In July we launched a new project with the NHS Confederation and the Local Government Group to examine the standards of care older people receive in hospitals and care homes. The ‘Commission on Dignity in Care’ aims to understand why older people continually face poor standards of care and what changes will help to drive improvement.
The Commission was established in light of a series of reports ranging from the Mid Staffordshire NHS Trust inquiry to the Health Ombudsman’s report on patient complaints. We regularly read reports criticising the unacceptable levels of care and the Commission hopes to come up with some practical solutions to combat these problems. We know that some hospitals and care homes are delivering excellent care and we want to share what it is they are doing and how they have done it. The truth is that we rely on NHS services and move into care homes when we are often at our most vulnerable and in need of high quality care and compassion. The Commission hopes to identify how leadership, values and culture can be influenced to ensure that people are treated as individuals and standards of dignity in care are improved.
Last week we held the first oral evidence session as part of the Commission’s enquiry. This first evidence session was very encouraging in the openness and frankness with which all the participants spoke. Perhaps the strongest point which was made a number of times was the failure of hospital and care home staff to treat people, who may have multiple and often complex health needs, as well as emotional needs, as individuals. Kathryn Hudson, Deputy Parliamentary and Health Service Ombudsman said she felt that in some places a culture exists which fails to respond to the whole person and instead treats patients as a ‘nuisance.’ Dr Jane Martin, Local Government Ombudsman suggested a ‘zero tolerance approach to neglectful behaviour’ was needed.
Whilst we won’t be able to make recommendations until we have heard all the evidence even at this stage it is possible to identify some of the commonly cited problems; poor discharge planning, failure of hospitals and care homes to deal with complaints and absence of care plans or failure to properly follow plans. Advocacy schemes, better data and improved training were seen as part of the solution. Sharon Blackburn from the National Care Forum said problems often stemmed not from a failure of technical competence but rather from the way in which care was delivered, and that good relationships between staff and patients or residents created the conditions for ensuring dignity in care.
Further oral evidence sessions will be held this month then the commission will consult on a draft report and recommendations and plans to publish a final report during the spring of 2012.