20 October 2014

People with Dementia ‘Will Experience Poor Care’

People with dementia will experience poor care at some point while living in a care home or being treated in hospital, the Care Quality Commission (CQC) has warned.

The CQC carried out a specific review of the care of people living with dementia as they moved between care homes and acute hospitals in England during 2013 and 2014. The review included 129 care homes and 20 hospitals from 22 local authority areas.

Although the CQC found more good care than poor care in the care homes and hospitals that were inspected, the quality of care for people with dementia varied greatly.  At present, a person living with dementia will experience poor care at some point along the care pathway, they concluded.

The findings highlight the need for staff caring for people living with dementia to put into practice NICE’s recommendations for achieving high-quality dementia care, as outlined in the dementia quality standards.

NICE published the dementia quality standard in June 2010, which describes what a high-quality dementia service should look like, and in April 2013 published a quality standard which provides guidelines on supporting people to live well with dementia.

In December 2013, NICE also published a quality standard on the mental wellbeing of older people in care homes.

When the CQC asked staff about awareness and use of the NICE quality standards on dementia, they found examples of where the standards and clinical guidelines were being used effectively, but also a lack of awareness or demonstrable use of best practice.

In about 40 per cent of care homes and about 33 per cent of hospitals visited by the CQC, they found aspects of variable or poor care regarding staff knowledge and use of available guidance.

In about 29 per cent of care homes and 56 per cent of hospitals the CQC found aspects of variable or poor care regarding how a person’s needs are assessed.

NICE’s quality standards can be used to empower patients and carers to play an active role in managing their condition or illness.  However, the CQC found that in about 33 per cent of care homes and 61 per cent of hospitals, there was a lack of involvement regarding people or their families and carers in decisions about their care.

Professor Gillian Leng, Deputy Chief Executive and Director of Health and Social Care at 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.”

Andrea Sutcliffe, Chief Inspector of Adult Social Care at the CQC, 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.

“Our new approach to the regulation and inspection of health and social care means that we can celebrate good care, identify where improvements are needed and take action where necessary so that people living with dementia, their families and carers can always be confident about the care they receive.”

NICE has produced a tailored resource for carers and care providers on supporting people to live well with dementia. This resource is aimed at both care providers and carers focusing on the key messages from each quality statement relative to each audience. It provides links to key resources, further information, and practical tools which are again relative to carers and care providers as appropriate.