'Excellence ratings' for care homes

Government acts in the wake of neglect exposed by The Independent

Nursing homes are to be told to submit to new "excellence tests" or risk losing public funding, under plans to be announced today.

Homes will be assessed on staff training and turn-over, daily activities for residents, and the quality of care they offer. Only those which professionally register all their staff are expected to be allowed to take part and the results of the tests will be published to give families information on what they can expect from individual homes.

Ministers have warned that only those institutions which meet the new standards are likely to be funded in future by local councils. But critics of the plan said small independent care homes might not be able to afford the cost of registering for the new scheme and could go bankrupt, forcing residents to move even if the home was offering outstanding care. The Independent has been highlighting the neglect of elderly residents in some homes, which campaigners say will get worse as public-sector cuts start to bite. More than half a million elderly people are in nursing homes and the number is expected to rise to 1.3 million by 2050.

Local councils spend around 50 per cent of their budgets on social care, the bulk of which is for the elderly. As a result of the public-sector funding cuts highlighting the neglect of elderly residents in some homes, which campaigners say will get worse as public-sector cuts start to bite. More than half a million elderly people are in nursing homes and the number is expected to rise to 1.3 million by 2050.

Local councils spend around 50 per cent of their budgets on social care, the bulk of it on the elderly. As a result of the public-sector funding cuts announced in October's comprehensive spending review, the same councils will have their budgets cut by up to 9 per cent a year for the next four years.

At Christmas, the Care Quality Commission (CQC) carried out spot inspections of 234 health and social-care institutions, including nursing homes, which revealed significant lapses in standards in more than a third of cases. Ten reviews resulted in the highest form of censure, which could to lead to the commission withdrawing licences to operate.

After one review, a nursing home in Luton – run by Southern Cross, Britain's largest care-home provider – was closed immediately because conditions were so bad. The commission found that 26 other institutions were not meeting required standards in all areas and ordered improvements.

Details of the "excellence tests" will be published by the commission today. Later in the year, the Government will unveil its long-term plans for reforming the care sector. These are likely to include the introduction of a new "insurance model" to pay for care in later life. People without insurance forfeit their assets when they die to pay for care they have received.

Speaking before a consultation to decide how the excellence rating will be assessed, Paul Burstow, the Care Services minister, said good-quality care was not always about money. "Compassion, common sense, treating people with dignity and respect are not simply about spending more. They are about the way you do things. We want to look at what's being done [in nursing homes] to add life to the years you're having rather than just adding years to the life you're leading.

"The new ratings will provide further pressure within the sector to improve. So it creates another lever for the commissioner to pull, to say we are only going to place people with you if you are excellent."

The scheme will start out as optional and the cost of the inspections will be borne by the care homes. The commission's chief executive, Cynthia Bower, said: "CQC's role is to identify and react to signs that people may be at risk of receiving poor care. But this is not the same as saying other provider are offering 'excellent' care.

"An excellence award can recognise best practice, be a spur to improvement for providers who already meet CQC's essential standards, and can help people who need longer-term care to make choices."

Under the plans, all staff working for "excellent" nursing homes will likely have to be registered with a new Health and Care Workers Professions Council. This means care workers could be "stuck off" for poor practice and eventually the body could require minimum qualifications for registration.

"We want to see if we can work it on a voluntary basis but you probably won't be able to have an excellence rating unless you employ people who are registered," said Mr Burstow.

His long-term intention was to make the care system much more transparent and clear for both residents and their families," he said.

What will be rated?

* What may be included in the new excellence ratings

* Ratio of staff to residents

* Turnover of staff

* Activity programmes for residents and evidence that they are taking place

* All staff to be registered with the new Health and Care Workers Professions Council

* Minimum qualifications for staff

* Spot inspections and independent feedback from residents and their families.

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