Survey highlights need to review care home star ratings system, says RNHA

Star ratings systems for assessing care services are by necessity a rather blunt instrument and should not be relied upon as the sole arbiter of quality, the Registered Nursing Home Association (RNHA) said recently.

Commenting on a Commission for Social Care Inspection (CSCI) report on a survey to find out what people think about the star ratings system introduced last year, the RNHA said it painted a less than convincing picture about the robustness of that system.

With around a quarter of local councils and up to four out of ten care home residents believing that the star ratings are too general to serve any real use, the RNHA says they should be regarded as just a very rough guide to the standards being achieved by individual homes.

When the ratings were introduced last year, the RNHA warned CSCI against applying the same criteria to assess, on the one hand, services provided to a very heavily dependent nursing home patient with multiple health needs and, on the other hand, services provided to a highly independent, generally healthy older person who lives at home but occasionally requires outside help and support.

At the time, the RNHA urged CSCI to give more thought to criteria that would be specific to nursing homes, a view that it still holds.

Said RNHA chief executive officer Frank Ursell: "We were concerned from the outset that CSCI inspectors would award stars on the basis of what they could easily measure, rather than taking account of the broader picture. In this way, CSCI risked ending up with a system that makes important what can be measured, rather than measuring what is really important."

He added: "To a certain extent, the findings of this recent survey have confirmed our suspicions about the subjectivity of the star ratings system. For example, whilst around two thirds of councils regard care homes' contractual arrangements as very important in assessing their quality, this view is apparently shared by only 18% of residents and 24% of relatives.

"It is noticeable that care home residents and their relatives place a particularly high priority on the reputation that a home has built up with its existing residents and the wide community."

The RNHA hopes that if the new Care Quality Commission intends to continue with star ratings, it will review and refine the ratings system in order to make it more relevant to the different services to which it relates.

"We hope that there will be a meaningful dialogue between the CQC, service users and providers," said Mr Ursell. "If that takes place within the broader context of how the quality of care can best be measured and evaluated, we may be able to create a ratings system that has more credibility among those who need to use it."

18.05.09

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