Unison, the public sector union, said a damning report by the nursing profession's regulatory body, the United Kingdom Central Council for Nursing, Midwifery and Health Visiting, had revealed a 'national scandal'.
Although the number of cases investigated by the UKCC's professional conduct committee was small - rising from 15 to 35 - they represent only the tip of the iceberg, as many less serious complaints are screened out before they reach the committee.
The report presented a picture of cruelty and appalling standards of care for some of the most vulnerable residents. Some suffered from dementia and mental disabilities and were not able to complain. Many bad practices were exposed only after complaints by other staff.
Bob Abberley, Unison's head of health, said: 'This damning indictment of standards in private nursing homes reveals an unregulated and secretive jungle where abuse and malpractice can flourish unchecked. It is a national scandal . . .'
The number of beds in private nursing homes has risen from 34,000 to 148,000 in the past six years. Complaints involved nurses, midwives and health visitors registered with the council. Deficiencies included:
Too few induction courses and written procedures, and almost non-existent training;
Some registered nurses showed a total disregard for their responsibilities, including safe storage of drugs and ensuring correct administration of medication;
A recurring theme is the physical and verbal abuse of residents who because of frailty or confusion find it difficult to complain;
Staff borrowed money from residents, withdrew money from their accounts without their knowledge or permission and charged residents for essential items. Financial control and audits were woefully inadequate;
Some poor treatment resulted from difficulties when nursing staff were also registered owners of the private homes or relatives of the owners. In some cases, financial constraints meant that matrons had insufficient resources to purchase nursing aids, domestic materials or even adequate food.
The report highlighted the inadequate and under-resourced registration and inspection systems used by the health authorities which are responsible for supervising private nursing homes. Tariq Hussain, who edited the findings, said one health authority had more than 4,000 beds but only one full-time and two part-time inspectors.
John Bowis, health minister, said the Government would talk to regulators about the report's recommendations. He added: 'Any single case of abuse of a patient in a nursing home is a betrayal of nursing trust. There are lessons for registration and inspection authorities including scope for better co-ordinated and streamlined regulation between authorities'.
Professional Conduct - Occasional Report on Standards of Nursing in Nursing Homes; UKCC, 23 Portland Place, London W1N 3AF; free.