APPENDIX 23
Memorandum by Continuing Care Conference
(EA30)
INTRODUCTION
1. The Continuing Care Conference (CCC)
welcomes the Committee's inquiry into Elder Abuse and is pleased
to have the opportunity to submit written evidence to the inquiry.
2. The Continuing Care Conference (CCC),
which was established in 1992, is a unique coalition of commercial,
charitable and public service organisations with a mutual interest
in providing better care for current and future generations of
older people. Members include care providers and commissioners,
financial service providers, trade and professional bodies and
providers of information, advisory and advocacy services. It has
no political affiliation and does not seek to represent any single
sectoral interest group.
3. CCC's mission statement is: "We
believe that all older people in Britain should live their lives
in dignity, comfort and in a place of their choosing. We want
all elements of society to make the necessary individual and social
investment to ensure that happens. Our task is to ensure that
policy-makers pursue this goal and to encourage the public to
join with us in our mission to persuade them to do so".
4. A list of members is attached, for the
Committee's information. Individual CCC members will be responding
separately and in more detail on several aspects of the inquiry,
according to their specific expertise and experience. CCC's evidence
concentrates on broad issues affecting the care sector which we
believe to be relevant to this specific inquiry and also to the
wider question of ensuring good care. Our memorandum does not
claim to offer a complete analysis, merely to point out some "macro"
points that we believe should be taken into consideration by the
Committee when evaluating the totality of evidence. Our recommendations
are therefore limited to specific points; they are not intended
to cover the full range of measures required to improve the experience
of older people, particularly vulnerable older people, receiving
care.
CAUSES OF
ELDER ABUSE
5. Inappropriate or Inadequate Commissioning:
One of CCC's long-standing concerns relates to inappropriate or
inadequate commissioning of care. Contractual arrangements for
long-term care relate more to the quantity and cost of care than
to considerations of quality.
6. The concerns of residential care providers
about the level of fees are well documented. A report from the
Joseph Rowntree Foundation published in June 2002 concluded that
the fees that councils are prepared to pay are between £75
and £85 below the reasonable costs of running an efficient
and good quality care home. Furthermore, a survey commissioned
by CCC in 2000 found little correlation between the quality of
care and the price paid by the commissioner. At that time, only
11% of local authorities "rewarded" providers who delivered
higher quality services through the payment of higher fees[5].
Other market factors, such as undersupply of care beds in some
areas, staffing difficulties and some care being provided by homes
struggling on in the face of financial difficulty, can contribute
to situations which fall short of the ideal.
7. Examples of such external factors are:
— A shortfall of care beds leading
to a tolerance of care homes that are not "fit for purpose"
— Residents being accepted by care
homes that are ill equipped to provide appropriate care. For instance,
care homes that are struggling financially due to inadequate local
authority funding may find themselves having to accept any and
all residents offered to them.
8. CCC has always argued that better care
standards and increased funding must to hand in hand. Whilst drawing
attention in this submission to difficulties caused for care homes
by the lack of local authority funding, CCC recognises the difficulties
faced by local authorities themselves.
RECOMMENDATIONS
9. Training: Good practice is fostered in
many ways. Of these, we would point to the importance of widely
available adequate training at all levels of the workforce. Staff
training on the Identification of Abuse and the Protection of
Vulnerable Adults should become an integral part of the internal
policies of care homes.
10. Regrettably, adequate training is made
difficult by local authorities which pay care homes for care with
no specific consideration for the support and development of the
infrastructure of training within an organisation. We believe
that there should be a national rate, regionally adjusted as appropriate,
paid to care homes by local authorities. Such a rate would be
increased in line with inflation.
11. Comprehensive Safeguards: CCC recommends
that Criminal Records Bureau (CRB) checks should be required across
all provider sectors. Currently statutory social services do not
have to undergo CRB checks. Another useful tool would be the development
of a Protection of Vulnerable Adults list, similar to that used
in child protection, which would identify those individuals who
are deemed unfit to work with vulnerable adults in any care setting.
12. Publicising Good Practice Initiatives:
CCC encourages and supports any efforts made to identify, publicise
and spread good practice within the sector.
November 2003
5 The 2000 survey of local authority purchasing policies
related to the provision of residential care and nursing homes
places for older people. 145 questionnaires were sent out to local
authority contracts units on 31 January 2000. 107 completed questionnaires
were returned, a response rate of 74%. The results of this survey
can, therefore, be assumed to be representative of the total population
of local authorities. Back
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