Over third of GPs would not recommend their local care or nursing home to friends or relatives

Exclusive More than 35% of GPs would not recommend their local care or nursing home to their friends and family, and a fifth say they have witnessed care that risked their patient’s health, a Pulse survey shows.

The survey of 362 GPs shows deep-seated concerns about the care being given to patients in care homes, with one in 10 saying that the care of patients was either poor or dangerously poor.

The survey prompted GPC chair Dr Laurence Buckman to call for the Government to look ‘seriously and urgently’ at elderly care in the NHS, as GPs complained of medication errors, bewildered patients and, in one case, a dementia patient suffered a broken neck after she able to access a lift.

The news comes after a Care Quality Commission report published in February found about a third of hospitals and care homes were failing to meet minimum standards for nutrition and dignity in the elderly in hospitals and care homes in England is still not good enough.

Asked if they would recommend their local care or nursing home hospital to their own family or friends, 38% of GPs questioned said they would not, compared with 36% who would.

Some 22% said they believed that some of their patients had received care that has risked their health at the local care or nursing home to their practice, and 10% saying that the care of patients was either poor or dangerously poor, compared with 41% who said it was good or excellent.

Dr Andrew Mimnagh, a GP in Sefton, Merseyside said there had been two worrying examples of dangerously poor care at homes in his area.

He said: ‘We had an example recently that made the local papers. A lady with dementia was regularly accessing the lift. The lift defaulted to the basement. She fell down a flight of stairs and broke her neck and ended up in intensive care and died.

‘The care home owners were prosecuted and fined. After this, it was found that patients in other homes could access lifts- it’s significantly dangerous.’

He added that local investigation was ongoing about whether the overuse of antibiotics at care homes had led to an outbreak of Clostridium Difficile.

He said  ‘There’s an erroneous belief by staff about what can be dealt with by antibiotics. The homes aren’t managing symptoms of cough without fever, there’s a bit of doctor-shopping going on until they get the scripts. It’s an accumulation of repeated, minor infringements that causes substantive harm. It’s avoidable.’

Dr Peter Swinyard, chairman of the Family Doctors Association added that below par cleanliness and staff speaking a different language were common problems in nursing homes

He said: ‘If you were choosing a care home for your friends or family you’d want to sniff as you walk in. There is no excuse nowadays for a nursing home to smell of stale urine. You’d also want to talk to the people doing the daily care. Are they speaking English? If the carers talk in Philipino across the bed, it’s very bewildering for elderly confused patients.’

He added: ‘The present system is a bit broken. Anywhere will do sometimes. We have to remember that this is the patient’s home as well as their place of care.’

Commenting on the survey results Dr Laurence Buckman chair of the GPC, said: ‘Services for older patients are under mounting pressure as demand rises from an aging population at the same time as budgets across the NHS are contracting.

‘Given this environment it is not surprising that many GPs and patients are concerned about the standard of care older people are receiving, particularly in care homes.

‘The government must look seriously and urgently at how all parts of the NHS meet the challenges that lie ahead for caring for an older population.

‘It is particularly vital that vulnerable patients get a high standard of treatment in care homes that are not only properly funded, but also adequately regulated.’

An RCGP spokeswoman said: ‘If any GPs are aware that care is threatened, sub-standard or dangerous, for whatever reason, they have a duty to make these concerns known to those in charge to assess and, if necessary, act.’