‘Special measures’ raise more questions than answers, says RNHA
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The Registered Nursing Home Association (RNHA) has called on health secretary Jeremy Hunt for reassurance that his hospital-style ‘special measures’ regime for failing care homes, announced last week, will be both workable and fair.
RNHA chief executive officer Frank Ursell said proposals lacked vital detail and it is was uncertain whether they could sensibly be applied to care homes.
“We welcome any constructive steps aimed at helping care homes to deliver high quality services to their residents,” said Mr Ursell.
“We have been calling for the reintroduction of a care home ratings system for some time and are pleased that it is now happening at last. A good ratings system helps care providers to evaluate how well they are performing against the general standards of their sector. It also helps potential residents and their families to decide which care home to choose.
“But the ‘special measures’ element that Mr Hunt is now talking about appears to have originated from steps taken originally to deal with failing NHS hospitals such as Stafford Hospital and several others that have been under that regime. So how exactly does Mr Hunt plan to apply this to care homes whose size, functions and funding arrangements are very different from those of big acute hospitals?”
The RNHA warns that if a care home is put into ‘special measures’, the risk is that the funding from local authorities to purchase places for older people would dry up, putting the care home immediately out of business before it could even address the quality problems that placed it in special measures.
“This must be thought through very carefully,” said Mr Ursell. “If the Government’s aim is to help care homes that are judged inadequate in terms of meeting essential standards, it will need to ensure that those homes remain financially viable during the period when key improvements are being made. Otherwise, the whole process will become a fruitless exercise.
“The practicability of the scheme will depend very much on the details that we have not yet been given. We hope that the health secretary and the Care Quality Commission will work closely with care home sector representatives to prevent the new arrangements from causing more problems than they solve.
“We should also like to hear about the kind of support that would be given to care homes that are put into special measures. As we understand it, NHS hospitals in this situation are given a great deal of help. How will that happen with care homes? Who will provide the assistance and for how long? All these questions need answering by Mr Hunt before his proposal can be seen as credible.
“We hope that it won’t be a case of one rule for the NHS and another for care homes. For example, we read that four hospitals in special measures have still not improved enough to be taken out of those measures. None has been closed. May we presume that care homes will be given at least the same time and flexibility to achieve improvements before they are forced to close? Again, this is very unclear.”