CQC finds ‘unacceptable’ variation in quality of dementia care

People with dementia are being put at risk of substandard care by an ‘unacceptable’ variation in the quality of treatment provided at care homes and hospitals across England, a review by England’s social care regulator has found.

The Care Quality Commisson’s Cracks in the Pathway report reviewed inspection findings from 129 care homes and 20 hospitals. The review found that, overall, services were delivering more good care than poor care. But it also found that nine out of 10 of the hospitals and care homes had some elements of care that were of variable or poor standards, a finding campaigners said was “staggering”.

The review’s key findings showed that:

• In 29% of care homes and 56% of hospitals inspected, assessments were not comprehensive in identifying all of a person’s care needs.
• In 34% of care homes and 42% of hospitals, there were aspects of variable or poor care in relation to people’s mental health, emotional and social needs.
• In 27% of care homes and 22% of hospitals, there was poor information sharing when people moved between the services.
• In 27% of care homes and 56% of hospitals, there were issues around staff understanding of dementia care.
• In response to its findings, the CQC is to appoint a national specialist adviser for dementia care and provide specialist dementia training to its inspection teams. The regulator will also add a section to hospital inspection reports specifically focused on dementia care.

Andrea Sutcliffe, the CQC’s chief inspector of adult social care, said the review had found some examples of “great care” delivered by “committed, skilled and dedicated staff”.

“But this is not the case everywhere or even within the same service meaning too many people are at risk of poor care. This has got to change. A wealth of guidance exists to drive the delivery of excellent care for people living with dementia. We need to make sure that every care home and hospital achieves the high standard of care we see in the best services,” she added.

Jeremy Hughes, chief executive at Alzheimer’s Society, said the CQC’s findings were “staggering” and highlighted “the plight that many people with dementia face”.

“The inconsistency of care found here means many people are rightly worried about being admitted to hospital or having to move into care. Carers have told us that their loved ones have gone for hours without food or water in hospital or that they were in pain but no one realised. Staff can also find communicating with people with dementia extremely challenging and wards and a new care home can be disorientating to navigate,” he said.

“However, we know there are many care homes and hospitals that are getting it right by training their staff in person centred care and making their homes and wards more dementia friendly. Developing staff and helping them understand the needs of people with dementia is vital if we are to improve the care people receive.”

Health secretary Jeremy Hunt said there was “no excuse” for poor care.

“We are focusing on improving the lives of dementia patients and their families as never before. That’s why we’ve trained thousands of NHS staff to recognise the signs of dementia and invested in dementia friendly care homes and hospital wards,” he said.

“The CQC play a vital role in improving care through their tough new inspections and it’s vital that they continue to shine a light on any poor practice so that we can drive up standards throughout the country.”