Thousands of care homes have no registered manager

More than 3,000 care homes in England do not have a registered manager, reflecting a crisis of quality in the sector, Action on Elder Abuse warns today.

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More than 3,000 care homes in England do not have a registered manager, reflecting a crisis of quality in the sector, Action on Elder Abuse has warned.

Releasing figures that “demonstrate a frightening picture of the state of residential care in England”, the charity said the sector’s problems went far wider than those of troubled provider Southern Cross.

As of the start of this month, there were requirements by the Care Quality Commission to have a registered manager in place at 3,011 care homes, about one-sixth of the total.

“The registered manager holds a crucial role in establishing and maintaining standards of quality. To have so many homes with requirements of this type is appalling,” said Action on Elder Abuse chief executive Gary FitzGerald.

Of the homes, 482 are owned by providers with applications to register managers still in progress with CQC. A CQC spokesperson said: “The 3,011 figure may be down to the need for care home providers to improve staff training, development and recruitment. It’s important to remember however that having a registered manager is a legal requirement as part of the new system of registration.’

Figures released to Action on Elder Abuse by the CQC under the Freedom of Information Act also revealed the extent of CQC requirements placed on homes run by the major four providers. As of 5 July, Southern Cross had “non-routine conditions” placed on the registration of 24% of its homes; the same was true of 32% of Four Seasons Health Care homes and 26% of Bupa homes. The figure for Barchester Healthcare was 17%.

FitzGerald said its findings showed that problems in the care home sector went far wider than Southern Cross, though he said that “not all the blame can be laid at the door of individual providers”.

He also attacked “bad commissioning by councils” and big cuts in inspections by the CQC from 2010-11, brought on by resources being diverted from site visits to the process of re-registering of care providers

Non-routine conditions require providers to make changes to ensure essential standards are met and can include for a registered manager to be appointed. However, the Action on Elder Abuse figures for the four providers exclude information on the number and nature of conditions placed on the providers’ homes.

A spokesperson for Barchester said it had 29 management posts awaiting registration, covering 14% of its homes, which would show up as a non-routine condition, and that it ensured that a “strong manager” was in place at its homes, regardless of their registration status.

The spokesperson added: “Barchester takes pride in having significantly fewer ‘non-routine conditions’ placed upon it than its competitors, including many local authorities and charities, but it is equally important to point out that for all providers, the vast majority of conditions not related to registration of managers are for minor infringements of administrative rules. It risks panic mongering to suggest that the current figures mean the sector is in crisis.”

A Four Seasons Health Care spokesperson said the data “highlights administrative issues and not care issues”, and were drawn from the registration process, not inspections of homes. He said: “Apart from having unregistered managers in place, these non-routine conditions may relate, for instance, to aspects of documentation, process, or other individual areas where an improvement is required.  We do not seek to under-play them and we address all individual recommendations by the CQC, but it is an enormous leap of logic bordering on irresponsible to suggest non-routine breaches of conditions imply that residents are not being properly cared for or are at risk.”

He added that there may be “good reasons” why managers are registered, including that they are working a trial period, and that Four Seasons had “capable management” in place in all homes. He also pointed out that 88% of its homes were rated good or excellent and none was rated poor before the abolition of the CQC’s quality ratings last year.

Oliver Thomas, Director, Bupa Care Homes UK, said: “Just because a home does not have a manager formally registered with CQC, it doesn’t mean that there isn’t a home manager in place nor does it mean that the home isn’t being managed properly.  The CQC system can be slow to register managers who have been in post for a while.  I am still seeing registrations being returned to me from October last year.”

CQC has announced plans to double the minimum number of inspections of adult care providers to yearly earlier this month, though this is dependent on extra resources from government.

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