/ Health

Why aren’t we getting better information on care homes?

Elderly couple in care home

With 80% of care home inspection reports more than two years old and a new rating system to be implemented, homes are being left to their own devices. Is this good enough for those relying on up-to-date information?

When my grandparents went into care homes several years ago, it was a hard decision and we took full advantage of the regulator’s inspection reports which were available online.

But if you’ve had reason to look for a care home recently, you may have been surprised to find that the Care Quality Commission stopped running its rating or ‘star’ system back in June 2010. Instead, its website tells us, it’s creating a ‘new measure of excellence’, with a consultation on a new system of assessment of care services due to start in December.

And as you leaf through the inspection reports on the regulator’s website you might feel a little sceptical. A recent parliamentary question revealed that 80% of the inspection reports are over two years old.

Too much can change in two years

My cursory search revealed that this was indeed the case, with the first home we randomly searched for showing its ‘latest inspection report’ dating back to January 2008. A lot can change in over two years – staff come and go, management move on and new systems can come into play, all having a major effect on the overall running and ethos of the home.

Our members overwhelmingly tell us they’re concerned about the quality of care in homes. If you saw businessman Sir Gerry Robinson’s depressing picture of dementia care homes for the BBC recently you’ll probably be concerned too. Yet the regulator tells us that 83% of care homes were rated good or excellent in 2010 compared to 69% in 2008.

So is all well behind closed doors… or is there something we should be concerned about? Are things improving and will the brave new world of inspection and rating prove a good one? In the meantime, for almost a year, there are many relying on increasingly out-of-date reports.

pickle says:
22 November 2010

Judging by the recent hoo-ha – care home manager being arrested for pinching drugs, and old people dying from neglect – it seems to me that there is a good case for getting on with care home inspections as soon as possible. At present the system is chaotic – does nobody care? After all it may your turn to enter a care home!

I suspect that the main reason for the poor style, quality and availability of the CQC reports is the methods that have been adopted to standardise their production. If you read through a stack of those that do exist, you soon find that all too often the scoring and the comments appear to relate to different places. I suspect that this is because they have a huge list of tick points that are either pass or fail. Get enough ticks and you are fine. However, do things a way that the ticks do not fully recognise, [or the box ticker cannot pin down] and the place is in trouble. Some homes may have no residents able to go out because of their mental or physical state, clearly they do not need spending money as they will have no ability to spend anything. It appears that a home might be judged on such issues as ‘no provision for residents to come and go’ or for ‘not have a formal pocket money system’.
As for changes happening almost over night, how true that is! Homes are demanding places to run and once an owner or manager feels it is time for a change, quality may already have started to slip. Unless the incoming owner or manager is very well qualified, quality can and does fall off the proverbial cliff. Getting it back requires someone who has the skill but more importantly the experience to know how to ‘route map’ the recovery, hint it is not by box ticking but more to do with recognising what the place needs to achieve to improve the standards of care.
One of the possible problems is that the ‘improvements for change’ may well upset both residents and their visitor(s). Both may well have become quite happy with procedures that in reality did not improve the outcomes for either party but were familiar. I speak from personal experience of a place that drew increasing criticism from an elderly relation visitor while it was declining, but also produced vocal complaints when improvements were introduced to better provide for the residents. I speak as a relative, not as as someone in the business.

In my experience the whole system is corrupt. My experience is, I feel sure, not atypical.
An elderly friend was persuaded, almost against her will, to go into a particular home, which proved to be dreadful. It was later found the social worker was receiving kickbacks to ‘introduce’ business, but the whole thing was hushed up, probably to protect the social workers who hadn’t been found out.
In any event, during my friends short stay in this home the CQC carried out a ‘surprise’ inspection. The home knew at least a month in advance when the inspection was taking place and spent a lot of time hiding all the problems and rehearsing the staff. The inspection itself consisted of a cup of tea with the owner in her office and a short chat with a carefully selected resident. Subsequently, after my friend had ‘escaped’ we downloaded the CQC report from their web site and had a good laugh over an excellent work of fiction.

My experience mirrors Beh4emoth – At my age many of my friends have been forced – either by their families or by NHS and Council attitudes to go into so called “Homes” – The Government does not care – except to ensure they don’t pay,

The cost to the person is around £30.000 a year – In one case directly the “home” “spent” all his money – he was thrown out on his ear as the Council would not continue his care in that “home” – he was eventually re-homed in an appalling place where he died in misery.

Others certainly hated the so-called “care” imposed by various “homes” and “lived” very unhappy lives until they died.

I certainly won’t go in one – I’d sooner commit suicide than die in misery imposed by an uncaring society – and having to pay for it. My life in places has been bad enough already – I will not allow anyone to commit me to end my life in imposed misery/

GERALD says:
15 October 2011

For every one person having a bad experience there are hundreds, if not thousands, who have had a good experience. Anyone considering going in to a Care Home must ensure that the Home they choose is compatible with their life style and the same as a hotel you often have to pay for what you want.This service is just like any other , the problem is that we all seem to have different requirements most of which it is impossible for any Care Home to be able to deliver.
I have been involved with Care Homes in different ways for many years and I am only just , now that I am at retirement age myself, beginning to understand the complexity of the task of dealing with this problem in an “holistic” way. It isn’t until you reach “Old Age ” that you that you can imagine the problems one has when one realises life is finite.
The public is not prepared to discuss their requirements enough as the subject is to difficult to deal with for most people, we cannot expect younger people to understand.

GERALD says:
3 August 2011

As most of the Care Homes I am aware of are situated within the Community which they serve I am amazed that anyone considering using the services of such a Home would not have any LOCAL knowledge to refer to. Surely the Public including GPs, Health workers, friends, neighbours etc. are the best source of information. I would also suggest that a trial period of a week or two would be advisable before making such an important life change.
No Care Home can possibly be everything to everyone and it is therefore imperative that the individual makes their own choices, they should not be reliant on any third party reports as their needs and wishes could be so complex that no third party could predetermined them.
As far as I am aware no inspectors in the CQC are even of an age to understand what it is like to be aged and even if they were they could not possibly be able to envisage all the complex personal problems which have to be considered for each individual person.
to expect the CQC to be able to serve the Public in the way you suggest it totally unreasonable

GERALD says:
15 October 2011

Well it looks like there does not appear to mutch of a problem with Care Homes, in light of CQC’s report on conditions in over 100 Hospitals could Which now focus on the Public Sector for a change and wards for the Elderly in particular

Sorry disagree

There are problems with ALL sectors with regard to elderly care. – Care homes are often appalling – geriatric hospital wards both private and public are appalling often.

What is required is a change of attitude towards elderly care. Too often they are regarded as either a milk cow until their savings run out – or a waste of space and time. If their care is raised to the level of everyone else – they could die in dignity.

I for one will not pay for enforced “care” home incarceration.

Gerald says:
17 March 2013

Dear Richard,

You really have missed the point, Elderly people have being paying for Care ever since 1949 when the NHS was set up and the Law states that all NHS care (inc. Nursing Home Care) should be FREE at point of service, if you refer to WHICH conversation site dealing with the NHS abuse of this system you will read many horror stories. If you also refer to the recent revelation s of the Mid Staffs Hospital you will also get another picture of how the NHS provides for the Elderly themselves
You can make up your own mind on what you should and should not pay for.

Gerald says:
15 October 2011

Dear Richard,

When you consider there has only been 4 correspondants other than you and I who have taken up pens to deal with this matter out of over 400,000 people living in Care Homes ,surely you could consider my statement reflects the overall situation better than yours. I have been working with the Elderly for over 25 years and seen many instances of good care, I have also had to chastice staff on a few occassions for showing lack of respect, but you will find these sort of individuals in all forms of life, it does rather reflect the society as a whole thatwe are living in today.Perhaps you could do your homework and find a Home locally with a good reputation and try it out for a week or two, this might be of use to you in the near future.

richard says:
17 March 2013

Sadly Which? posters do not represent the vast majority of the elderly – In fact they are mainly wealthy middle class – On other forums there are far more elderly complaining about the disgusting treatment of the elderly – I have been working for the Elderly in a slum area of London for over 25 YEARS and their treatment is appalling unless ALREADY a pauper – and often not then – In addition both of my parents HAD EXCELLENT FREE – repeat FREE – long term care well after 1948 so that is wrong too- as did my parent’s friends – As I said I have released my cash and equity without trace to ensure when or if I require long tern care it will be paid by the state NOT by me.- as I have already paid for it through NI as promised in 1948.

Gerald says:
21 January 2013

General Question,

Has anyone had any help from either Help The Aged OR

Age Concern ???

Gerald says:
7 February 2013

Why haven’t we been given more information of whats been going on in staffs hospital…..400 to 1000 unexpected deaths and no action taken by the watchdogs what is going on .If this is what its like in one Hospital what is it like Nationally. Why has WHICH not included the NHS in their survey on Care for the Elderly ?????