State of Care report shows ‘avoidable’ emergency admissions are increasing

This year’s State of Care report looks at the pressures on accident and emergency (A&E) services due to an increase of admissions for ‘avoidable’ conditions. The report also brings together the findings of more than 35,000 inspections to inform you of the quality of health and social care services in 2012/13.

What is an avoidable admission?

Avoidable conditions are illnesses and sicknesses like:

• bone fractures.
• dehydration.
• pneumonia.
• respiratory infections.

We call them ‘avoidable conditions’ because they can be treated in the community (in people’s own homes or in community settings) or caused by poor care or neglect.

Pressure on accident and emergency services

• More than half a million people aged 65 and over were admitted as an emergency to hospital with potentially avoidable conditions in the last year.
• The number of avoidable emergency admissions varies from place to place, with some parts of the country managing much better than others.
• Among people living in care homes, hospital admissions for avoidable conditions were 30 per cent higher for people with dementia. Once in hospital, people with dementia also have poorer outcomes than those without dementia.

CQC Chief Executive David Behan said: ‘Those responsible for care in local areas need to work together quickly to address the number of avoidable emergency admissions to hospital.  

"GPs, care homes, home care agencies, community health services and hospitals, with local commissioners, must plan effectively make sure our older and more vulnerable people are cared for in the way they deserve. 

"Where care can be provided for people outside of hospitals, it is better for them and eases pressures on hospital services."

Quality of health and social care services

• There has been no overall improvement in the NHS around treating people with dignity and respect.
• One in five inspections of nursing homes revealed safety concerns, including failure to give out medicines safely or not carrying out risk assessments when starting to care for someone, and ongoing staffing pressures.
• There is a link between high staff turnover in residential homes and numbers of death notifications, which may suggest that too much staff churn results in gaps in care.
• More than 10 per cent of inspections of residential homes uncovered problems with either safeguarding and safety, staffing, or the care and support received by residents – for example, people not being helped to eat and drink enough.
• More than 10 per cent of home care agencies did not meet standards in staffing or monitoring quality.
• Common quality issues at home care agencies include late or missed calls and this is known to have a profound impact on people using services, leaving people feeling vulnerable and devalued.