NEWS RELEASE FROM THE
REGISTERED NURSING HOME ASSOCIATION
Issued 3rd March 2001
GOVERNMENT ACCUSED OF BAD FAITH
ON NEW MINIMUM CARE STANDARDS:
NURSING HOMES FORESEE BUREAUCRATIC NIGHTMARE
Nursing home leaders have accused the government of 'bad faith' over national minimum standards for care homes for older people, which were published yesterday (2nd March).
Over 240 individual standards are being imposed, covering everything from the width of internal doors and size of communal areas to sources of advice for continence care.
According to the Registered Nursing Home Association (RNHA), few of them will make a real difference to the quality of care delivered to patients, whilst their volume and complexity will risk detracting from their intended purpose.
Whilst welcoming in principle the publication of national standards, the association says government ministers have not kept their pledge to restrict standards to a small number of overarching issues. Instead, homes will have to adhere to what the association calls 'the bureaucratic nightmare of hundreds of detailed and sometimes dubiously effective or applicable rules and regulations'.
Nor, claims the association, do the new standards focus sufficiently on the nursing, as opposed to social care, needs of some quarter of a million people receiving nursing home care across the United Kingdom. There is little indication in the standards, it says, of the unique qualities which nurses bring to the care of older people.
The RNHA, which represents over 1,000 nursing homes across the country, points to
strong progress made by the sector over recent years in driving up standards of nursing care in ways that are essentially practical and sustainable in the long-term.
Speaking for the association, chief executive officer Frank Ursell said: "We had been hoping to see the government build on this common sense approach and move forward on the basis of a broad consensus between providers and regulators about what works and what doesn't. We believe standards should focus more on outcomes than processes. We should be concentrating on improving or maintaining patients' health, not on whether a door is 800 or 780 mm wide."
He added: "Instead of the vision for health improvement we had been hoping for, we are being showered with reams of paper. This is the opposite of what we had been led to expect from our negotiations with ministers and senior civil servants over the past two years. I am sure that right across the nursing home care sector there will be a sense of profound disappointment and, dare I say it, betrayal. Where is the partnership which we have heard so much about from the government?"
Initial analysis of the new standards by the RNHA has already revealed several examples of ambiguity and potential confusion, as well as major resource implications which do not appear to have been thought through by the government:
Those examples include:
1. Standards 1 and 2 (page 2) which lay down what information and type of contract prospective care home residents should receive. The RNHA believes the emphasis should have been on ensuring that individuals find a home that is right for their needs and best suited to their individual preferences, rather than simply on the provision of information.
2. Standard 20.1 (page 26) which says that apart from corridors and an entrance hall, homes must have communal space amounting to at least 4.1 square metres for each resident but which appears ambiguous about whether or not the dining room must be separate from the sitting room. The RNHA warns that many nursing homes could face major structural changes, unwarranted expenditure and unnecessary disruption to their patients.
3. Standard 22.5 (page 28) which says that doorways into communal areas, residents' rooms, and bathing and toilet facilities must have a clear opening width of 800 mm. Again, the RNHA warns of significant potential problems for homes whose door widths may be fractionally narrower than the new regulation demands.
4. Standard 28.1 (page 34) which says that a minimum ratio of 50% trained members of care staff (NVQ level 2 or equivalent) must be achieved by 2005. Whilst welcoming a recognition of the importance of training, the RNHA hopes it will be matched by the necessary resources (possibly amounting to as much as £500 million) to ensure that tens of thousands of care assistants receive that training.
Commented Mr Ursell: "We, in the nursing home sector, have been waiting around two years for these standards to be published. We are wholeheartedly committed to delivering high quality care to very vulnerable patients with complex, multiple nursing needs, but we do not see how these so-called minimum standards are really going to help. At worst, the government's standards risk taking people's eyes off the ball and plunging the providers of care and the inspectors of standards into a self-defeating cycle of ensuring that there are ticks in boxes.
He concluded: "Instead of pages and pages of regulations, we should really be working shoulder to shoulder with the government in defining genuinely effective methods for ensuring that individual patients' nursing needs are professionally and independently assessed and that tailor-made solutions to meet those needs are adequately funded and evaluated. Sadly, the document which the government has produced represents a golden opportunity missed."
END
For further information please contact: Frank Ursell, Chief Executive Officer, Registered Nursing Home Association Tel: mobile 07785 227000 at any time, 0121-454 2511 (office on Monday).
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