A stark variation in the quality of care homes at a regional and local authority level across England has been highlighted by new research.
The North West is the worst performing region in England when it comes to the proportion of satisfactory care homes, while London is the best performing region. In some areas such as Stockport or Salford, older people and their families face little choice of quality care, with three in five homes rated not good enough. That’s according to new analysis by Independent Age, the older people’s charity.
The key regional findings reveal:
• The North West contains seven of the eight worst performing English local authorities on care home quality, with one in three care homes across the region performing poorly.
• The North West (33.6 per cent of care homes performing poorly), Yorkshire and The Humber (32.2 per cent) and South East (28.2 per cent) are the worst performing regions of England for care home quality.
• London (20.3 per cent of care homes performing poorly), the East of England (20.8 per cent) and the South West (21.1 per cent) are the best performing regions for care home quality.
The new analysis is based on CQC inspections of care homes which rate homes as either ‘outstanding’, ‘good’, ‘requires improvement’ or ‘inadequate’. The analysis regarded homes rated ‘requires improvement’ or ‘inadequate’ as being poor performers.
Performance at local authority level shows even greater variation. Five local authority areas have more than half of homes rated ‘inadequate’ or ‘requires improvement’:
• Stockport – 62.9 per cent of homes
• Salford – 61.5 per cent
• Tameside – 54.8 per cent
• Manchester – 51.3 per cent
• Kensington and Chelsea – 50 per cent.
In contrast, five local authority areas have less than five per cent of homes rated 'inadequate’ or ‘requires improvement’, including three that have no care homes with those ratings:
• Isles of Scilly, Islington and Rutland – 0 per cent
• Richmond upon Thames – 2.3 per cent
• Thurrock – 2.9 per cent.
And variation even within a single region can see older and disabled people living in neighbouring areas facing very different choices:
• In Bury, which is in the North West, around 1 in 8 care homes in the local authority are rated ‘inadequate’ or ‘requires improvement’.
• But in neighbouring Salford, older and disabled people are faced with far fewer choices of quality care, with three in five homes in the local authority rated ‘inadequate’ or ‘requires improvement’.
Commenting on the findings, Simon Bottery, director of policy at Independent Age, says: “No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country.
"The market is simply not providing a decent choice for older people and their families but there is little indication that local authorities or the government are giving the problem the attention it deserves. Money is likely to be one cause but not the only one. The government has an opportunity to address this in its upcoming green paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them.”
Independent Age believes the drivers for care home quality variation includes factors such as low levels of funding by local authorities, low pay and difficulty recruiting staff, and the lack of a good support mechanism for improving care homes that are struggling. The care homes market is now valued at nearly £16 billion. However, social care is facing a £2.6billion funding gap by 2019/20.
In order to improve quality in the market, Independent Age makes the following recommendations:
• The Government must seek to tackle variation in care home quality in its forthcoming green paper on social care.
• In areas where there is a failure of quality, the local authority needs to understand the drivers for variation in the area and must do more to fulfil their Care Act duty to shape the local care market.
• Drawing on CQC data, Department of Health must understand what drives regional variation and demonstrate leadership on tackling variation in care home quality.
Margaret Willcox, president elect of the Association of Directors of Adult Social Services (ADASS), says: “High quality care is essential to providing good adult social care to professional standards expected by elderly and disabled people and their families, who both need and deserve it.
“Most health and adult social care services in England are providing people with safe, high quality and compassionate care, as recognised in last year’s annual Care and Quality Commission (CQC) report, with 71 per cent of adult social care services inspected rated as “good”.
“However, the CQC raised concerns that the sustainability of the adult social care market is approaching a tipping point. Despite councils working hard with providers and the sector to maintain and improve the quality of care provided, the chronic and historic underfunding of social care has severely impacted on their ability to do so.
“Reductions in funding, increased demand by people living longer and with more complex needs, and the cost of the National Living Wage, while welcome, are putting significant pressures on councils and providers who are finding it hard to recruit and retain staff, especially in home care in those areas of high employment.
“The £2 billion for adult social care for the next three years will help plug the funding gap for adult social but this is only a short-term measure.
“Adult social care needs to be a national priority. The forthcoming social care Green Paper provides a critical opportunity to future-proof adult social care and improve quality, and we look forward to working with the sector to help the Government achieve this vital goal for the benefit of society as a whole.”
The briefing ‘Care home performance across England’ is part of an Independent Age campaign to improve the quality of care homes available to older people.
