Dementia care suffering because services are struggling to cope, CQC says
People with dementia are not receiving care that meets their needs because health and adult social care services are struggling to cope, a report by regulator the Care Quality Commission (CQC) has concluded.
In addition, the regulator said the quality of mental health services varies widely across the country and are not improving quickly enough. It also revealed that that only 80% of mental health services have adequate staffing levels - an 11% drop from 2011-12. At the same time, staffing for physical health services has actually increased.
The CQC’s Care Update found that people with dementia living in a care home are more likely to go to hospital with avoidable conditions such as urinary infections than similar people without dementia. Once in hospital, they are more likely to stay longer, be readmitted, and die there than similar people who do not have dementia.
It concludes that those services involved in caring for people must do more to make sure people get safe, quality care that identifies and meets their needs.
In addition, independent hospitals and community services still have some way to go to provide a good quality of care for people with mental health issues, the report said.
CQC’s latest Care Update is based on more than 20,000 inspections carried out between April 1 and December 31, 2012.
David Behan, chief executive of the CQC, said: “The majority of services are delivering good quality care. However care providers must do more to make sure that care is based on people’s individual needs.
“The people in charge of care homes and hospitals must work better, individually and together to ensure the right services are in place for people with dementia and their staff must be trained to identify dementia.
“A patient-centred culture of care needs strong leadership, openness and transparency, and CQC will look closely at this in the coming year, particularly in those services caring for some of the most vulnerable people in our society.
“We will also be using and sharing the evidence of what works well to drive change in those providers and services that need to improve.”
However, Paul Jenkins, CEO of mental health charity Rethink Mental Illness, has urged the Government to act now to protect people with mental illness. “This report shows an alarming drop in the standards of care for people with mental illness,” he said. “Our members have been telling us about the impact of cuts for years, and this report provides hard evidence of how mental health services are being hit.
“The Government has repeatedly claimed that one of their key ambitions is to put mental health on a level with physical health, but this report shows that on the ground, this isn’t happening, in fact the gap is widening.
“This is particularly worrying in light of The Schizophrenia Commission’s findings, which revealed last year that some mental health services are already desperately under-resourced and under-staffed. They found ‘shameful’ standards of care on some acute mental health wards, which can make patients worse rather than better. We need to be investing more of our health budget in mental health, not letting things get even worse.
“Ministers must act urgently to make sure that mental health services have the resources and staff that they need to provide the care that all patients deserve. It could be the difference between life and death for some of the most vulnerable people in our society.”
Mike Farrar, chief executive of the NHS Confederation, also urged standards to improve. He said: “The health and care system is probably under the most pressure it has ever experienced, facing a combination of unprecedented financial pressures, radical structural reforms and reorganisation about to come into effect, and the intense focus on quality which the Mid Staffordshire Inquiry has produced.
"Against this backdrop, it is good to see that the Care Quality Commission reports there has been good progress and that the majority of services are delivering good quality care.
"But until every patient and service user, in every part of the country, gets first class care and every single time, we are failing to achieve the standards the public rightly expects of us.
"The fact that care home residents who have dementia are more likely to require hospital treatment for avoidable conditions than people without dementia is wholly unacceptable. The number of people with dementia is rising, and is expected to reach 1 million in the next 30 years, so we must prepare properly now. The changes required need not be expensive to implement or to deliver, but they do require a step change in behaviours, values, training, and importantly, improvements to the way the service is set up to make sure that no one falls between the cracks."
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