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CQC finds gaps in nursing home DNR policy and training

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Nearly a third of nursing homes do not have a “do not attempt resuscitation” policy, according to a review by the Care Quality Commission.

In those nursing homes that do have a policy, just 37% of staff had received training on it, the regulator found as part of a special review of healthcare support for care home residents carried out with the British Geriatrics Society.

It has today published results from inspections and interviews at 81 care homes – including 27 nursing homes – in nine primary care trust areas considered to be especially “at risk of poor performance”. 

The regulator looked at whether older people and those with learning disabilities were treated with dignity, had choice in their care and were safe. The review will inform a programme of dignity and nutrition inspections at 500 homes later this year.   

Results showed a quarter of care home residents did not feel they were offered a choice of male or female staff to help them use the toilet.

In addition, only 44% of care homes received routine visits from GPs and 35% reported they “sometimes” had problems getting medicines to residents on time.

However, the commission said 77% of care plans had considered the views of the resident and 96% of homes identified the changing health care needs of residents through informal or responsive monitoring.

Meanwhile, the second part of the review was carried out by the British Geriatrics Society, which represents clinicians specialising in older patients’ care.

It analysed previously unpublished CQC data from a national survey of services provided by PCTs to care homes in their area. The society found more than half of PCTs did not offer access to the full range of health services that care home residents may need.

In only 43% of PCT areas were care home residents likely to have access to a full range of community health services – namely mental health teams, dietetics, occupational therapy, physiotherapy, podiatry, continence, falls and tissue viability.

Society president Finbarr Martin said the analysis “confirms our fears that the healthcare needs of older care home residents are being neglected in some areas”.

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Readers' comments (2)

  • Anonymous

    It isn't surprising that many nursing homes do not have a coherent and legally correct DNACPR policy - hospitals also struggle with DNACPR, DNACPR behaviour for end of life patients who are within their own homes is grossly muddled and flawed, and as soon as mental incapacity enters the picture prior to an arrest, hideous complexities become involved.

    It must be pretty bad, if the CQC managed to notice part of that mess !

    Older patients seem to get a pretty raw deal, and for some reason the concept of patient autonomy often seems to fade away as soon as a patient is old !

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  • Please can someone tell me what the standard is for displaying instruction signs re a resident in a residential care home where the family agreement is DNAR.
    Should the notification be limited to the patient notes only or should it be displayed on the door the patients room
    Thank you

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