Chief Inspector of Adult Social Care at the Care Quality Commission Andrea Sutcliffe says that almost a third of services are failing what she calls the ‘mum’ test.
The Care Quality Commission is an independent organisation that regulates the provision of health and social care in England. The Commission inspects care providers to ensure that they are safe, effective and compassionate, offering an overall high-quality care service.
When assessing a residential care home or a care service, Ms Sutcliffe considers whether it would be a service that she would be happy for someone she loves and cares about to use.
In nearly one third of cases, the answer is no – with the services being graded by the Commission as inadequate or requiring improvement. Almost of quarter of those services had previously received a warning by the Commission but had not improved, with some actually getting worse.
Ms Sutcliffe notes that there is sometimes ill-treatment and neglect of the elderly which she describes as “quite shocking”. In some cases, care home residents are found suffering from malnutrition and dehydration. She explains that her inspectors have found instances where food is provided but simply left with a resident who requires assistance to eat.
A major reason that staff do not provide a good service is that they are frequently too overstretched to be able to care for each resident adequately. For example, elderly people who are wheelchair or bed bound need to change position frequently – typically every two hours – so that they are not putting pressure on particular areas all of the time. Cleanliness is essential and massages are highly beneficial. If there are not enough staff to ensure each bed or wheelchair bound resident gets this level of care, bed sores can develop, muscles can stiffen and contract, and the lungs get wetter and less able to breathe properly. Blood clots can also form in the blood vessels causing severe complications.
Ms Sutcliffe also observed that in some homes there was a lack of stimulation. The only form of entertainment was a TV blaring through the day. Although this might not amount to cruelty or neglect, it would certain be fair to say that this is not a good life.
What you can do
If you have an elderly relative who may need care in the future, make sure they have a Lasting Power of Attorney (LPA) in place. Should they lose mental capacity in the future, a Lasting Power of Attorney will allow you to be involved with aspects of their care such as assessments for funding under the NHS Continuing Healthcare scheme, choosing a care home or care service and negotiating with the home if you are unhappy about the services that have been provided.
There are two types of LPA: one covering decisions relating to finance and property, and the other covering decisions relating to health and care. All adults aged 18 or older should have these documents which allow you to nominate someone you trust to make decisions for you, should you lose the capacity to do so in the future. The finance and property LPA can also be used at any time once registered with your permission, making it a very useful document where an elderly relative still has mental capacity but would benefit from some help with their bills and accounts.