The difference in law between elder abuse and neglect and the role of the Care Quality Commission (CQC).
Abuse and neglect both have different meanings in any context, but their consequences can equally impact the emotional and physical wellbeing of an elderly person. Abuse is deliberately harming someone. Neglect is generally taken to be defined as not preventing that harmful action for whatever reason.
- Abuse: the deliberate maltreatment of an individual, misuse of power and authority by a person the elderly person ought to be able to trust.
- Neglect: the unintended or deliberate provision of poor treatment that does not respect the dignity of the individual.
Causing harm justifies making a claim
In law, the more meaningful distinction depends on whether actual harm is done. Neglect can result in sub standard care (e.g. an elderly resident left in a soiled bed for long periods of time). That is an unacceptable standard of care and while it may not justify a civil claim for compensation, making a formal complaint is worth considering. If standards do not improve the family may wish to think about moving their relative to another home, disruptive as this can be. Examples of neglect that we have advised clients about previously also include:
- Failing to ensure adequate food is eaten.
- Putting a water jug or glass out of reach.
- Ignoring a person's need for cleanliness and hygiene.
- A lack of adequate supervision for residents at risk of falling.
- Medication errors.
- Inadequate supervision allowing a resident to wander out at night.
Any of these examples of neglect can lead in some cases to physical or psychological injury or harm. One of the more serious examples of neglect causing harm is the failure to prevent, monitor or treat bed sores, which can lead to serious injury.
If the neglect causes actual harm, family and friends may wish to think about pursing compensation. For example, if your relative was not given or encouraged to drink fluids and became so dehydrated that they required a period of hospitalisation to recover, there may well be claim in civil law.
Provided actual harm results from neglect, whether deliberate or caused by simple oversight, lack of training or inadequate staffing levels, you would have grounds for bringing a claim for compensation.
Making a complaint
If you have a complaint about a care home, nursing home or any other social care provider, you should first make that provider aware of your concerns. Most homes will have an established and effective complaints procedure.
If you are not happy with their response, you can ask the Parliamentary and Health Service Ombudsman to look into matters or take things further with the appropriate local Social Services department – which will have its own procedure that you'll then need to follow.
Complaints about independent health care services (i.e. those run by private or voluntary organisations) should be addressed to those providing the service in the first instance. The Association of Independent Healthcare Organisations (IAHO) represents many independent providers and has a code of practice for dealing with complaints which its members should follow.
Ultimately, the Care Quality Commission (CQC) oversees standards of care delivered by any public sector or private provider.
The role of the CQC
The Care Quality Commission (CQC) evolved out of three previous commissions which were amalgamated in a very short timescale. It operated in a shadow form in 2008 and officially launched the following year. It is charged with making sure that hospitals, care homes, dental and general practices and other care services in England provide people with safe, effective and high-quality care.
The CQC’s role is to monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety. It is important to note that the CQC does not set those standards – they are established by the Department of Health and other government departments. All the CQC does is inspect and enforce those standards.
The CQC’s remit has been extended significantly and it now inspects care in hospitals, care homes, people’s own homes, dental and general practices, and other services against those prescribed national standards.
They publish their findings on the CQC website and in printed inspection reports. The CQC currently inspects most hospitals, care homes and home care services at least once a year. Dental services are inspected at least once every two years. These inspections are unannounced unless there is a good reason to let the service provider know the inspection is coming.
The CQC has the authority to recommend improvements to service areas and the power to insist that any improvements it identifies are carried out within an agreed timescale. It has the power to impose fines on providers that do not comply with recommendations for improvement and ultimately can close down care homes and similar institutions which it considers to be consistently sub-standard.