One in four care homes unsafe, says watchdog as experts criticise 'Russian roulette' in social care

One in four elderly care homes are unsafe, a damning watchdog report reveals today as experts warn choosing one is like "playing Russian roulette".

Poor leadership and staff shortages mean residents in a quarter of care homes are going weeks without being cleaned and are served dangerous levels of medication, the first comprehensive audit has found.

The report, by the Care Quality Commission (CQC), also reveals that a third of residential nursing homes are failing to provide safe levels of care.

Caroline Abrahams, Age UK

Examples of poor care included out of date medicine being given to residents, care staff being used as stand-in chefs and care home managers who could not name a single resident.

Experts last night said the “scary” situation is liable to get worse, while CQC officials advised people choosing a care home for their elderly relatives to “check the smell” and “use their instinct” before committing.

“It appears to be increasingly difficult for some providers to deliver the safe, high-quality and compassionate care people deserve and have every right to expect,” said Andrea Sutcliffe, Chief Inspector of Adult Social Care at the CQC.

“With demand for social care expected to rise over the next two decades, this is more worrying than ever.”

Caroline Abrahams, Charity Director at Age UK, said: “There is no excuse for poor care and we cannot tolerate it and we should not tolerate it. The statistics are frankly pretty scary.

“You can be lucky, but it’s like playing Russian roulette.”

The CQC began inspecting every registered adult social care provider, including domiciliary care and special needs services, both private and publicly funded, in October 2014.

Today, the inspector has released a report after it completed inspections of all 24,000 providers in England.

It found that of 10,858 residential care homes inspected, more than 2,600 were rated either inadequate or requires improvement for safety.

Meanwhile of the 4,042 residential nursing homes visited by the CQC, 1,496 - or 37 per cent - were unsafe.

Across the entire adult social care sector, including domiciliary and community social care, 23 per cent of services were found to require improvement for safety, and 2 per cent were judged to be inadequate - approximately 6,000 organisations.

Twenty-two per cent of services were found to require leadership improvement, while 2 per cent have been branded inadequate.

The report also concluded that 26 per cent of the services which were initially rated “Good” but subsequently reinspected had deteriorated, a sign that even the top end of the market is in “precarious” shape, according to the CQC.

Among the worst examples were the Meadowbrook Care Home in Shropshire, where ants were found crawling over dining tables and soiled mattresses discovered.

Meanwhile Aamina Home Care, a Lincolnshire-based domiciliary care agency, was found to deliver six minutes of care for people requiring 45, as well as administering medicines unsafely and at the wrong times. One patient needed medicines administered in four hour gaps, but was given them all at once.

Since 2015, the organisation has prosecuted five providers for the most egregious failures - all involving the death or serious injury of resident, resulting in cumulative fines of more than half a million pounds.

At Mosley Manor Care Home in Liverpool, one of those prosecuted by the CQC, some residents had not been bathed for three weeks and there was no soap or hot water in the communal bathrooms.

In February’s budget the Chancellor, Philip Hammond, pledged an additional £2 billion for the social care sector over the following three years.

The Association of Directors of Adult Social Services yesterday said more would be needed, however the new report indicates poor management is also a significant cause of unsafe homes.

The report found that managers often do not properly check the skills and qualifications of staff before hiring them, a problem exacerbated by a high turnover rate and a heavy reliance on temporary agency employees.

Staff attrition in nursing homes is approximately 33 per cent a year.

Ms Sutcliffe advised people to thoroughly inspect care homes before sending their relatives, including smelling the premises and interviewing the registered manager to see how well he or she knows the residents and staff.

“Ask yourself, “does this feel like a home or an institution”,” she advised.

Nicola O’Brien, Head of Policy and Campaigns at Alzheimer’s Society, said unsafe care homes were particularly worrying for the relatives and friends of dementia sufferers.

“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.

“Too often we hear the consequences of inadequate care – our investigation last year revealed people with dementia left in soiled sheets, or becoming ill after eating out of date food, and that only a third of homecare workers have received dementia training, leaving families fearing for their loved ones.”

Last night, the Labour Shadow Health Minister Barbara Keeley, said the report proved the “social care funding crisis” was now “seriously affecting the quality of care”.

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 by care users and their families.

“That’s why we have introduced tougher inspections of care services, provided an additional £2 billion 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.”