being altered or falsified.
Linzi Collings, Mrs Halfpenny’s daughter, said yesterday: “We welcome the review’s findings and recommendations but still feel frustrated that there is still a lack of accountability for how severe the problems became before action was taken.”
:: Care companies should be required to provide evidence to the Care Quality Commission (CQC) that they can both recruit and sustain a skilled workforce.
:: Relatives to have a named contact within each home and concerns about safeguarding must be passed to an independent figure outside the home if they are not dealt with promptly.
:: Open meetings must be held on a regular basis with residents and relatives to discuss general concerns and provide details of any significant safeguarding concerns. Local authorities to attend and minutes shared.
:: Residents to be involved in CQC inspections as well as opportunities for relatives to meet an inspection team.