Calderdale's care home provision 'one of the worst in the country'

Care home provision in Calderdale is one of the worst in the country, according to a government watchdog's statistics, and the authority says it must take action to tackle the situation.
Cabinet member for Adults, Health and Social Care, Coun Bob MetcalfeCabinet member for Adults, Health and Social Care, Coun Bob Metcalfe
Cabinet member for Adults, Health and Social Care, Coun Bob Metcalfe

The authority has to focus on the quality and sustainability of local provision of care homes – most privately owned and run – going forward, members of the Adults Health and Social care Scrutiny Board heard when it met at Halifax Town Hall.

A report to councillors said that the government watchdog the Care Quality Commission (CQC) rated Calderdale only 13th out of 15 authorities in Yorkshire and Humberside,

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As this was the lowest rated region in the country, “that must make us one of the worst in the country”, board members said.

Over the last five years, more than half – 54 per cent – of the district’s residential and nursing homes had been under suspensions and restrictions.

The report examined how the authority was in this situation and what steps should be taken to get out of it.

With far more care homes than nursing homes, Calderdale needs a more mixed model of provision, they heard, including some intermediate care.

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A CQC representative and some managers of care homes are being invited to attend a future meeting of the board, and the council’s Director of Adult Services and Wellbeing, Iain Baines, who was appointed to post in September, has been tasked to submit a report showing what Calderdale needs to do to be the best in the county rather than one of the worst.

This report was an overview of the situation and future items will take a more detailed look at particular issues.

Cabinet member for Adults, Health and Social Care, Coun Bob Metcalfe (Lab, Town) said this week that although the council only owned and ran one, good-rated, home on its own, its staff would continue working with care providers to offer help and support with the goal of driving up standards.

“The council owns and runs only one care home – Ferney Lee Care Home in Todmorden, which has a ‘good’ (CQC) rating,” said Coun Metcalfe.

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“However, our dedicated staff work incredibly hard to support residential and nursing care homes across the borough.

“In Calderdale there are 31 residential and nursing homes with a published CQC rating.

“Of these, there is currently one Calderdale home rated outstanding and 18 that are rated good.

“Of the nine that are rated as requiring improvement, seven have one or more good rated features across the five areas rated by CQC, and we want to build on this.

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“Unfortunately, three homes are rated inadequate and we are working closely with the providers of these homes to ensure that improvements are made, and most importantly people are safe and well and receive the care we would want for ourselves.”

The drive for improvements would continue in difficult times, he said.

“Delivering residential and nursing care is challenging and complex, with homes facing difficult financial situations and staffing issues.

“As a council we are committed to working with our providers, the CQC, the Calderdale Clinical Commissioning Group and families to continue to focus on improving the quality and safety of care provided.

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“Our ambition is to support all our providers to be rated good or outstanding.”

According to the CQC, as of November 18, of Calderdale’s 32 residential and nursing homes 18 were good but the authority only has one outstanding rated home – Waterside at Todmorden – which provides some pointers as to key reasons for success.

But nine homes required improvement and three were inadequate. One home only opened recently and had yet to be inspected.

Asked what made Waterside “outstanding” officers advised that the home had a consistency of staff whereas other homes struggled with factors outside their control such as a shortage of nurses.

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A culture change was taking place, with homes – of which Calderdale has more individual providers, rather than large companies, than other places – initially attending provider forums established by the council as competitors recognised the benefits of collaboration.

Providing more public sector homes – a council home rated inadequate a few years ago was rated good, showing council support could drive standards up quickly – would be difficult in times of austerity and paying the real living wage would add £3 million to the cost of residential and nursing homes, board members heard.

Coun Metcalfe updated the board on the situation regarding Allied Healthcare, a major home care provider in financial difficulties, though only serving 17 people in Calderdale, where the council had used its contingency plans to transfer all 17 to another care provider.

Officers provided some context for the 54 per cent of homes being under suspensions or restrictions at some point during the last five years, saying it was not unusual to have voluntary or formal suspensions.

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Homes sometimes took this decision themselves while they resolved problems.

Officers said there had probably not been enough attention in the past on the quality of residential and nursing home provision.

It was right that some providers had left the market and others were struggling but the council could help them improve and a number of those categorised as needing improvement were “very close” to achieving a “good” rating.

CQC reports were not always as objective as might be thought, it was said – but members believed it was clear they should not endorse poor homes.