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Editorial Elaine Cole DEPUTY EDITOR

Care homes crisis must be addressed urgently The annual report on the state of health and social care in England from the Care Quality Commission makes for worrying reading. As well as safety concerns in 80 per cent of the hospitals that it inspected, the watchdog warns of a shortage of nurses in care homes – one in three vacancies is unfilled in some places and one in five care homes inspected had too few staff on duty to ensure patient safety and good quality care. THE PRESSURES FACING THE CARE HOME SECTOR ARE ONLY GOING TO INCREASE

Part of the problem, says the CQC, may be that acute trusts are trying to increase nurse numbers significantly in the wake of the Mid Staffs scandal, leaving care homes struggling to recruit nursing staff. Trusts are in a strong bargaining position. Care homes, as well as being understaffed, offer lower pay than the NHS and pensions are significantly poorer, not to mention the sector’s negative portrayal in the media and attitudes towards work in care homes among some nurses who have chosen to pursue careers elsewhere. For some, the rewards of working with older people trump all these factors, but the satisfaction of even these nurses must be threatened by the struggle to meet rising demands with too few staff. Care home nursing can be seen as ‘basic’, but research shows residents can be highly dependent and likely to deteriorate quickly. They often have more than six medical diagnoses and commonly take up to eight different medications. These pressures facing the care home sector are only going to increase as homes provide more and more end of life care. And it is important to prevent admissions to hospitals where frail older patients can get confused and fall. It is difficult to see how acute and care home sector shortages can be met in the short term. Urgent action on pay and conditions to retain the nurses we have is a start. And in the longer term, the government must ensure that an adequate number of nurses are trained if both sectors are to meet the future challenges they face. See analysis page 14 Air your views on

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