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Stormont watchdog lambasts failings in care for our elderly

By Patrice Dougan

Published 24/02/2011

A delay in discharging 100 older people from hospital has been slammed as “unacceptable”.

The failing has been highlighted in a report on the care of |elderly people by a Stormont watchdog.

The report by the Public Accounts Committee criticised delays in releasing older people from hospital, in particular an incident last December when 100 people were not discharged “as a direct result of funding constraints”.

The delay occurred in the Western Trust, but the report claims such delays are “not confined to one trust”.

The 51-page report also criticised the regulatory body tasked to ensure care homes are running satisfactorily for not being strict enough when issuing sanctions on under-performing care homes and for not carrying out enough unannounced inspections.

It also recommended that future care of the elderly is focused on providing more domiciliary care staff to ensure people can stay in their homes as long as possible, moving away from the residential and nursing home model.

Currently the delivery of institutional care for older people costs in the region of £265m per year.

The report into care of the elderly said it was “unacceptable” that around 100 elderly people experienced delays in being discharged from hospital to residential care and nursing homes in the Western Trust in December last year.

It said: “Such delays cause bed-blocking within hospitals and are not in the best interests of the patient.”

It went on to say: “It is unacceptable that a patient’s discharge from hospital is dependent on the transfer of resources between organisations within the health and social care sectors.

“The committee recommends that the causes of delayed discharges throughout all trusts are thoroughly investigated and that prompt, well co-ordinated strategies are devised to ensure that patient discharge is managed effectively.”

The report also criticised the Regulation and Quality Improvement Authority for being “reluctant to impose sanctions on under-performing care homes”.

It added that the RQIAs policy of one announced and one un-announced inspection every year could lead to “complacency among providers”.

It said it had “strong reservations about the effectiveness of announced inspections in providing a sound basis for evaluating standards”.

The committee recommended that RQIA uses a “range of sanctions” against care homes which fail to provide the appropriate care.

It said it should also focus its inspection procedures on unannounced visits at irregular intervals so providers cannot predict when they will be subject to an inspection.

Historically, Northern Ireland has had a younger population than the rest of the UK, but that situation is now changing.

Population projections for the next 20 years anticipate a significant increase in those aged 65 and over.

With that in mind, the committee said it supports the Department of Health’s recommendation that care for the elderly shifts from institutional to domiciliary care.

PAC chair Paul Maskey said: “It is clear that the majority of older people want to stay in their own homes for as long as possible.

“In practice, this means developing and offering appropriate domiciliary care to older people as a real alternative to institutional care.

“Despite claims by the department that the balance of provision is shifting from institutional to care in the home, much more needs to be done.”

In the report, the committee recommended that trusts “look closely at how spending on residential care can be reduced as community-based provision improves”, and that “the department develops a specific target and timescale for increasing the provision of domiciliary care”.


The Report on Arrangements for Ensuring the Quality of Care in Homes for Older People makes 12 recommendations to improve the care elderly people receive here.

These include:

  • Developing a specific target and timescale for increasing the provision of domiciliary care.
  • Delayed discharges throughout all trusts are investigated and that discharge is managed effectively.
  • Families and those living in care homes receive accurate information about the quality of care homes.

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