A small-scale review of healthcare services in care homes by regulator the Care Quality Commission (CQC) has found that some residents struggle to access services.

The review of 81 care homes - an equal mix of residential care, nursing and learning disability-focused services - found that some residents had their basic health needs unmet in some areas. Findings included:

  • A quarter of residents did not feel they were offered a choice of male or female staff to help them use the toilet
  • Staff at 38% of care homes indicated GPs made routine visits
  • More than a third (35%) of homes reported they had problems getting medicines to residents on time 'sometimes'
  • In 10% of care homes they said they paid for their GP surgeries to visit.

However, the review did find good practice in areas such as care planning, with 77% of homes inspected taking the views of the person into account. Also, 96% identify changing healthcare needs of residents through informal or responsive monitoring.

Amanda Sherlock, CQC'S director of operations, said that while the small sample size limits the regulator's ability to draw national-level conclusions, the review will be used to help identify problem areas, which will be investigated in its upcoming inspection programme looking at dignity and nutrition in 500 care homes. "All staff and relevant agencies, including the emerging commissioning cluster groups, have a role in improving the quality of and access to healthcare services for care home residents," she said. "This is a responsibility which needs to be taken seriously. "While we have identified good practice in areas, this review suggests some providers have fallen short of delivering effective care by considering the healthcare needs of residents as a secondary requirement. "Despite having a disproportionately high level of dependence on health services, this group appear to be more disadvantaged than the rest of the population in accessing these services."

David Congdon, head of campaigns and policy at Mencap, said: "We welcome this CQC report as it raises real concerns over how far the health needs of adults with a learning disability are being met in care homes. Crucial areas of health for vulnerable adults, including access to GPs, the provision of medicine, and poor practice regarding DNR and best interest decision policies, all stand out as areas which urgently need to be addressed by many care homes. "The CQC needs to ensure that its system of inspections is rigorous enough to highlight where care homes are failing to meet the health needs of people with a learning disability, and that adequate safeguarding is taking place. And where homes are failing, strong action must quickly be taken."