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Standards of care and support

A nurse tending to a patient

Throughout 2009/10 we have seen further improvements in the standards of health and social care in England. Fewer services gave serious cause for concern than in previous years.


of mothers who responded to our survey said they 'definitely' had confidence and trust in the staff caring for them during labour.

The improvements were not across the board, however, with some areas of care showing deterioration and the quality of services varying from place to place.

Our overall findings relating to the quality of care and support included:


of care homes for older people were not meeting the minimum standard for medication, which includes record keeping and staff training.

  • A continued increase in social care performance with, for the seventh successive year, no councils rated “poor”.
  • The proportion of councils judged to be “excellent” at improving the quality of life for people who use services increased from 25 per cent in 2008/09 to 34 per cent in 2009/10.
  • The overall quality of regulated services continued to show further improvement overall. The proportion of services rated “poor” fell from three per cent in May 2008 to one per cent in April 2010.
  • The variable quality of inpatient mental health services, as suggested by our visits to wards with detained patients, continued to cause us concern.
  • The proportion of care services arranged by councils that achieved higher quality ratings improved considerably.

Anne's story

Anne has been living in a nursing home in Weston-super-Mare for two years now. She thinks the home has a “lovely homely atmosphere” compared with others she’s known, and that the staff are “very understanding, patient, and polite”.

Another thing Anne appreciates is the way residents are genuinely involved in decisions that affect their life in the home.

“When the home is recruiting staff, two of us sit on the interview panel to make sure we have a say about who is appointed,” she said. “If we don’t think a candidate is right for the residents, the management would not take them on – our views are respected.

“This is important, because the attitude and ability of the staff has a big influence on our daily lives.”

Four residents talking around a table
Catherine, the home’s registered manager, also asks residents for feedback before staff have their performance appraisals. A couple of years ago the home set up a residents’ forum, which usually meets every three months.

One of the residents or Catherine chairs the meeting, and everyone gets a copy of the minutes afterwards.

“We discuss all sort of things”, Anne said, “and if by any chance we wanted a residents-only discussion, staff would leave the meeting.”

The residents have their own newsletter and are also kept as involved as possible in external events.

We believe in the human touch… wherever possible we try to put people before policy and procedures.

Catherine, registered manager

“At the time of the general election last year, Catherine arranged for us all to vote by post. Afterwards we wanted to meet our new MP, but he was so busy it was difficult to get a slot in his schedule, so Catherine arranged for the mayor to come and visit us instead!”

As registered manager, Catherine is a key link between the residents and the care and nursing staff, and sometimes between residents and their families.

She talks to each resident every day to gets their feedback on day-to-day life at the home, and if she needs to negotiate with families on behalf of a resident, Catherine ensures that the resident’s wishes are given top priority.

"We believe in the human touch," Catherine said. "Wherever possible we try to put people before policy and procedures and to consider things from a resident's perspective while making sure we follow good practice. The most important qualification we look for in staff is true dedication to caring for older people and to making our residents feel that living here is their 'home away from home'."