England’s Care Home Standards Under Scrutiny: Nearly One in Five Rated as Failing
New analysis reveals a concerning state within England’s elderly care sector, with nearly one in five care homes categorized as failing.
Alarming Number of ‘Inadequate’ and ‘Requires Improvement’ Ratings
An investigation has uncovered that 132 care facilities across England have received the lowest possible rating of ‘inadequate’ from the Care Quality Commission (CQC), the sector’s regulatory body. Furthermore, an additional 2,418 homes are classified as ‘requires improvement’.
Regional Disparities in Care Quality
The investigation highlighted significant regional disparities, with certain areas showing particularly high rates of sub-par care. Notably, in Liverpool, Halton, and Camden in central London, a staggering 40% of care homes are deemed to be below the expected standards.
Industry Leaders Voice Concerns Over “Postcode Lottery” of Care
Professor Martin Green, chief executive of Care England, has strongly criticized the “postcode lottery” effect, where the quality of care appears heavily dependent on location. He attributed this issue to inadequate commissioning practices by local authorities and insufficient funding rates.
Alison Bennett, the Liberal Democrat spokesperson for care, echoed these concerns, stating that “millions of elderly and vulnerable people across the country are struggling to access the necessary and deserved care.” She described the figures as “shocking” and reiterated the urgent need for social care reform. Bennett further criticized “Conservative neglect of local health and care services,” asserting it has severely impacted the National Health Service (NHS) and left families struggling to find appropriate care options for their relatives.
Bennett urged immediate action, emphasizing, “We cannot afford to wait three more years for the Government’s social care review. It must be completed by the end of the year to ensure people receive the care they urgently require.”
Interactive Tool to Examine Local Care Home Performance
Detailed findings from the investigation, encompassing nearly 14,000 care facilities, are available through interactive maps. These resources allow users to assess the overall performance of care homes in their specific area and view individual ratings for each facility.
CQC Inspection Framework and Rating System
The CQC typically inspects care homes every three years, with new establishments assessed within 12 months of opening. Homes are evaluated and assigned ratings based on a four-tier system:
- Outstanding (Blue)
- Good (Green)
- Requires Improvement (Amber)
- Inadequate (Red)
In Liverpool, which has the highest proportion of underperforming care homes, 29 out of 80 facilities received an ‘amber’ rating. According to CQC guidelines, this signifies that a service “is not performing as well as it should, and we have instructed the service on necessary improvements.”
Four homes in Liverpool were rated ‘inadequate’ (red), indicating “the service is performing poorly, and we have taken enforcement action against the responsible individual or organization.” The CQC possesses legal authority to prosecute non-compliant entities, with penalties ranging from substantial fines to imprisonment in severe cases.
Geographic Breakdown of Sub-par Care Homes
Following Liverpool in terms of high percentages of sub-par care homes are:
- Camden (40%)
- Halton (39%)
- Coventry (36%)
Conversely, certain London boroughs demonstrated exemplary performance. Islington, Kensington and Chelsea, Wandsworth, and Westminster reported zero sub-par care homes. In these areas, all 61 care providers were rated as either ‘good’ or ‘outstanding’ according to the analysis, accurate as of March 3rd.
Across England, 14 out of 153 local authorities reported that 30% of their care homes were underperforming. The Isles of Scilly, with only one care home, received an ‘amber’ rating.
CQC’s Five Key Assessment Areas
Care homes are also assessed across five key domains: safety, effectiveness, care, responsiveness, and leadership. Performance in these areas contributes to the overall CQC rating.
Recent Neglect Cases Highlight Systemic Issues
Recent incidents of alleged neglect further underscore the challenges within the care sector. This month, footage emerged of a disabled man eating from a bin at a private care home in Coventry, captured by a hidden camera installed by his concerned mother.
An investigation by ITV News uncovered multiple instances of alleged neglect at supported-living facilities operated by Lifeways, a major private care provider in the UK. Secretly recorded video showed Connor, a 23-year-old with complex needs, subjected to verbal abuse and mockery. In another instance, Connor was seemingly left unattended for an extended period and had to wake up his caregiver.
Connor was placed in the Lifeways facility in 2018, with the local council allocating £4,700 weekly for his care. The facility received a ‘requires improvement’ rating from the CQC in the previous year.
Connor, 23, has bipolar disorder, as well as autism and developmental delays as a result of a rare genetic condition called Phelan-McDermid Syndrome
The council paid Lifeways £4,700 per week for Connor’s stay, which was meant to include round-the-clock, one-to-one care – but a secret camera set up by his mother Lindsay revealed him eating from the bin for an hour, completely unsupervised
Andrea Kinkade, CEO of Lifeways, acknowledged the allegations in an ITV News interview, stating, “It is absolutely appalling to hear those stories and to hear about anybody who receives neglectful care or lack of care… It is absolutely shameful.” She claimed these incidents were “historic” and had been addressed robustly, leading to suspensions and dismissals at the time.
Abuse Allegations at Surrey Care Home
In a separate case, a Surrey care home faced scrutiny in February after footage of alleged abuse of an elderly resident was shared on the program ‘This Morning.’ ITV broadcast distressing clips recorded by Clare Miller and her brother, documenting the care of their mother, Ann King, at Grange care home in 2022. One clip depicted Ann being roughly handled in her bed while pleading with staff to stop. Other footage showed staff taunting Ann, dangling her possessions before her, and using offensive language.
Grange care home issued a statement to ‘This Morning’ asserting: “The behaviour of the individuals involved in Mrs King’s care three years ago was reprehensible and does not reflect our high standards. We have since implemented significant reforms to ensure families and care providers alike are protected from the actions of rogue individuals.”
Clare Miller told This Morning of the abuse her mother Ann King suffered at the Grange care home in Surrey in 2022
Government Response and Sector-Wide Challenges
A spokesperson for the Department of Health and Social Care stated, “Everybody deserves to be treated with dignity, and these figures are unacceptable.” They acknowledged inheriting a “social care system in crisis” and highlighted government actions, including £3.7 billion in funding and the launch of the Casey Commission to build consensus for a National Care Service. The spokesperson also cited Dr Penny Dash’s review, noting the CQC’s efforts to improve performance and public trust in its oversight abilities.
CQC Chief Executive Warns Against Over-Reliance on Rankings
Sir Julian Hartley, chief executive of the CQC, recently cautioned the public against placing undue trust in the regulator’s rankings. In an interview with the Sunday Times, he admitted the CQC had “lost its way,” with many reports being outdated. He attributed these issues to a new IT system that resulted in data loss, a backlog of safety alerts, increased training demands, and the departure of experienced inspectors.
Care Homes Warn of “Breaking Point” Amidst Funding and Staffing Pressures
Earlier this year, care homes across Britain warned they were nearing “breaking point” due to overstretched staffing levels, raising concerns about potential sector collapse. Social care providers cautioned in January that forthcoming changes to National Insurance Contributions (NICs) would further escalate costs by an estimated 10% in April, exacerbating the existing funding crisis. Care England estimates care homes will need to increase fees to local authorities by 8%, or over £3,000 annually, to offset increased costs stemming from recent budget measures.
CQC Acknowledges Sector Fragility and Calls for Feedback
James Bullion, interim chief inspector of Adult Social Care and Integrated Care at the CQC, told MailOnline, “Our annual State of Care report published in October last year highlighted that the adult social care sector remains fragile. The number of new requests for local authority adult social care support resulting in no service being provided has increased by 27% over the last 5 years.”
He continued, “Waits for care home beds and home-based care account for nearly half of delayed discharges for patients in hospital for more than 14 days. While staff vacancy rates have dropped slightly, the average vacancy rate in social care is still nearly three times higher than in the national workforce, and care workers are among the lowest paid members of society.”
Bullion emphasized, “The majority of care homes in England are good or outstanding and this reflects the incredible efforts of carers and providers who have gone above and beyond to provide high quality care. While we know many people are accessing good, safe care, it is clear that the issues in the sector continue to impact on quality of care for too many others.”
He concluded by stating the CQC has “accepted in full the findings and recommendations in the Penny Dash review, which identified clear areas where improvement is urgently needed,” and is “working at pace and in consultation with our stakeholders – including Local Authorities – to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve.” Bullion urged anyone with concerns about care quality to provide feedback through the CQC’s “Give Feedback on Care” service.