Can a 15 minute care visit to somebody with dementia ever be justified? The short and emphatic answer seems to be: no!
Care providers think they are unacceptable – a view reinforced when we chatted with visitors to the recent Health Social Care Expo in Cardiff.
And Andrea Sutcliffe, Chief Inspector of Adult Social Care at the CQC also thinks they are unacceptable. In a recent interview with The Times she explained at great length why she believes such brief visits are disorientating and possibly even distressing for service users with dementia. They certainly don’t provide a basis for effective care. So why do they still happen?
Here’s what Andrea said in the interview:
‘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?’
The last bit of that quote is revealing. The government recently made a dramatic U-turn in the Care Bill – removing the part that would reinstate the CQC’s power to inspect local authorities. This would have provided a straightforward mechanism for eliminating the practice.
Instead , the CQC plans to penalise providers that are prepared to deliver 15 minute visits. Given the lack of control that the CQC has over cash-strapped local authority commissioners, perhaps this is the only option they have to pursue. I’m sure it’s not the one they would have wanted. But that’s what is behind the last part of Andrea’s quote.
How will this work?
Somehow it is hoped that going after providers will in some unspecified way put pressure on local authorities and persuade them to stop commissioning this type of care. This has all the hallmarks of a messy and unworkable fudge. It also seems grossly unfair to domiciliary care providers.
If a reputable care business decides that it cannot offer a service that a local authority wants to purchase, what then? Do the commissioners turn to a provider that cares less about its standing with the CQC? And ultimately, what happens to the overall standard of care that is delivered?
When adult social care budgets have been cut by £2.7bn over 3 years, and while the Local Government Association believes they need an extra £400m each year to stand still, how can it be reasonable to place the onus on care providers to ensure that this doesn’t result in inadequate standards of care?
Ultimately we need an open and honest debate about the type of social care we want to provide as a nation, and the real cost of doing that. Maybe then we’ll have a more workable system for delivering the standards of care we all want to see.
What do you think?