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Dementia Care Homes and Inadequate CQC Ratings

Analysis of CQC reports shows specialist dementia care homes are more likely to receive inadequate ratings compared to ordinary care homes.

Reporters for the Daily mail have carried out an analysis of CQC gradings given to specialist dementia care homes. Figures reveal that specialist dementia homes are almost twice as likely as ordinary care homes to be given a substandard rating by the commission.

Currently, 22 per cent of homes which accommodate dementia patients are classed as 'inadequate' or 'requires improvement' by the Care Quality Commission. This compares with 12 per cent for non-dementia in English care homes.

The Daily Mail uncovered the harrowing examples of poor care in an analysis of inspection reports on the CQC's website. The Alzheimer's Society described the findings as 'heartbreaking'.

Examples of poor practice

Relatives at a care home in Northamptonshire resorted to coming in each day to feed their loved ones – as well as other residents – as staff did not have the time.

One nurse at a home in Lincolnshire told the CQC she was using Google for advice on looking after patients as she had not been properly trained. Some patients were at severe risk of dehydration and malnutrition.

Why do specialist dementia care homes perform worse than nursing homes?

It is hardly surprising that the analysis found that the performance of dementia care homes was worse than their counterparts. The complexity of providing a service for people with dementia demands:

  1. An environment specifically created to ameliorate the condition.

  2. Staff who have been trained with the specific skills and understanding of dementia.

  3. Availability of staff who are prepared to work with people who suffer from dementia.

The needs of people with dementia are often far greater than service users in non-specialist care homes. Admission of people who use specialist dementia services often takes place when family and other community support mechanisms are unable to cope with the presenting problems.

This means from day one the home has to provide a service for a person who may have no means of contributing to the care of themselves, resulting in the requirement for more staff to meet the needs of the person.

The difficulties in recruiting care staff is well documented., and I have no doubt it will be even more difficult for specialist dementia care homes.

The root cause

The root cause and the bottom line is the lack of funding. Creating a dementia supportive environment, staff training and improvement in the recruitment of staff demands more money. Improvement in practice will not be achieved by enforcement alone. Specialist care homes for people with dementia need to be properly funded. Most providers will know what is lacking in their service but find it difficult to provide quality services with the funding that is currently available to them.


We all take on board the comments of Kate Terroni, of the CQC, said: 'It is a basic human right for people to be treated with dignity and respect and to feel safe. Where we find this isn't happening, we will take robust action.' This issue however is not just about enforcement (important as that may be), it is also about an understanding of what is leading to the poor performance of specialist dementia care homes.

Although improvements in good practice can always be made, I believe that the root cause to the poor performance of specialist dementia care homes lies in the lack of funding. We are dealing here with a group of people who place great demands on services. Care homes will need to become more innovative in their learning and employ staff who are highly skilled in their understanding of the needs of people with dementia. Only then will we see improvement in the services provided by specialist care homes for people with dementia.

Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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