Wednesday 16 January 2019
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RNHA backs call for national review of care home workers' pay

The Registered Nursing Home Association (RNHA) today backed a call by Age UK, the Local Government Association and the NHS Confederation for a government-led review of care home workers’ pay, qualifications, recruitment and retention.

Their joint proposal for a Care Quality Forum to undertake such a review is recommended in a new consultation document (Delivering Dignity) on ways of ensuring that hospitals and care homes respect the dignity of older patients.

Said RNHA chief executive officer Frank Ursell: “The fact that the Local Government Association is supporting a review of pay and conditions is highly significant. We in the long-term care sector have argued for many years that we are
suffering from a lack of adequate resources to sustain consistently high standards.”

He added: “Is this perhaps a sign that our message has got through? If it has, we hope that both government and local councils, who together pay for a high proportion of care home residents’ places, will now plan to increase their funding rather than, as they are doing right now, cutting it back.”

Mr Ursell said nursing homes throughout the country would welcome any concerted attempt to put older people’s dignity at the heart of service delivery.

But, he warned, such initiatives had to recognise that enabling staff to spend more time with individual patients was ultimately a matter of money. More staff on duty at any one time, more training and more supervision inevitably meant more public funding. Otherwise, a lot of the good words spoken in an impressive-sounding consultation document would end up as just another release of hot air.

Mr Ursell also counselled caution by those who might be tempted to take a ‘high and mighty attitude’ towards particular styles of communication with older people.

He said: “Of course we want to avoid older patients being addressed in ways that could be construed as condescending or patronising. But if, as the publishers of the Delivering Dignity document suggest, there is a ban on using everyday words like ‘dear’, they could easily end up achieving the very opposite of what they intend.

“What we should strive for is communication that is natural, polite and tailored to the
specific preferences and expectations of the individuals concerned. We don’t want to
end up with a sterile lexicon of politically correct terminology.”

He added: “Nor should anyone run away with the idea that there is a mountain to climb when it comes to care homes respecting the dignity of older people.

“Among care home residents who took part in a survey by the Personal Social Services Research Unit published at the end of last year, 88% said that the staff who looked after them were caring and sensitive, with 100% of the relatives interviewed for the study expressing the same view. This suggests that there is a high level of conscientiousness among the vast majority of professional carers.”

The RNHA will be studying the consultation document very closely and responding with its own ideas. It points out that people admitted to hospital are usually there for only between about four and ten days, whilst individuals stay in care homes for many months and, in some cases, for a few years.

“Necessarily, this changes the nature of the relationship between the carers and the cared for,” said Mr Ursell. “We believe that well run care homes have a lot to teach hospitals about interacting with older people. Equally, we accept that we can learn from others.

“We agree with the authors of the consultation document that compassion is an extremely important quality among professional carers.

“Our hope is that the consultation document will facilitate a dialogue and, at the same time, kick-start a process of policy review at the highest levels about the amount of resources the country is willing to put into caring for its oldest citizens. Without that, the rest is window-dressing.”