Home care providers to be penalised for 15-minute visits to those living with dementia

The Care Quality Commission’s chief inspector of social care has said that 15-minute home care visits to people with dementia are “ineffective, inappropriate and unsafe”.

Andrea Sutcliffe told The Times that the Care Quality Commission (CQC) is planning to penalise home care providers who offer home visits of around 15 minutes to people with dementia.

She told The Times that she found it hard to see how 15-minute visits could ever be justified for dementia sufferers and that they were usually inappropriate for any elderly patient.

New regime imminent

According to The Times, the new inspection regime she is poised to introduce would penalise the domiciliary care companies prepared to supply this type of visit to people with dementia. That, in turn, will put pressure on local authorities who commission them. The CQC will also have some limited powers to inspect councils where there is poor provision of care in an area.

“Ultimately, this is about needs,” Ms Sutcliffe told The Times. “If you are providing a service for someone living with dementia, if you go in and all you are there for is 15 minutes, how confusing is that for the person you are supposed to be providing a service to? How can that be reasonable to meet their needs, effective in supporting them, appropriate for them?

“How can it be ‘caring’ when the person is still confused about who has just come through the door? How can it be safe when the person does not know what’s going on? What are the leadership and management of that company doing in saying that is an appropriate way to provide services?”

Call for more powers

United Kingdom Homecare Association (UKHCA), the representative association for domiciliary care agencies, reacted swiftly to Ms Sutcliffe’s comments. UKHCA’s policy director, Colin Angel, said: “We are disappointed that England’s Chief Inspector is prevented from directly tackling councils which commission care that they themselves admit is inadequate.

“This Government undertook a U-turn in the Care Bill and failed to reinstate CQC’s powers to inspect and report routinely on councils. This means that CQC no longer has the power to hold councils to account for inappropriate care.

“It is helpful that England’s social care regulator is reinforcing UKHCA’s message that inappropriate short visits can be detrimental to people who have home care. However, we are deeply concerned that CQC is unable to address poor commissioning practices at source by regular inspection of councils.”

Funding cuts hinder social care

A spokesman for the Local Government Association, said that budgets were now extremely tight, adding: “A reduction of £2.68bn to adult social care services over the last three years means local authorities are struggling to meet the rising demand for home care visits. Unless local government finance is put on a sustainable footing social care will remain substantially underfunded and services will suffer as a result.

"We agree that 15-minute visits should never be the sole basis for care and councils do not base their provision of support on such an approach. However, in some circumstances such as administering medication they can be appropriate, but only as part of a wider comprehensive care plan involving longer one-to-one visits.

"Helping the old and vulnerable to maintain their independence and dignity is a vitally important job and councils have worked very hard to protect social care services from the full impact of cuts. However, the shortage of funding is being exacerbated by increasing demand and councils need an extra £400m each year just to maintain services at current levels. It is not possible to substantially raise the standard of care on a nationwide basis until more money is put into the system."