public health and social care

10.08.17

Concern raised as dignity and choice not being preserved in care homes

A major new report has revealed concerns about the state of care homes in England, including issues with poor environments, a lack of activities and not enough care being taken by staff to maintain residents’ dignity.

The report, called ‘What’s it like to live in a care home?’, was drawn up by representatives from Healthwatch, who visited 197 care homes in 67 local authority areas between January 2016 and April 2017 to talk to residents and get an idea of what life in care is like in England.

The majority of residents and relatives surveyed said the care they received was good, and researchers also reported innovative uses of technology and staff who went above and beyond the call of duty to make residents feel comfortable and happy.

But in some areas, many elements of care were not quite up to scratch.

Some residents said that maintaining dignity and choice with simple things like getting dressed was sometimes problematic. One person in a Wiltshire care home told Healthwatch that staff pulled clothes out of their drawers without asking what the resident wanted to wear.

Another resident in Wolverhampton stated that laundry was not always returned, and that sometimes their clothes were seen being worn by other people.

A total of 67 reports also said the environment of care homes was an issue, with problems including wallpaper peeling off and dead plants littering communal spaces.

Almost 50 reports explained that there was a strong need for more or better activities put on for residents, and another 43 claims focused on staffing in terms of low numbers, training and turnover. Over 30 reports stated that access to wider health services needed to be better for those in care.

“It’s not easy running a care home, particularly as the sector as a whole is trying to get to grips with the dual challenge of managing rising demand with limited resources,” said Healthwatch national director Imelda Redmond. “But getting the basics right doesn’t have to cost the earth and should be the least we should all be able to expect for our loved ones and ourselves should we need care support.

“Even the best homes we visited aren’t perfect, and it is vital that managers and care staff regularly speak with their residents to work out what’s going well and where they might need to improve.”

The Healthwatch lead argued that nobody would want someone dictating how we should live our lives in our own homes, so why should care home residents be expected to tolerate it? 

“Care homes are not institutions, they are people’s homes, and the only way to ensure they feel like this for residents is to put them at the heart of shaping how the care home runs,” she added. “Healthwatch is here to help with this and I would urge anyone who wants to share their experiences, good or bad, to get in touch.”

LGA: Another ‘stark reminder’ of the social care crisis

Responding to the report, the LGA stated that councils expected care homes to meet a high standard that went beyond simply getting people dressed and washed in the morning.

“While it is clear that in some places, there is work to be done and areas for improvement, it is encouraging to note that most people have said the care they receive is good,” Cllr Izzi Seccombe, chairman of the LGA’s Community Wellbeing Board, said.

“The recent Care Quality Commission report also found that the majority of care provided for adults is rated ‘good’ or ‘outstanding’. Councils as commissioners work closely with providers who deliver services to ensure both the availability of high-quality care and continuous improvement.”

However, Cllr Seccombe did concede that the study was yet another “stark reminder” of the reality of the funding crisis facing adult social care and the urgent need to bring stability to the provider market.

“While the £2bn announced in the Spring Budget for social care was a step in the right direction, it is only one-off funding and social care services still face an annual £2.3bn funding gap by 2020,” she argued. “It is absolutely critical that the government brings forward its consultation for social care announced in the Queen’s Speech, and that it works with local government leaders in delivering a long-term sustainable solution for social care.

“This must address the issue of long-term funding, but it must also create the conditions necessary to ensure the development of the right kind of care and support services.”

And Margaret Willcox, president of the Association of Directors of Adult Social Services (ADASS), added that the report was an “insightful” look which her organisation would take forward to deliver improvements across care homes and ensure high standards were being met.

“While it is not all about funding, the very difficult financial state of social care clearly impacts on the quality of services, and this report is a reminder of the need for government to address this for the short and longer term without delay,” she stated.

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