Social Care: 'One In Four' Services Failing

Vulnerable people are at risk of receiving "poor or unsafe care" as pressures on services take their toll, according to a new report.

The ageing population and the rising number of patients who suffer from complex or multiple illnesses mean that some care providers are struggling to give "person-centred" care, according to the Care Quality Commission (CQC).

Pressure on the care system is having an impact on the respect that patients are receiving in some areas, according to the State of Care report.

Based on evidence from 13,000 CQC inspections, it found that one in 10 NHS hospitals did not meet basic standards of respect and dignity. And at 375 out of 2,500 nursing homes there was a lack of respectful care.

Inspectors noted that 272 out of 1,362 nursing homes and residential care homes and 38 out of 258 NHS hospitals failed to ensure that the people in their care were given the food and drink they need or helped them to eat or drink.

The CQC also raised concerns about staff numbers. It found that 40 out of 250 NHS hospitals did not have adequate staffing levels and a quarter of nursing homes failed to meet the CQC staff standards.

Increased pressure on care providers is leading to slip-ups in basic care practices such as record keeping and medicine management, the CQC said.

Overall, one in four services failed at least one of the 16 key standards.

More than one in five NHS hospitals failed to meet standards in medicine management and 22% had poor record keeping, inspectors found.

The CQC, which regulates health and social care in England, said that when it witnessed poor care, there were three main underpinning factors - a care culture in which the "unacceptable care becomes the norm", an attitude to care that is "task-based", not person-centred, and providers who try to manage with high vacancy rates or poorly deployed staff.

David Behan, chief executive of the CQC, said: "Our report highlights concerns we have that pressures on some services are leading to problems in the quality of care, keeping people safe, treating people with dignity and respect, and involving people in decisions about their own care.

Health Secretary Jeremy Hunt said: "While there is much to praise about the NHS and social care today we still need to do much more to raise standards of care across the board.

"I've made it absolutely clear that quality of care needs to be valued as highly as the quality of treatment. And that there can be no hiding place for those providing poor care or sub-standard practice."

He said that the Department of Health plans to measure patients' hospital experiences, adding: "By shining a light on those organisations which have problems, we will be able to drive up standards so that everyone gets the quality of care they should expect.

"Where there are problems we expect the CQC and other regulators to take swift action."

Dr Andrew McCulloch, chief executive at the Mental Health Foundation , said the report highlights that vulnerable patients are facing "unnecessary and unacceptable risks", adding: "Unless action is taken further scandals will be inevitable."

Katherine Murphy, chief executive of the Patients Association , added: "At the heart of this report are a number of serious issues: unsafe discharges from hospitals to care homes, the exploitation of vulnerable residents and the fear that many have of raising concerns.

"The basics of good care, such as dignity, compassion and respect, cannot be delivered in a conveyor belt approach which is task orientated or lacking in empathy and human care."

Jamie Reed, Labour's shadow health minister said: "This report raises worrying questions about the quality of care some people are receiving, particularly the most vulnerable in our society.

"The Care Quality Commission is right to say patients are paying the price for falling staffing levels in care homes, nursing homes and hospitals. Figures this week showed that over 7,000 hospital nursing jobs have been axed since David Cameron entered Downing Street, with almost one thousand in the last month alone.

"The loss of experienced nurses is picking up speed and healthcare assistants are increasingly being used to cover nurses roles. Ministers are taking unacceptable risks with standards of patient care - they cannot continue to ignore the warnings from nurses' leaders."

The report also states that there is a growing demand for nursing care within social care settings.

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing (RCN), said: "This supports what our members have long been telling us about a growing demand for nursing care in the face of reduced staff numbers and a dilution of skills.

"The report echoes the RCN's warnings that not enough hospitals, nursing and care homes are adequately staffed and, when coupled with the wrong mix of skills, is having a real effect on patient care.