Unified registration and national regulation systems urged for care homes
Ending the distinction between nursing homes and residential care homes could prove cost-effective and lead to higher standards of care, according to a report commissioned by the Joseph Rowntree Foundation.
The study recommends a single registration system for care homes under which a wide spectrum of appropriate services could be provided. It also proposes a single system for regulating homes to be overseen by a National Office for Standards of Care which would set standards and arrange for homes to be inspected.
The researchers, from the University of Bristol, argue that the new system could be used to achieve services that are closer to the care needs of individuals. The level and mix of staffing in each home could be adjusted to take account of changes in the assessed care needs of residents.
Prof. Malcolm Johnson, co-author of the study said: "This proposal for a system of single registered homes is about achieving greater flexibility and should not be misinterpreted as a call for every nursing or residential home to cater for every level of dependency. Providers must be able to choose the type of care they are prepared to offer and residents must be able to choose the type of home they wish to live in.
"The aim is for a continuum of long-term care, ranging from small family placement schemes for individuals who have support needs, through care homes offering a "home for life", to establishments catering for frail and sick people who need professional nursing"
The report finds that the increasing age and frailty of people moving into residential care homes as well as nursing homes has made a continued distinction between the two untenable.
Differing regulation requirements mean that rules allowing homes to seek "dual registration" with both social services and health authorities have had limited success in achieving a wider range of care services.
A unified registration system would be potentially cost-effective because payments from public funds to cover fees could be linked to individual care needs instead of depending largely on the type of home. Such changes would put an end to concerns that some people who need skilled nursing care are being placed in residential homes because it is cheaper. It would also help to avoid accusations of excessive staffing levels and over-charging in some nursing homes.
In proposing a National Office for Standards of Care, accountable to the Secretary of State for Health, the report argues that the regulators should be wholly independent of the providers and direct purchasers of care. It calls for an Ombudsman for Continuing Care to be established to provide an independent adjudicator for complaints.
Prof. Johnson said: "Regulation of care homes is essential because of the vulnerable clientele. It needs to be independent, excellent and applied even handedly across all sectors"
