Care homes: The known and the unknown

The Care Quality Commission inspects care service providers in England

BBC News, Nick Triggle, Health Correspondent

The BBC Panorama exposé of Essex’s Old Deanery care home is shocking. But once you’ve absorbed the revelations, it’s natural to wonder just how widespread such abuse is. Andrea Sutcliffe, the chief inspector of social care, has been quick to say it is a minority issue. She is undoubtedly right. But what the regulator doesn’t know is just how big a minority. More than 17,000 care homes are registered in England. Since 2011, 1,200 have been given warning notices. Some of those are to do with care and staffing, but some are because of more mundane aspects, such as management and administrative processes including record-keeping (which of course is important but not evidence suggesting residents are being mistreated). What is more, most care homes have since made the improvements needed – although more than 400 still have the notices in place. From this, it would be easy to conclude that problems exist in just about 2% of homes (400 as a proportion of 17,000) and that in most cases the issues do not translate into the abuse found at the Old Deanery. But really this just tells us what is known. What it does not tell us is unknown. The uncomfortable truth: Let me explain. The problem with care homes – and Care Quality Commission inspectors are fairly open about this – is that it is much easier to hide abuse than it is in, say, hospitals. Hospitals are essentially open environments. Public and staff come and go. By comparison, care homes are private places where the main care being provided is personal, often intimate.