Older people, hospitals and failure

'Truly appalling and truly shocking' is how Amanda Sherlock, Care Quality Commission's Director of Operations, has described the CQC findings on care for older people in 100 hospitals.

Few would disagree – even though there are good stories to be shared about the hospitals that do get this right (45 of the 100 hospitals were fully compliant with dignity and nutrition standards), and do have a culture of kindness and respect.

Among the many responses to the news, I was most struck by one particular quote cited in a Guardian article by Polly Curtis and Paul Owen:

A junior hospital doctor, who wishes to remain anonymous, writes that he does not find the examples in our news story on the CQC's report shocking. 'I see most on a typical day at work,' he says. 'The really shocking thing, I suppose, is that I, and most of my junior medical colleagues, see this sort of thing as ... the norm. It doesn't really occur to use to go around blowing whistles, since we've never known any different.'

This is honest, and it is very very sad.

Older people in institutions – whether in hospitals or in residential or nursing care homes – are easily overlooked and ignored. Recognising this, some years ago JRF supported research into the views of older people living in care homes about 'a good life'. The research identified some very simple, yet too often unmet, aspirations – including retaining a sense of personal identity and esteem, and having meaningful relationships with other people … having someone who knows you well and spends time with you.

On Monday, we'll be publishing a paper from our Better Life programme on older people who need a lot of support. The paper explores ways of supporting older people that are based on mutuality and reciprocity, not on seeing older people as passive recipients of care. What is so striking in the stories captured (and which are so absent in the minority of hospitals that were found to have failed) is the ways in which older people contribute in two-way relationships.

The junior doctor's comments also point other problems: the relationship between the chronic underfunding of social care and the lack of integration of health, care and housing support. The reality is that too many older people spend too long in hospital wards, when they needn't and shouldn't be there.