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14 July 2008 : Column 179W—continued

Care Homes: Inspections

Mr. Amess: To ask the Secretary of State for Health what criteria are used by the Commission for Social Care Inspection to judge the performance of care homes; how many (a) care homes, (b) residential homes and (c) nursing homes in (i) Southend, (ii) Essex and (iii) England were ordered to close in each of the last five years; and for what reason in each case. [214039]

Mr. Ivan Lewis: We have been informed by the Commission for Social Care Inspection (CSCI) that it
14 July 2008 : Column 180W
assesses the performance of care homes against the Care Homes Regulations 2001, taking account of the relevant national minimum standards (NMS). Inspectors also assess how care homes comply with other regulations, such as those relating to health and safety.

CSCI uses key lines of regulatory assessment (KLORA) to help in making judgments about each NMS outcome group. These guidance documents provide inspectors with examples of evidence that may be found in an excellent, good, adequate or poor service. The KLORA are a description of what the standards might look like in practice, not an additional set of standards that have to be met. They help to translate evidence into a judgement of either excellent, good, adequate or poor, to assist in assessing how well a care service is performing.

The following tables show the information held centrally with regard to the cancellation of registration of providers of care homes and care homes with nursing in Southend, Essex and England during the operational years from 2003-04 to 2007-08. The data cover both cancellation of registration under section 17 ‘normal’ cancellations following the set Notice of Proposal procedure and section 20 ‘urgent applications to a Justice of the Peace’, of the Care Standards Act 2000.

It should be noted that all care homes are residential. CSCI distinguishes between those that provide personal care only, nursing homes and non-medical nursing homes.

In Southend, three care homes underwent cancellation of registration during the period. These cancellations were due to continuous failure on the part of the providers in question to meet regulations and an unacceptable degree of risk to people living in the services.

In Essex, one care home underwent cancellation of registration during the period. The home, which was deregistered in 2004-05, provided a poor physical environment and had issues regarding staffing. This provider subsequently applied for a voluntary cancellation.

We have been informed by CSCI that to provide the reasons for all cancellations in England since 2003-04 would involve disproportionate cost.

Number of compulsory cancellations of registration issued (care homes in Essex and Southend on Sea)
Type of home Area 2003-04 2004-05 2005-06 2006-07 2007-08 Total

Care home—personal care only

Essex

0

1

0

0

0

1

Care home—personal care only

Southend on Sea

1

0

1

0

1

3

Total

1

1

1

0

1

4

Note:
Figures shown are non-urgent cancellations. There have been no urgent cancellation orders in either of these council areas during the period shown.
Source:
CSCI registration and inspection database. Data as at 27 June 2008.

Number of compulsory cancellations of registration issued (care homes in England)
Type of home 2003-04 2004-05 2005-06 2006-07 2007-08 Tot al

Care home with nursing

10

6

8

6

7

39

Care home—personal care only

49

21

25

28

31

162

Total

59

27

33

34

38

201

Note:
The figures shown include both urgent and non-urgent cancellations. Urgent cancellations are shown separately in the following table.
Source:
CSCI registration and inspection database. Data as at 27 June 2008.

14 July 2008 : Column 181W

14 July 2008 : Column 182W

Number of urgent cancellations of registration issued (care homes in England)
Type of home 2003-04 2004-05 2005-06 2006-07 2007-08 Total

Care home with nursing

0

0

1

0

0

1

Care home—personal care only

0

5

0

3

9

17

Totals

0

5

1

3

9

18

Source:
CSCI registration and inspection database. Data as at 27 June 2008.

Mr. Laurence Robertson: To ask the Secretary of State for Health (1) how often care homes are subject to inspection; and if he will make a statement; [218370]

(2) what the standard of care was in each care home inspected in each of the last three years for which details are available; and if he will make a statement. [218371]

Mr. Ivan Lewis: We have been informed by the Commission for Social Care Inspection (CSCI) that The Commission for Social Care Inspection (Fees and Frequency of Inspections) (Amendment) Regulations 2006 require CSCI to make arrangements to inspect care homes, domiciliary care agencies and adult placement schemes at least in every three-year period. The Regulations permit CSCI to take a proportionate approach to inspection, based on an assessment of the quality, risk and outcomes for the people who use services.

In order to make these assessments, CSCI carries out key inspections of all registered services. Key inspections, which are usually unannounced, are a thorough examination of how well a service is performing. Inspections take into account information provided by the owner or manager, the views and experiences of people living there, their relatives, staff and visiting professionals, as well as information CSCI finds when it visits the service. CSCI also considers any relevant information it has received about the service since the last inspection, for example, concerns that may have been raised.

CSCI uses all information collected to measure how far the experiences of people using a service meet their expectations in areas that are important to them. Inspecting in this way helps CSCI to put residents at the heart of how it judges the quality of services. From these judgments, CSCI awards quality ratings, which help it to plan how often the service should be inspected in future. The frequencies are:

This does not mean that a service will not be inspected more often if necessary. CSCI also carries out shorter, targeted, random inspections. These are usually unannounced and can take place at any time of the day or night. CSCI may undertake a random inspection because it has received information that suggests people using the service might be at risk, or to check on improvements that should have been made.

During each year in which services rated excellent or good are not inspected, CSCI carries out an annual service review. During a review, CSCI analyses all the information received about the service during the last 12 months, including any complaints or notifications. It also surveys people using the service and other interested parties. If, as a result of the review, CSCI considers the quality of the service may have changed, it may decide to bring forward the next key inspection or to carry out a random inspection visit.

To provide information on the standard of care in every care home inspected in each of the last three years would incur disproportionate cost. CSCI inspects homes against the National Minimum Standards (NMS) for Care Homes for Older People or the NMS for Care Homes for Adults. The decision as to which set of NMS should be used is made by the inspector at the time of the inspection and is based on the current age profile of the residents of the home. The following tables show the percentages of homes meeting or exceeding the individual NMS during the last three years for which information is available.


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14 July 2008 : Column 184W
Percentages of services meeting or exceeding individual NMS for care homes for older people 2004-05 to 2006-07
National minimum standard
Private Council Voluntary Totals for all services

2004-05 2005-06 2006-07 2004-05 2005-06 2006-07 2004-05 2005-06 2006-07 2004-05 2005-06 2006-07

Information

72

78

78

71

76

77

76

84

82

72

78

78

Contract

81

85

83

74

78

77

85

89

87

81

85

83

Needs assessment

82

85

84

84

85

84

88

87

86

83

84

84

Meeting needs

81

83

83

82

84

82

88

90

89

82

84

83

Trial visits

96

97

97

93

94

95

99

99

98

96

97

97

Intermediate care

80

86

87

81

82

87

90

92

95

82

86

88

Service user plan

56

57

56

58

55

58

57

58

56

56

57

56

Healthcare

77

77

79

80

83

80

83

84

83

78

78

79

Medication

56

59

60

60

60

60

58

58

60

56

59

60

Privacy and dignity

88

89

89

90

92

94

94

94

94

89

89

90

Dying and death

88

89

88

86

87

88

93

92

93

88

89

89

Social contact and activities

80

78

75

82

79

76

87

86

85

81

79

76

Community contact

97

98

97

97

98

98

98

98

99

97

98

97

Autonomy and choice

90

90

91

94

93

94

95

95

95

91

91

92

Meals and mealtimes

84

84

85

86

89

89

89

91

92

84

85

86

Complaints

85

86

87

86

88

89

91

90

90

85

87

88

Rights

96

96

96

97

97

96

98

98

98

96

96

96

Protection

73

73

76

82

85

86

82

83

84

75

75

78

Premises

68

66

67

57

63

69

76

73

75

68

67

68

Shared facilities

89

87

86

88

88

88

93

92

92

89

88

87

Lavatories and washing facilities

78

79

78

74

79

78

84

86

86

78

80

79

Adaptations and equipment

75

77

77

77

81

83

88

89

88

77

79

78

Space requirements

93

93

92

90

90

91

95

95

95

93

93

92

Furniture and fittings

70

77

77

70

76

78

84

88

89

72

78

79

Heating and lighting

67

72

73

70

75

77

78

82

83

68

73

74

Hygiene and infection control

72

75

77

74

82

83

83

85

85

73

77

78

Staff complement

79

80

81

73

79

78

84

84

84

79

81

81

Qualifications

61

70

76

72

84

90

77

80

84

64

72

78

Recruitment

59

64

68

60

71

78

67

71

75

60

65

69

Staff training

69

70

71

77

79

80

83

82

80

71

72

72

Day to day operations

67

72

76

74

81

87

82

84

87

69

74

78

Ethos

89

88

87

94

94

94

95

94

93

90

89

89

Quality assurance

60

66

68

66

71

76

71

78

81

61

67

70

Financial procedures

85

87

87

86

89

88

92

94

93

86

88

88

Service User Money

87

87

91

88

90

93

92

93

93

87

88

91

Staff Supervision

62

65

65

77

81

78

75

75

75

65

67

67

Record Keeping

67

67

66

65

68

69

73

73

72

67

68

67

Safe Working Practices

52

53

60

54

59

66

62

62

67

53

54

61


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