A nursing shortage in the care sector has been identified in a major report by the Care Quality Commission, which found an “unacceptable” variation in the quality and safety of care across England more generally.
The CQC’s annual report – called The State of Health Care and Adult Social Care in England 2013-14 – highlighted that in the past year, 20% of nursing homes failed to have enough staff on duty to ensure residents received safe care.
“When our inspections identify poor care, they must lead to improvement by providers”
There is a “significant variation” in the quality of adult social care – with nursing homes delivering much poorer services than residential care homes, said the regulator.
Describing a care home in Nottingham with “terribly poor” care, the CQC found patients were ignored when they shouted for help, and were positioned too far from their food resulting in it being spilled down them.
The regulator said that alongside its inspectors’ concerns, one of the nurses working at the care home had spoken out about the problems, eventually leading to the provider being barred from operating at the home.
The report said that that in the future, encouraging more nurses to work in care homes should be a “higher priority”.
The regulator drew no firm conclusion on the reason for staff shortages, but suggested it could be due to recruitment drives by the NHS in its attempt to secure additional healthcare-based nurses.
It said: “The recent increase in nurses in the NHS following the Francis Report may have exacerbated this. There may also be challenges about the perception of how well non-health care nursing roles are seen to fit into long term career paths for nurses.”
The CQC will roll out a new regulatory approach to the adult social care sector this month, which will involve more thorough inspections and a new ratings system.
Meanwhile, reviewing its inspections of acute services over the past year, the CQC said shortages of midwives in maternity units was a frequent issue, “including cases where the ratio of midwives to mothers was below recommended safe levels”.
However, it pointed to examples where progress had been made around staff shortages, such as nurses in trusts being recruited from Ireland, Spain and Portugal.
In addition, the report found that “too often” doctors and nurses in acute hospitals failed to understand the interactions between physical health and mental health that can delay or prevent recovery.
“Too often people with mental health problems receive a second-class response when they seek urgent help,” it said.
CQC chief executive David Behan said: “The findings from our inspections over the last year clearly show there is too much variation in quality and safety between services and within services.
“While we will celebrate good and outstanding care where we find it, we are calling time on unacceptable inadequate care,” he said.
“When our inspections identify poor care, they must lead to improvement by providers, who should learn from the good and outstanding care we champion through our new ratings,” he added.