What’s so special about care homes and special measures

Last month, the Health Secretary, Jeremy Hunt, announced that the special measures scheme which was introduced in failing hospitals in the wake of the scandal at Mid Staffs was to be extended to care homes.

Commencing this October, care homes registered with the Care Quality Commission (CQC) will be subject to a new inspection regime which will introduce a rating system.

From April 2015, those care home providers who are deemed to have delivered an inadequate quality of service will be placed in special measures.

There can be no argument with the Government’s contention that those who fail to treat the old and vulnerable with dignity and respect should be exposed and that abuse cannot be tolerated or allowed to continue under any circumstances.

It is also the case that the overwhelming majority of providers strive to offer the highest possible standards of care to those using their services, subject to the financial constraints placed upon them given the budgets set by commissioning bodies, predominantly local authorities. There are many good examples of providers working alongside residents and their families in order to deliver the care and support required both by law and as a matter of basic humanity.

Furthermore, the proposal to offer assistance to providers who are considered to be delivering a poor quality of care in order to drive through improvements will also be welcome.

A consultation will take place over the autumn as to precisely how this scheme will operate in practice. As always, the devil will be in the detail and providers will be keen to understand how this new regime differs from the existing regulatory framework, what sort of assistance will be made available to providers and to what extent this approach will mark a step-change from what is widely perceived within the industry to be an unduly punitive enforcement policy.

In making the announcement, the threat of closure of those homes which continue to fail to deliver an acceptable level of care once assistance has been made available was presented as a key element of the new regime. As providers are already well aware, this is a power that the CQC already has. It follows that the success of this new approach, intended to drive up standards rather than simply punish those who fall short of delivering an acceptable level of care, will turn on the nature and effectiveness of the support available to those operators whose homes are placed in special measures.

Whilst it may well be the case that the special measures scheme has begun to deliver improvements in hospital care, the differences, not least in funding, between hospitals and care homes cannot be overlooked.  Writing in the Guardian newspaper in response to this announcement, Professor Martin Green, OBE, chief executive of Care England, commented that

‘The NHS spends £100,000 a minute on training. If we’re going to see a level playing field and the same expectations placed on care services as in health services, then the government must come forward and lead the agenda in terms of redistributing the money.’

He concludes by acknowledging the potential for this special measures regime to improve failing services but only if ‘developed in co-operation with the care sector and funded appropriately.’

Time will tell whether this proves to be the case or whether the new measures will prove not to be so special after all.

For further advice and assistance on regulatory matters in the social care sector, contact:

Mark Quigley, Head of Regulatory Department.

Mark Quigley
0191 226 4899

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