Healthwatch Isle of Wight Response to 14 August 2015 County Press Article
Healthwatch is an independent consumer champion for health and social care services. Since January this year, Healthwatch Isle of Wight has been raising concerns about the quality of care in an increasing number of residential care homes on the Island both at the Health and WellBeing Board and the Health and Adult Social Care Scrutiny Committee.
Healthwatch Isle of Wight was therefore very disappointed to read the comments from Karen Baker IW NHS Trust Chief Executive and Cllr Steve Stubbings (IOW Council Executive member for adult social care) detailed in the IOW County Press on the 14th August 2015.
The inference from both that the Care Quality Commission are partly responsible for the major incident status at the IOW NHS Trust recently, is both misleading and irresponsible.
Throughout the course of 2015, Healthwatch Isle of Wight has received feedback from a number of members of the public, expressing concerns around the quality of care provided within a significant number of residential homes on the Island. Healthwatch found that of the 92 IOW residential and nursing homes registered with the Care Quality Commission, 17 have been inspected under their new inspection model and had their reports published. Of those 17, only 3 have been rated as good. 8 are requiring improvement and 6 have been rated as inadequate. Put quite simply, this is not good enough.
This compares to a ratio of 58% of homes on the mainland who have been inspected under the new CQC inspection model and are rated as good, with only 8% rated as inadequate .
Care homes face enormous pressure with the reduction in funding available for adult social care, difficulties in recruiting staff and increasing complexity of needs of the people they care for, however, the Isle of Wight has significantly poorer CQC inspection results than other localities within the Wessex region. Our care sector has reached a crossroads and cannot be allowed to continue with business as usual.
Healthwatch is aware that there are many homes on the Island that provide an excellent quality of care to the vulnerable adults they support, however there are also a growing number of homes who are providing unsafe and inadequate care. In this day and age, older people, who are among the most vulnerable in our society, should not be placed at risk in services commissioned by the Local authority.
The following comments have been taken from recent CQC reports:
"Some staff did not show a caring attitude towards people and the majority of staff interactions were task focussed and did not deliver individualised care”
“Some mattresses and bedding in peoples rooms were stained brown and smelt of urine. Staff remade the beds with linen that was not clean.
A person told us
“ if you need the toilet, you sometimes have to wait 20 minutes”
“Drinks were not readily available to people”
“One person repeatedly put their hand up to try and attract the attention of staff, but was ignored each time.
This is not an acceptable standard of care. Poor care is poor care and providers should be supported to improve, not given justification for their failure to meet `Fundamental Standards`
Healthwatch Isle of Wight is also unimpressed with the previous statement made by the NHS Trust that implied older patients were being too picky about the homes they choose to be discharged to. We understand that there are significant pressures faced by the Trust, but this is no doubt compounded by the closure of some wards due to refurbishment.
One of the underpinning principles of the Isle of Wight Safeguarding Adults Multi-agency Policy states that `commissioners and contractors must ensure that contract monitoring has a clear focus on safeguarding and dignity, and that any shortfalls in standards are actively addressed. ` This clearly indicates the responsibilities of local commissioners, however, feedback from the Local Authority would indicate that in January this year, 108 care reviews were more than three months out of date. Quality assurance visits to residential care homes had also been phased out unless as the result of a safeguarding concern. This kind of reactive movement has not led to the development of a culture of quality service improvement within adult services and of significant concern are the homes with a consistent history of poor care, preceding the introduction of the new CQC Fundamental standards. Why are they consistently allowed to fail?
When referring to the new inspection model used by the Care Quality Commission, Cllr Steve Stubbings stated in the press that “they don’t actually address whether the home is giving a good level of care”. Healthwatch would dispute this. When the Care Quality Commission inspect a residential care home, they use a variety of methods to assess quality. This includes an observation of staff working practices, a review of documentation, requesting feedback from service users, families and professionals. They also gather intelligence from the local authority and Healthwatch Isle of Wight. Although some of the most recent inspection reports have been negative, the positive aspects of care that exist have been highlighted within the reports. Some of the reports make comments such as “ staff had received the necessary training, “staff had a caring and respectful manner” or “staff could not do more”. However, when coupled with the serious concerns that have also been highlighted, it is clear that the new inspection regime is achieving its goal of uncovering safe practices.
Despite the fact that many homes have been praised for the care demonstrated by staff, good intentions and a caring approach does not ensure safe and effective care. The most recent Care Quality Commission reports have highlighted a series of shortcomings from many different providers and these cannot be allowed to continue.
The Care Quality Commission Fundamental Standards “or onerous new rules” were introduced to drive up standards of care. They include the right for people to be treated with dignity and respect at all times while they are receiving care and treatment. And the right to have care or treatment that is tailored to them and meets their needs and preferences. These are basic rights that anyone should expect whilst needing care and support. Any drive to improve quality and standards should be encouraged and applauded, not blamed for system pressures.
Healthwatch would urge that residents, family members, staff or members of the public contact them with feedback about residential care homes on the Isle of Wight, whether good or bad. We can then use this to support providers and commissioners to improve the services they provide.
The care and support of older people will affect us all either personally or through members of our family so it is vital that we get it right, first time, for everyone. This is nothing less than people deserve.
