Overhaul in approach to elderly care 'needed'

By Nick Triggle
Health correspondent, BBC News

Image caption,
Nursing standards have been criticised in a series of reports

Being compassionate should be as important as being clever when it comes to the recruitment of staff to care for the elderly, experts say.

The recommendation was one of a series made by the Commission on Improving Dignity in Care for Older People to improve standards in hospitals and care homes in England.

The group said too many vulnerable people were currently being "let down".

The review comes after a series of critical reports into elderly care.

Cases of neglect have been documented by the likes of the Health Service Ombudsman and Patients Association in the past year.

And so the commission was set up by Age UK, the NHS Confederation and the Local Government Association to set out a blueprint for how the NHS and social care sector should tackle the issue.

Patronising language

In total, the commission published 48 draft recommendations which will be consulted on over the next month before a final action plan is published in the summer.

The measures cover issues such as making dignity a priority at board level, encouraging staff at all levels to challenge bad practice and ensuring patronising language, such as "old dear", is not used.

The report said language which denigrates older people should be as unacceptable as racist or sexist terms.

Another key recommendation involved the role of ward sisters, which the report said should be given the authority by management to take action when standards slip.

But it is the issue of staff training which there will be most focus on. There have been suggestions in the past that nurse training has become too academic.

Some places have started to trial ways of testing the emotional intelligence and bedside manner of students.

The commission said it should become commonplace for universities and professional bodies to take into account compassionate values as much as they do qualifications.

One of the authors of the report, Sir Keith Pearson, told BBC Radio 4's Today programme that dignity was "the essence of proper nursing".

He said: "There are pockets within the NHS and the care home sector where we are seeing excellent care. But you can go to hospitals...and you can see a couple of wards where dignity has broken down."

Sir Keith said there were clearly some nurses and professional carers who held old people "in contempt", adding: "Recruiting for values and then training for skills is enormously important."

He said people considering a career in nursing needed to be aware that 60% of patients in hospitals were over the age of 65 and they needed to be able to show compassion and kindness to elderly patients.

Sir Keith conceded that those nurses and carers who could not adapt to this "root and branch" change to the system would have to go.

But Peter Carter, general secretary of the Royal College of Nursing, suggested the most important factor when it came to standards was ensuring there were enough staff.

"It is absolutely critical that hospitals and care homes employ safe numbers of nurses with the correct skill mix. This is the key challenge that must be met."

Roswyn Hakesley-Brown, of the Patients Association, said the recommendations were a "step forward".

But she added without action on the ground it would be of no comfort to the people "who contact our helpline every day to tell us their loved ones are being left without adequate pain relief, are not being helped to eat and drink or who are left to lie in their own faeces because a nurse says she is too busy to help them to the toilet".

Care services minister Paul Burstow said the commission had made some good recommendations and he would be looking to work with the group to improve standards.

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