Unacceptable gaps in the quality of care of people with dementia mean it is likely they will experience poor care as they move between care homes and hospitals, a review by the Care Quality Commission (CQC) has found.
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 29% of care homes and 56% of hospitals CQC found assessments were not comprehensive in identifying all of a person’s care needs. Additionally, the CQC found that in about 34% of care homes and 42% of hospitals there were aspects of variable or poor care regarding how the care met people’s mental health, emotional and social needs.
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.
Supporting 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.
Risk of poor care
Andrea Sutcliffe, CQC’s 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.
“A wealth of guidance exists to drive the delivery of excellent care for people living with dementia. We need to make sure that every care home and hospital achieves the high standard of care we see in the best services.”
Jeremy Hughes, chief executive of the Alzheimer’s Society, added: ‘With a staggering 90% 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.”
Professor Gillian Leng, deputy chief executive and director of health and social care at the National Institute of Health and Care Excellence (NICE), said: “It’s vital that the excellent care highlighted in this report is replicated everywhere across the country. People with dementia deserve the best quality of life in their old age. With NICE’s range of guidance available to all, there is no excuse for standards of care to fall short.”