ONE IN EIGHT care homes in England – more than 2,100 in total - have never had a ‘Good’ Care Quality Comission inspection report, OlderLivingMatters has discovered.
Before Christmas, there was an outcry when Ofsted revealed 138 schools, out of more than 24,000, have never had a ‘Good’ rating. But the care regulator admitted to OLM this week that 2,108 care homes, out of 16,000, have not received a ‘Good’ report, since its new inspection regime was introduced in 2014. And OLM’s investigations indicate some homes have been on the receiving end of highly-critical reports going back to 2011 and earlier.
The CQC’s ‘blacklist’ throws a shocking light on the widespread extent of substandard care in English homes Care homes throughout the country feature on the list – with 363 in the North West, 447 in the South East. 260 in the South West and 130 in London alone. And all the so-called 'Big Five' care groups have multiple homes on the list.
Barchester and Sunrise, which pride themselves on their exclusive ambience, both own homes on the list, as do Four Seasons, Bupa and Care UK as well as Britain’s largest care group, HC-One, the self-styled ‘Kind Care Company’.
Homes for frail older people, dementia sufferers and adults with disabilities all feature. They have all been rated ‘Inadequate’ or ‘Requires Improvement’ since the inspection regime was set up in 2014, to mirror Ofsted’s system. Each home is rated for safety, effectiveness, responsiveness, leadership and caring and then given an overall rating of Outstanding, Good, Requires Improvement and Inadequate. At present 11,489 homes in England have a ‘Good’ rating, 2,841 ‘Require Improvement’ and 298 are actually ‘Inadequate’. The smallest category is ‘Outstanding’ with just 294 homes receiving the top grade
In homes on the list, inspectors have found elderly people and dementia sufferers living in filth and squalor, without decent care, clothing or food. In archived reports, are stories of mattresses encrusted with faeces, urine-soaked clothing and helpless residents left naked in degrading situations while carers treat confused older people with disdain and casually humiliate them. There are reports of people with disabilities being physically threatened and cared for by staff who do not have the skills or knowledge to care for or protect them.
In one particularly harrowing case, an elderly resident told the CQC inspectors that she prayed for death, rather than continue living in one of the worst homes on the blacklist. But far more than the instances of ‘abuse’, the list discloses the endemic nature of poor care, driven by insufficient staff numbers. And the reports often show the routine, casual neglect of older and vulnerable people in so many apparently respectable homes. Meanwhile, owners seem ready to accept another below par report as a fact of business life.
Reports on New Park House in Stoke reveal an unremittingly awful history. It was so bad, when CQC inspectors went in last year, that frail residents told them: ‘”I'd rather die than live like this." They went on to say: "I pray over and over for the Lord to take me, it's no life."
Home to as many as 70 older people, New Park House looks like a grand Georgian Mansion, but looks can be deceptive. The home recently won one of OLM’s Worst Care of the Year Award 2017 – and for good reason. It has received 10 negative reports from the regulator since 2011. But it is not just privately-owned homes are on the list and homes catering for publicly-funded residents. Dozens of homes owned by leading and high-end care companies feature, along with 22 local authorities and household name charities.
There are numerous harrowing instances in the CQC’s reports, but many more cases of apparently consciously substandard care. So extensive are the problems, the industry must face accusations of institutionalised neglect.
Andrea Sutcliffe, Chief Inspector of Adult Social Care at the CQC) said: 'There are still too many services that are rated as ‘requires improvement’. This is a real concern as it means people living in these services cannot rely on consistent, good quality care, which is what they and their families have every right to expect. I am particularly worried about services that fail to tackle the problems we identify and we are increasing our focus on these services to ensure they take our findings seriously and act upon them.'
She added: 'The adult social care system as a whole needs to take this problem seriously. We should not be content that people in vulnerable circumstances can’t rely on the care and support we would want our own loved ones to experience.'
Care industry leaders often complain that they are not given sufficient public money to staff homes properly. Currently, Local Authorities pay up to £615 a week for nursing care. But, on the list, alongside state-funded care homes, are numerous exclusive care facilities, charging more than £1,000 a week for care. One of the most expensive homes in the country, where individuals are personally paying up to £1,500 a week features.
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Care UK is alone among the large operators in publishing indicative fees on its website. It discloses that residents in its Ellesmere House in London’s fashionable Chelsea pay ‘from’ £1,535 a week for nursing. On the CQC website, however, reports show the home has received five negative reports going back to 2013 – including one with an ‘Inadequate’ rating.
Home owners could find themselves defending expensive legal actions over the blacklist. In December, the Competition and Markets Authority announced that care home residents and their relatives had the same rights as any consumer – and could sue or refuse to pay if they do not receive the good or services they have paid for.
In the United States, local authorities and individuals have gone to law to reclaim fees from care groups which have provided inadequate care.
Although repeated negative reports appear to have little impact on attitudes, legal action might finally put an end to the endemic scourge of poor care.