VOL: 97, ISSUE: 47, PAGE NO: 31
Pat Ramdhanie, RGN HV DNDNo one would dispute that the regulation of long-term care is in need of review. It also seems evident that such a review should reveal lessons to be learned from the experience of the past 16 years.
No one would dispute that the regulation of long-term care is in need of review. It also seems evident that such a review should reveal lessons to be learned from the experience of the past 16 years.
In the wake of the scandal of poor care in some local authority homes, the need for the registration and inspection of private and voluntary care was recognised and addressed by the Registered Homes Act 1984.
Those charged with implementing this legislation were drawn from the 'caring professions'. Social workers regulated residential homes and nurses regulated nursing homes and private hospitals.
But there was no appreciation that any training might be required. What training there was consisted of 'learning alongside Nellie', and no one checked how much Nellie knew. There were neither national standards nor any system of audit by which to measure performance.
Every regulatory authority devised and implemented its own standards. This depended on the commitment, personality and often the charisma of the unit head. Safe Enough, a recent report by the Social Services Inspectorate, revealed that in many instances this failed to safeguard users and was not helpful to providers.
All this is to change in April next year when the Care Standards Act 2000 replaces the Registered Homes Act.
This will create a central independent regulatory body with nationally agreed minimum standards. Long-term care will no longer be divided into residential and nursing care, but will simply be care.
Nurses working in the community need to be aware that they may be the only people with nursing knowledge who set foot in a care home.
Those working in elderly care units need to know the type of home they are discharging their patients to, or where their patients come from. Nurses need to be mindful of the vulnerability of those living in care.
What does not seem to have been adequately addressed is the need for the comprehensive training of registrars and inspectors. Learning materials are to be developed and delivered by organisations with no knowledge of the subject, working with the current post-holders - some of whom have questionable work practices.
It is difficult to think of any occupation in which training would be so badly managed. Imagine being taught to drive by a non-driver. To coin a phrase, such ideas are too silly even to laugh at. But no one is laughing at these training proposals, perhaps because savings have to be made in long-term care.
The logistics of reorganising the current system into an independent regulatory body are daunting. However, if the government is serious that regulation is to be improved to protect the vulnerable, then training must be given a higher priority.