The Future of Elderly Care Homes CQC to prosecute
“CQC to prosecute providers without warning for serious care failings under government plans.”
CQC chief executive David Behan said: “Those who run health and care service are accountable for the quality and safety of the care they provide. People have a right to expect that care homes and hospitals meet basic standards of care.”
Delivering care to anyone brings with it huge responsibilities for the service providers, which as a service provider I am happy to accept.
The focus of legislation and regulation is to protect vulnerable people, and that is without doubt correct.
Inspection and regulation of Care Homes is extremely in depth and relies too heavily on written evidence.
Trust in nurses and nursing care has gone.
This has been replaced with the ethos Care Homes are guilty until they can prove themselves innocent, and even with written proof, the balance of judgement lies solely with the inspector appointed by the Care Inspectorate.
The days of the long term elderly care wards where the patients had access to Geriatricians and highly skilled nursing staff are in the distant past.
Now Care Homes are caring for elderly people with extremely complex health care needs.
Instead of the experience and personal attention of a Geriatrician, it is the responsibility of the General Practitioner to provide the medical support to the elderly.
Instead of the trained nursing staff of an elderly care hospital, Care Homes can employ in some cases quite inexperienced, newly qualified trained nurses to provide the nursing care.
The trained nurse to care assistant ratio is also vastly diluted.
Nursing Care
Excellent care is what every care home provider wants to give but I believe Care Homes need more support than they presently receive.
New regulation and standards brings with it more paperwork and documentation and a constant need for development of its services.
Most Care Homes care for their residents in a respectful and dignified manner, but the shift and emphasis is now on complex management systems, paper trails, and not evidence based on practice.
Very few nurses in a management role have the required extensive management training or expertise.
Their main aim is to ensure the delivery of excellent practical care. Whilst modern management methods are to be welcomed a balance needs to be struck and that is sadly missing.
Guidance
It is vitally important that Care Homes are inspected regularly and any complaints are investigated thoroughly but that must be in a fair manner to everyone involved in the process.
Every inspector has their own opinions on what systems should be in place.
The Care Inspectorate do not accept the responsibility for giving guidance to service provider. It is up to the Care Home manager to read the mind of the inspector.
Failing to have this gift leaves the Care Home very much at a disadvantage and the mercy of their inspector.
The system which was adopted by the Health Board regulators and inspectors was a role of inspection but also support to the Care Homes in achieving excellence.
Any new legislation would be introduced to each home by way of a memo and if the new legislation involved a shift of focus or change in practice the Health Board hosted a seminar to introduce the changes which were being suggested.
Patient care is everyone’s priority, the young people of today will be the elderly of tomorrow.
Is elderly care improving and progressing as it should?
What is the best way forward?