Safety in care homes has been criticised by the Care Quality Commission with 23% rated as requiring improvement and 2% as inadequate.

The CQC said the low ratings were ‘concerning’ and ‘indicate poor quality’. The study, in which data was pulled from 33,000 inspections of 24,000 services, said:

“Poor safety can mean systems and processes that are not adequate for managing medicines or determining staffing levels.”

The report found there were ‘often unsafe levels’ of staff in the care homes, and even when ‘appropriate numbers’ of staff were in place, often they were lacking in the appropriate skills to have a positive impact on safety.  Unfortunately, where appropriate numbers of staff were in place, if they did not have the necessary skills this could have an impact on safety.

During one inspection of a service that was rated as inadequate, the CQC found the manager did not know what skills their agency workers had, and did not have the skills needed to support the people with complex needs.

Staff training was also a factor on safety, particularly in areas such as infection control, risk assessments, safeguarding and medicines.

The study of care homes is the first time the body has undertaken such in-depth analysis since its new regulatory regime in October 2014, and also since April 2015, when it took over health and safety responsibilities from the Health and Safety Executive. During this period, it has prosecuted five care providers.

While all five prosecutions so far have related to a breach in safe care and treatment requirements, the cases have covered a wide range of safety issues, including medication errors, uncovered radiators and use of bed rails.

The CQC found a number of recurring themes such as: issues with documentation and allocation of medicines, risk assessments, equipment, and staff training.

The five prosecutions included:

  • A provider was fined £190,000 following the death of a 62-year-old man who broke his neck in a fall from a shower chair at a nursing home in West Yorkshire.
  • A provider was fined £50,000 and a former manager £665 after the death of a resident at Cotton Hill House care home, following errors with the administration of his anti-coagulant medication.
  • A provider was fined £24,600 following an incident when a 79 year old woman fell against an uncovered radiator and suffered serious burns.
  • A provider was fined £82,430 following 14 offences for failing to provide safe care and treatment, failure to notify the CQC of the deaths of ten residents, and failure to notify regarding three serious incidents.
  • A provider was fined £163,185 after two offences with one resulting in avoidable harm to a resident who died in hospital after falling out of bed and re-fracturing his hip.