Big and beautiful is viewed by the luxury end of the care home industry as the best commercial model, but it is not necessarily the most likely to secure an Outstanding rating from the CQC.
In fact, according to Andrea Sutcliffe, chief inspector of adult social care at the CQC, the smaller, more intimate homes are achieving the best results.
“We are seeing that the smaller and medium sized care homes are having much more positive ratings, in terms of Good or Outstanding, compared to the larger or very large services,” she told Care Home Professional. The CQC describes a large home as having 50 or more beds.
Ms Sutcliffe cautions that the modern trend of building brand new care homes with 60 or more beds – a size described by consultants as the sweet spot commercially – could lead to worse care if it is not coupled with investment in skilled staff.
“Over the past few years a number of operators have gone for the economies of scale of a larger build with more rooms. Actually, that mitigates against the person-centred, homely feel and the ability of a manager to be on top of what needs to be done throughout his or her service in the way that we see in some of the smaller services,” she describes.
“I do think that there is something about people, particularly at the luxury end of the market, focusing on presentation, of what looks good, as oppose to focusing on what is even more important, which is how it feels,” she adds.
Operators of larger care homes can reach the Outstanding, or Good with Outstanding features, but it is tougher than for a smaller home. “This is a challenge for the market, which is to say: ‘OK, you may have a home of a larger size, but how are you going to ensure that the things that people value, which is the care and attention to detail, the way the home is a community and people know and get on well with each other?’. How can you take these really important features from the best small services that we see, and ensure that they are present in larger homes where it is undoubtedly more difficult to do that,” Ms Sutcliffe suggests.
The modern trend of marketing care homes with hotel-quality interiors could backfire if the public studies CQC rating reports and discovers that many of these services require improvement. “If we were going to choose a hotel, we would be very impressed by the décor and the design. This is not the same as in a nursing home where people should be looking for what it will be like for somebody living with dementia,” she concludes.
The full interview with Andrea Sutcliffe will be published in the June edition of Care Home Professional. Click here to subscribe to the monthly magazine, which is free to qualifying professionals.