26 November 2018: This week the Guardian has run a series of stories that show the current unacceptable state of the care home sector. An analysis of data from the Office for National Statistics shows that in the last five years, malnutrition, lack of hydration and bedsores have been referred to in the death certificates of over 1400 care home residents.* Numerous other examples of appalling care are described, many of which are attributed to low staffing levels.
The current regulatory system does have the potential to bring about improvement. In theory, homes are unlikely to profit from bad care due to a poor CQC rating
None of these findings justify blanket criticism of the entire care home sector, although almost one in five of care homes is rated as inadequate or requiring improvement. The death of a care home resident from malnutrition does not always imply poor care: sometimes residents are unable to eat, for example, in the late stages of dementia. Nonetheless, at the Relatives & Residents Association, we all too frequently hear of residents missing meals or being unable to eat or drink because there is no one to help them, usually because homes have insufficient or poorly trained staff, which is in turn blamed on insufficient funding. Yet accounts filed at Companies House show that many care homes rated inadequate by the regulator, the Care Quality Commission, are part of organisations making large profits.**
The current regulatory system does have the potential to bring about improvement. In theory, homes are unlikely to profit from bad care due to a poor CQC rating will mean they will not be able to attract new residents. But this only works if people are aware of ratings. The evidence from our Helpline, however, demonstrates that few people are even aware of the existence of CQC, regulations or ratings. This implies that CQC needs to be far more rigorous in their condemnation of homes that do not, as required by law, meet the regulations, prominently display their ratings and manipulate their image by transferring a poorly rated home to a ‘new’ company as though it is a new entity that has not yet been inspected. Local authorities also have a crucial role to play here. They have a duty to manage local markets to ensure that self-funders have a choice of homes and, of course, they should not continue to place their own clients in the worst rated homes.