CQC failing abused elders

Topics covered: Ridouts professional advice

Action on Elder Abuse, a specialist charity, has produced a report which claims that the Care Quality Commission is failing to protect adults experiencing abuse or neglect in hospitals.

The report asserts that the CQC has failed to follow up on individual incidents of maltreatment identified in inspections to ensure that patients are safeguarded.

The findings were based on an Action on Elder Abuse analysis of CQC’s inspection of 100 hospitals against dignity and nutrition standards.

CQC found one in five hospitals were not compliant with either the dignity or the nutrition standard. Failings included curtains not being closed when people were receiving personal care, call buttons being left out of patients’ reach and staff speaking to patients in a condescending or dismissive way. Some patients were also not given the help they needed to eat or interrupted during meals.

Action on Elder Abuse said many of the incidents met the definition of neglect in the No Secrets guidance, which includes “ignoring medical or physical care needs”, while repeated cases of poor care constituted “institutional abuse” under No Secrets.

The Nursing and Midwifery Council said it had initiated fitness-to-practice investigations into nurses whose practice was called into question by the CQC.

However, Action on Elder Abuse found:

• CQC made no adult safeguarding referrals on the back of the inspections.

• Serious issues of abuse or neglect did not result in hospitals being deemed non-compliant with the standards, because the CQC judged overall performance rather than individual incidents.

• Hospitals were given 14 to 28 days to respond to issues that should have warranted an adult safeguarding referral.

• Hospitals with more serious issues were given longer to address them.

Whilst the CQC has a protocol on safeguarding, the report said: “These inspections suggest CQC has little or no sense or urgency in terms of its regulatory activity, often leaving very vulnerable people in neglectful or abusive settings while waiting for ‘action plans’ to be delivered by a care provider.”

Action on Elder Abuse said suspicions and or evidence of abuse and neglect identified by CQC needed to be reported as adult safeguarding referrals, with any decision not to do so explained in the relevant inspection report.

A CQC spokesperson said: “The analysis suggests we may not have followed up on safeguarding issues in the right way. We take these matters very seriously, as CQC’s national report made clear, and are confident we picked up on these during the inspections.”

The report urges CQC to ensure that inspectors have comprehensive training in the Mental Capacity Act and Human Rights Act to identify cases of these pieces of legislation being breached.

It also called for the Department of Health to “urgently consider” an independent inquiry into the operation and management of the CQC to establish whether it was “fit for purpose”.

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