Social Care Report: 'One In Four' Services Failing

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

The ageing population and the rising tide of patients who suffer from complex or multiple illnesses mean that some care providers are struggling to provide "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.

The report, based on evidence found from 13,000 CQC inspections, found that one in ten NHS hospitals did not meet basic respect and dignity standards.

And at 15% of 2,500 nursing homes there was a lack of respectful care. Inspectors noted that 20% of 1,362 nursing homes and residential care homes and 15% 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 16% 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.

Jeremy Hunt said a 'rasing of standards' was necessary

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."

NHS Confederation chief executive Mike Farrar said: "It is extremely worrying that some organisations are still not getting the basics right every time.

"In every part of the health service, we must make it a priority to get the cornerstones of good care right every time, including providing the right food and drink, treating people with dignity and respect, and co-ordinating arrangements to support people when they are ready to leave hospital."

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.

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