It has been six years since the coronavirus pandemic hit and changed our lives forever. Thanks to Baroness Hallett’s forensic Covid Inquiry, we know a lot about what went wrong – and crucially what is needed to ensure those mistakes don’t happen again.
However, at the risk of repeating myself, it has been six years, and we still don’t have a plan. The government said back in March it was consulting on an action plan for the sector. More than six months later, we are still waiting. Sector bodies reacting to the Inquiry’s report into the “devastating” impact of the pandemic on adult social care this week all said they were pleased to be working with the Department for Health and Social Care (DHSC) on that plan, which is encouraging. But, frankly, isn’t time of the essence?
We now know that 43,000 people lost their lives in care homes to the virus, due in part to reckless government failures to protect them. We don’t know how many staff also paid the price. The problem is that, if a new pandemic hit tomorrow, it remains unclear what would be done differently to prevent this “devastating” loss from happening again.
Care consolidation “by accident”
As if the Covid Inquiry report wasn’t enough analysis of the care landscape to digest in one week, the Care Quality Commission (CQC) has also released its annual State of Care report, concluding that care home consolidation is happening “by accident, not design”.
The report, published today, is worth digesting in full, but the headline takeaway the regulator wants to highlight is clear: when it comes to quality, medium-sized care homes may have the worst of both worlds.
The watchdog said its analysis by home size showed that larger and smaller homes received more good and outstanding ratings. A focus group of CQC inspectors and specialists suggested that medium-sized homes may lack the financial stability and resilience of larger providers, while also being less able to invest in keeping buildings, systems and resources up to date.
The analysis added that ‘some inspectors are seeing that medium-sized care homes have a high turnover of management staff, whereas larger homes may have a bigger leadership structure to improve governance’.
These issues can have an impact on the quality of care people receive, the CQC warned.
One of the issues raised during the pandemic was the complexity of coordinating a national response across a fragmented patchwork of care providers with vastly differing management and governance structures.
The CQC’s findings suggest that larger care homes may deliver better-quality care in part because their leadership structures are more resilient.
As we continue to wait for an official blueprint in the form of a ‘national care service’, including, crucially, answers on funding, the question that arises this week is: does the consolidation of care home environments represent something policymakers have so far failed to provide: a more resilient model of care evolving in response to market forces?
