Improvements in NI elderly care not happening fast enough: watchdog

In a report on his ‘Home Truths’ investigation conclusions published yesterday Eddie Lynch, the Commissioner for Older People in Northern Ireland (COPNI), called for new safeguarding legislation to be introduced – saying “the pace and scale of change is not enough”.

Published in June 2018, the original report called for “systematic change” across the care home sector, and said the recommendations “address issues of safeguarding and human rights, medicines management, regulation and inspection, accountability and governance, to name but a few and will impact on how all nursing homes deliver care, are inspected and how they are managed.”

The investigation revealed that some residents at Dunmurry Manor, on the outskirts of Belfast, had suffered “a horrific catalogue of inhuman and degrading treatment”.

Mr Lynch published his latest report after meeting relatives of those affected by the mistreatment at Dunmurry Manor.

He said he had called on seven relevant authorities – including four Health and Social Care Trusts, the RQIA, the Department of Health and Runwood Homes – to respond to 59 recommendations.

Mr Lynch described many of their responses as “lacking in substance” and had requested further information.

“Despite seeking additional information which did offer some assurance, I remain concerned and frustrated by the pace of change,” he said.

“The relevant authorities have had 16 months to demonstrate action on these recommendations and I am not assured that enough work has been done to make the necessary improvements to the safeguarding and care of residents in care homes.

“The majority of my recommendations have been ‘accepted’ by the relevant authorities and I acknowledge there have been some changes in practice. For example, Runwood Homes has stated that it has put in place a robust medicines management regime at Dunmurry Manor as well as staff, training and policy changes.

“I’m told that staff across the RQIA, the Trusts and Runwood Homes will undertake comprehensive Human Rights training. And the RQIA has stated that integrated inspections are now taking place and a proportion of inspections are being undertaken at night time and weekends. I welcome these actions, but the pace and scale of change is not enough.”

Mr Lynch advised the families that many of the responses received, cited the need for a “ministerial decision” in order to be implemented. These included: the development and implementation of an Adult Safeguarding Bill; stronger financial penalties for providers who don’t meet minimum standards of care; a ratings system for care homes; changes to complaints systems to identify the roles and responsibilities of authorities in handling complaints; the establishment of an independent body to encourage and support whistleblowers, and dementia friendly standards to hygiene and cleanliness of care settings.

The commissioner went on to say: “I am frustrated that in 2020 we still do not have an Adult Safeguarding Bill. I met with Minister Swann this week and I look forward to further discussions so that the above recommendations can be progressed as a matter of urgency. I call on the Minister and the Northern Ireland Assembly Health Committee to progress this work without any further delay and oversee the full implementation of all my recommendations.”

Concluding his meeting the families, Mr Lynch acknowledged their “bravery and efforts” in bringing the mistreatment to light.

He said: “Given the nature and magnitude of the recommendations made to the relevant authorities and the number of responses received, this has been a long and complex investigation and I want to thank families for their patience and understanding in getting to this point.”

Responding to the new report, a statement from Runwood Homes said: “Staff at Runwood Homes immediately and efficiently addressed all of the applicable Recommendations highlighted by the Commissioner following the Home Truths report published in June 2018, and provided responses and evidence required, as was assured, by October 2018.

“We are pleased that the Commissioner’s Consideration Report, published on 29 January 2020, states that our actions to improve the Dunmurry service were deemed adequate, providing all parties with the confidence that all Recommendations were critically tended to.”

The statement adds: “Operational management at Runwood Homes continues to firmly monitor and review all services in order to further develop and proactively improve overall performance, for the benefit of service users as well as staff; meeting people’s individual needs and wishes in a dignified, kind and respectful manner at all times.

“The core of our organisation is to provide good quality care, 24 hours a day, in a comfortable and safe setting, and we are committed to evidencing our high quality care delivery throughout all of our residential care and nursing homes.”