Regulator warns of growing ‘risk of poor care’ as 1 in 6 nursing homes fail safeguarding standards

One in six nursing homes inspected by the Care Quality Commission (CQC) last year failed to meet key safeguarding standards, research reveals.

The CQC’s annual State of Care report to Parliament also shows that 14% of mental health and learning disability services and 12% of residential care homes failed to meet safeguarding standards.

The regulator warned of an increased risk of “poor or unsafe care” for patients after its review of over 13,000 inspections of health and social care services found that the increasing pressures facing social care providers are impacting the quality of services delivered.

Among the most commonly failed areas were standards linked to dignity and respect of patients, medicines management and record keeping and poor nutrition. 

Rising demand and growing numbers of clients with complex needs was exacerbating staffing problems in the social care sector, the CQC warned. Almost a quarter of nursing homes (23%) and 16% of care homes inspected failed to meet standards on staffing levels.

The report also warned that too much care is being delivered in a “task based” rather than “person centred” way with too many providers overseeing a “care culture in which the unacceptable becomes the norm”.

Poor staff development was also identified as a significant problem, with many social care services failing “to support staff with proper training, supervision, appraisals and development opportunities”.

The College of Social Work said that the report reinforced its concerns about the training of non-social work staff who are charged with key care duties.

Bernard Walker, chair of The College’s adults faculty, said: “As budgets are squeezed, there are very clear arguments for investing in social workers rather than cutting posts.”

“Social workers are unique in providing the knowledge and skills that enable service users to live independently as part of their communities, potentially reducing the requirement for costly packages of care.”

Ruth Cartwright, England manager at the British Association of Social Workers, said:

“Most community care social workers will have at times had some concerns over the care being offered to their service users by these kind of services. I would hope that they would take that up with the provider, their office, or the CQC.”

“The CQC talk about poor staffing levels and calibre. I think that is linked with financial constraints. All of our owners of care homes and domiciliary care agencies are complaining that the reason they can’t get enough good staff is that they’re not paid enough by local authorities to run the services,” Cartwright added.

“This is part of the workforce that isn’t valued enough despite the fact that hands-on care is incredibly difficult work.”

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. These pressures cannot be used as an excuse to deliver poor care.”

The CQC review also reiterated the findings of the regulator’s  review of learning disability services published earlier this year. The review, which was triggered by the Winterbourne View abuse scandal, found that independent hospitals for people with learning disabilities were more likely to fail standards in areas including use of restraint than NHS hospitals.