Care Quality Commission
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Review of healthcare services for care home residents published

The Care Quality Commission (CQC) has today published the results of a review of how the healthcare needs of care home residents are met.

It addresses how older people and people with learning disabilities living in care homes access healthcare services, whether they have choice and control over their healthcare and whether they receive care that is safe and respects their dignity.

Inspection teams visited a small sample of care homes, interviewing managers, residents and staff, observing care and examining case files.

Emerging themes of non-compliance will influence future detailed CQC thematic inspections including the dignity and nutrition review for care homes being undertaken in summer 2012.

A summary of the data can be found in the accompanying key findings document and the full data is on our website. 

The review found good practice in areas such as care planning, with 77 percent of homes inspected taking the views of the person into account and 96 percent of homes identifying the changing healthcare needs of residents through informal or responsive monitoring.

However, the review found that access to some services appeared to be too variable.

Despite care home residents having higher levels of dependence on services than the rest of the population, basic health needs were unmet in some areas. For example in just under forty percent of homes for older people, those who need an initial continence assessment wait more than two weeks for it, which is considered too long and is likely to have an impact on their welfare.

Further findings:

  • A quarter of residents did not feel they were offered a choice of male or female staff to help them use the toilet (25 percent)
  • Staff at thirty-eight percent of care homes indicated GPs made routine visits
  • Thirty-five percent of homes reported they had problems getting medicines to residents on time ‘sometimes’
  • Ten percent of care homes said they paid for their GP surgeries to visit.

CQC director of operations Amanda Sherlock said:

“The small sample size limits our ability to draw national-level conclusions. However, we will be using this review to help us identify problem areas and we’ll be looking at these issues in our upcoming inspection programme looking at dignity and nutrition in 500 care homes.

“All staff and relevant agencies, including the emerging commissioning cluster groups, have a role in improving the quality of and access to healthcare services for care home residents. This is a responsibility which needs to be taken seriously.

“While we have identified good practice in areas, this review suggests some providers have fallen short of delivering effective care by considering the healthcare needs of residents as a secondary requirement.

“Despite having a disproportionately high level of dependence on health services, this group appear to be more disadvantaged than the rest of the population in accessing these services.”

The British Geriatric Society (BGS) president, professor Finbarr Martin, said: “We welcome the publication of this report and data.

“We have analysed it in regard to the provision of NHS services for the 400,000 older residents in care homes in England and we are developing a series of materials and case studies to help commissioners to develop appropriate integrated services.

”We recommend that NICE considers the creation of quality standards to support this.”

Key findings from the review are available in a separate report. The full data set is available on our page for the review of Meeting the health care needs of people in care homes.

The BGS, under a data sharing agreement with CQC, has conducted an analysis of the data which looked at the services provided to older people in care homes commissioned by PCTs in their districts: Find out more on the BGS website.

Note to editors

  • CQC identified nine PCT areas considered to be at risk of poor performance and selected nine care homes in each at random for in-depth investigation. For each individual PCT, this included three residential care homes, three nursing homes and three homes for the learning disabled.
  • These PCTs – now in commissioning clusters - were: Birmingham East and North, Greenwich, Luton, North East Essex, Nottinghamshire County, South Tyneside, Southwark and Warrington.
  • CQC carried out this review under its ‘special review’ powers. The full methodology is on the CQC website.

For further information please contact Sarah Robertson in the CQC press office on 0207 448 9401 or out of hours on 07917 232 143.

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