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CQC Allied Healthcare warning symptomatic of challenges facing sector

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The Care Quality Commission (CQC) recently issued a notice to several local authorities saying it has serious doubts about the future of Allied Healthcare, which provides personal care services to more than 13,000 people in their own homes throughout the UK.

Earlier this year Allied Healthcare was struggling with debts, blaming low fees paid by councils for the home-based care services they provide and in April 2018 the firm announced its intention to apply for a Company Voluntary Arrangement (CVA) in order to re-structure its finances.

The CQC stated on their website that Allied Healthcare ‘failed to provide adequate assurance regarding future funding beyond 30th November’. The firm has described the move as ‘premature and unwarranted’ and some press reports do suggest that an offer made from a new lender could secure the firm's immediate future.

The UK Homecare Association, the professional association for homecare providers, has previously warned that services were being put at risk, saying that councils were trying to get care ‘on the cheap’, claiming only one in seven local authorities were paying a ‘fair price’ for home care, forcing a number of firms to pull out of contracts.

Around 9,300 people rely on Allied Healthcare services across 84 council areas in England. The CQC said it had a legal duty to warn councils that business failure was likely – which does not mean it will definitely happen – and services could stop as a result. Should that prove to be the case, the affected local authorities would have a responsibility to step in to ensure continuation of those services.

Overworked and stressed care services could result in harm

This is the first time a CQC notice like this has been issued to a care provider. Previous warnings have related to individual services, but many families will be unsettled by the prospect of any disruption to the care given in their own home to elderly or vulnerable relatives. The real concern for many is that any disruption or an economically driven ‘lowering of standards’ could result in increased incidence of neglect or harm among some of the most vulnerable individuals in society.

A survey conducted by researchers at University College London (UCL), reported in the Daily Telegraph in March this year, revealed that abuse and neglect is present in nine out of 10 nursing and care homes. More than 1,500 carers at 92 homes across the country were asked if they had witnessed, or taken part in, troubling behaviour in the past three months. Verbal abuse was reported by 5% of respondents and 1% reported common physical abuse.

The report’s authors noted that abusive behaviour was worse when homes were understaffed and carers felt overworked, stressed or under pressure and unable to provide the level of care they would like to offer.

What is true in a care home environment is also true in a homecare context

Abuse and neglect can occur anywhere: in your own home or a care home. Homecare in particular should ideally provide a service based around a person’s needs, which requires getting to know the individual and their desires and values, building trust and a rapport.

Harm or sub-standard care or neglect that appears to be deliberate is thankfully very rare (and makes the headlines for that very reason). However, increasing financial pressures and organisational realities in the homecare sector in general could mean that caring for vulnerable clients becomes more ‘task’ rather than ‘person-focused’ – a time pressed, tick-box exercise.

Despite any aspirations to deliver person-centred care, that potentially could lead to a greater risk of harm (even if unintentional) and already low standards of care becoming lower still. It is possible to sympathise entirely with care home and homecare providers in the public and private sector who say they require more funding. That is an issue the government of the day and ultimately the nation as a whole will have to face as the population continues to grow older.

No excuse for jeopardising the safety and well-being of vulnerable people

However, whatever the reasons for being in residential care or receiving homecare of some kind, any vulnerable individual of any age has a right to health, dignity and individual respect. When a parent or loved one has suffered abuse or been neglected or harmed, it is no defence to cite the bottom line or balance sheet as the root cause.

Yes, it is true that meaningful investment and reform is urgently required, otherwise we run the risk of the system collapsing completely, but equally providers must also fulfil their moral and legal obligations to those for whose care they are responsible.  Our solicitors can help when anyone or any organisation in that position of trust causes harm or distress to a vulnerable relative, either deliberately or by failing to provide necessary care – irrespective of the underlying reason.

UPDATE (7 December 2018)

Subsequent to writing it has been confirmed on 2 December 2018 that Allied Healthcare reached an agreement with Health Care Resourcing Group (trading as CRG) to acquire Allied Healthcare’s trading assets, with ownership and full service provision transferring at 4 pm on 30 November 2018.

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