Patchy care puts people living with dementia at risk, says CQC

A major review of dementia care carried out by the Care Quality Commission (CQC) says the unacceptable gap in the quality of care means it is likely that many people living with dementia will experience poor care as they move between care homes and hospitals.

CQC inspected care in 129 care homes and 20 hospitals across England, looking at four areas: how people’s care needs were assessed; how care was planned and delivered; how providers worked together and how the quality of care was monitored.

In about 29 per cent of care homes and 56 per cent of hospitals CQC inspected, it found assessments were not comprehensive in identifying all of a person’s care needs. In about 34 per cent of care homes and 42 per cent of hospitals, CQC found aspects of variable or poor care regarding how the care met people’s mental health, emotional and social needs.

Entitled Cracks in the Pathway, the report says the variation in how care is assessed, planned, delivered and monitored by hospitals and care homes puts people living with dementia at risk of experiencing poor care.

It found when people are admitted to hospital via A&E there is too much focus on a person’s physical health needs. There is also poor sharing of information between health professionals, people living with dementia in care homes and hospitals may not be able to tell staff about their pain and there is a lack of understanding and knowledge of dementia care by staff.

The report adds that supporting both the physical health and mental wellbeing of a person – as well as managing known risks such as falls and urinary tract infections– can help reduce avoidable admissions to hospital and unnecessary long stays in hospital.

Commenting on the report’s findings, Andrea Sutcliffe, chief Inspector of adult social care, said: “People living with dementia, their families and carers have every right to be treated with respect, dignity and compassion.

“Our review found some 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.”

Health secretary Jeremy Hunt said: “There can be no excuse, and no hiding place, for poor care within our NHS – 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.

Jeremy Hughes, chief executive at Alzheimer’s Society, said: ‘With a staggering 90 per cent of the care homes and hospitals inspected found to have aspects of variable or poor care, this report highlights 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.

“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.”

Davina Ludlow, director of carehome.co.uk, the UK’s leading care home recommendation website, called for more effective sharing of best practice between care homes and hospitals for dementia patients. She said: “The care sector as a whole must find a way to improve the service it provides for people living with dementia. The key to this is training. Employees who work with dementia patients need to be 100 per cent confident they’re giving the very best treatment.“

“The majority of care home employees are getting dementia care right, offering superb levels of care for people with complex needs, every day."

“It would be useful for that best practice to be shared with staff in hospitals in particular, who may not come into contact with dementia patients on a daily basis, but still need the specialist skills to provide the right care.”

To read the full report go to http://www.cqc.org.uk/cracksinthepathway