Living in a nursing home is “like playing Russian roulette,” charities have warned, after it was revealed one in four of Britain’s social care services and a third of nursing homes are failing on safety.
Thousands of vulnerable people are at risk of failing to receive the right medication, being left to go hungry, and being ignored when they ask for help, said the Care Quality Commission (CQC).
The news comes as it emerged the number of people with dementia in England and Wales is set to rise to 1.2 million by 2040, sparking calls for the Government to pay “urgent attention” to social care to avert a future crisis.
Theresa May’s controversial ‘dementia tax’ policy, which caused chaos for the Conservatives during the general election campaign, was conspicuously absent from the Queen’s Speech.
The Prime Minister repeatedly refused to answer the crucial question of the level of any care cap, at one point referring to the policy as a “concept”.
Analysis by the CQC shows that 23 per cent of care homes, nursing homes and home care services require improvement on safety, while a further 2 per cent – 343 services, in which almost 20,000 people are cared for – are inadequate.
When it comes to nursing homes, which care for people with the highest level of need, one in three were failing on safety.
Campaigners called the findings “disturbing” and called for “action, not more words” from the Government to stop the imminent collapse of the social care system, which they said has been devastated by cuts.
The CQC said staff shortages can mean “there are not enough checks and balances in place to ensure people are getting the right medication and the right support to eat and to drink”.
“These are things you do not want to be happening to your loved one or mum,” said Andrea Sutcliffe, chief inspector of adult social care.
Issues seen by inspectors include people not getting help to go to the toilet in time, and being washed and dressed then put back to bed to make things easier for staff.
Caroline Abrahams, charity director at Age UK, said services across the country were patchy and called for considerable investment in the sector.
“Taken as a whole, this report is a graphic demonstration of why older people desperately need the Government to follow through on its commitment to consult on proposals for strengthening social care later this year,” she said.
“The report also makes a compelling case for why considerably more investment in social care is required.” On nursing homes, she said: “You can be lucky but it's a bit like playing Russian roulette.”
The Royal College of Nursing (RCN) said Government cuts to local authority funding had made attracting and retaining social care staff “extremely difficult”.
“When care staff are paid minimum wage, getting a job in a supermarket can seem more appealing. Some carers are not even paid for the time it takes to travel between home visits,” said Gary Kirwan, the RCN’s senior employment relations adviser.
“The few remaining registered nurses in the sector are overstretched and responsible for a large number of staff and residents. Care providers must improve pay and conditions to make it a more attractive career, with professional development and education prospects.
“But underfunding remains the biggest issue. When cuts to local authority social care budgets put more pressure on the NHS, the Government must show it recognises that by giving councils adequate funding for care services.”
Nicola O’Brien, head of policy and campaigns at the Alzheimer’s Society, said people with dementia “deserve better” than what is currently provided.
“It is disturbing that safety has been flagged as the biggest concern in care, when providers are caring for some of the most vulnerable adults in society,” she said.
“Without funding to put the right protocols in place, it’s no surprise that providers are being forced to cut corners. We need to see Government act before the care system collapses, with clear detail on consultation for reform that is backed up with action, not more words.“
Inspectors also raised concerns about organisations slipping down the ratings, with a quarter of those last rated as good deteriorating since their last inspection.
Ms Sutcliffe said failing services do not always treat people with dignity and respect – leading to situations that are “completely and utterly unacceptable” in the modern age.
“So, services where we have gone in first thing in the morning and we've found people who have been got out of bed, washed, dressed and put back to bed because it's easier for the night staff to do it than the day staff,” she said.
Ms Sutcliffe said other issues included a reliance upon agency staff who do not necessarily know the people they were caring for, and were therefore not able to provide the services needed.
A failure to carry out proper checks on staff and poor staff training had also been highlighted by inspectors.
More than 21,000 adult social care services in England have been given a rating by the CQC in five areas: safety; leadership, and whether a service is caring, effective and responsive to people’s needs.
Across these five indicators, 19 per cent of services require improvement, 2 per cent are inadequate, 77 per cent are good and 2 per cent are outstanding.
While most services are good and should be praised, Ms Sutcliffe said “nursing homes continue to be the worry area,” with only 67 per cent rated as good.
She said that “many of these homes are struggling to retain and recruit good quality nursing staff and this has an impact on their ability to provide good services”.
Just over 1,800 services rated as good previously have now been re-inspected.
Of these, a quarter have deteriorated from good, including 5 per cent that are now rated as inadequate. “What it says to me is that there is a struggle for services to continue to maintain the high quality care that we know is vital and important for people,” Ms Sutcliffe said.
“That, I think, shows the fragility in the sector and that good quality care is potentially precarious and we need to make sure that we're focusing on it and that we're not complacent about those good quality ratings.”
However, she added that four out of five services rated previously as inadequate had improved at the point of re-inspection.
Overall, inspectors looked at 1,493 community social care services, 5,511 agencies providing care in people’s homes, 10,858 residential care homes and 4,042 nursing homes.
Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), said: “This report recognises that there is a lot of great care provided by committed leaders and staff through high quality services to people in care homes and in their own home.”
She said extra Government funding was welcome but did not meet increasing needs and costs.
“The risk of adult social care approaching its tipping point is still real and we will focus on re-doubling our mutual efforts to ensure that the quality of care doesn't deteriorate and that older and disabled people and their families get the reliable, personal care they need and deserve.”
Health minister Jackie Doyle-Price said: “While this report shows that the vast majority of people receive ‘good’ or ‘outstanding’ adult social care, it is completely unacceptable that standards in some settings are below those rightly expected bycare users and their families.
“That's why we have introduced tougher inspections of care services, provided an additional £2bn to the sector, and later this year we will be consulting on the future of social care in this country to put it on a stable footing for the future.”
Shadow Health Minister, Barbara Keeley, said: “This report confirms that the social care funding crisis caused by this Government is now seriously affecting the quality of care across the country.
“Behind these statistics are thousands of vulnerable adults failing to get the medicines they have been prescribed, being ignored when they ask for help or having home visits missed.”
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