Overlooking poor care: how to prevent neglect

5 February 2025

Helen Wildbore, director of Care Rights UK, was featured on Sky News yesterday discussing neglect in care homes. In this blog, she shares the types of cases we hear through our adviceline, why neglect occurs, and what needs to be done about it.

When we were approached by Sky News to cover neglect, sadly my first thought was the number of people who get in touch about poor care. Two of our advisers at Care Rights UK have worked in the sector for over 20 years and they have never seen it in such a poor state. Concerns about poor care seem to be getting more prevalent and the problems people are experiencing are getting more complex.

What we hear

Every day our advice team hear from someone experiencing poor care. This can include dehumanising treatment such as not having access to dentures, hearing aids or being dressed in someone else’s clothes, through to more serious incidents of neglect. These can include lack of support to eat or drink, lack of medical care (even after accidents or falls), lack of support to stay clean, being left in soiled clothes or sheets, or withdrawal of drink at the end of life.

We hear the devastating impact this poor care has on people, putting their dignity and ultimately lives at risk, especially for the older people we support. We should be able to expect our care to be safe and dignified, especially at end of life.

Poor care also has a terrible impact on family and friends, witnessing the impact on their loved one and feeling powerless. Relatives and friends tell us they have feelings of guilt about their loved one moving into care and when things go wrong they can feel helpless as there is nowhere to turn to get support.

Things can go wrong in any care setting. Good care homes respond to concerns appropriately and quickly, often raising the safeguarding alarm themselves. Good managers will see concerns and complaints as part of running a safe and responsive service, listening to people living in the home and their families as a way to ensure mistakes are learnt from.

However, this is not always the case. The power imbalance in care homes is so skewed that people feel afraid to speak up about poor care for fear of repercussions, such as bans on visiting or eviction. Care homes can respond defensively to concerns, deflecting the issue onto the person raising the alarm as the ‘problem relative’. This can be distressing and lead to a sudden breakdown in relationships and trust - in the place where their loved one calls home.

What is causing neglect?

It is no surprise that the care sector is in crisis. It has been for years and many of the problems pre-date the pandemic. Care services are so stretched that staff often can’t spend the time they need to, or would like to, caring for a person which means they can more easily miss the early signs of neglect. Staff shortages also mean a reliance on agency staff, who don’t know the person as well, so can’t pick up on their communications cues or early signs of pain or distress.

People are being failed by the very systems designed to protect their rights. Safeguarding teams at local authorities can be too reliant on information from care providers we hear, and where people living in care and their families are not heard, investigations can be skewed. It is the regulator’s role to ensure minimum standards but in England the Care Quality Commission has been called ‘not fit for purpose’ by the Secretary of State. Inaction by the Care Quality Commission over a number of years has left people at risk.

The pandemic has had an impact too. The restrictions on visiting and access to family carers during COVID normalised the isolation of people from their relatives and friends. These family carers are the trusted eyes and ears on the ground, who can pick up on communication cues, spot signs of pain or distress, act as the chosen representative to be your voice when needed. That’s why we are calling for a new legal right to a Care Supporter, so that everyone has a right to the support of their trusted loved one when they need it, across all care and health settings.

What’s the solution?

Many of the causes outlined above are long-standing, well documented problems that have been raised with governments over many years. Now is the time for urgent reform of the sector. The appointment of Baroness Louise Casey to the independent commission on reform of social care is welcome. However, the proposed timeframe for the commission is of grave concern.

Change must come quickly and include a complete professionalisation of the workforce. We need more care staff, who are properly trained and supported, with qualifications and rewards to put them on par with their NHS colleagues. We need to see the involvement of people relying on care, and their families, at all levels - being listened to and taken seriously when raising concerns about poor care, being involved in investigations and inspections to ensure care is safe and dignified. We need to see robust regulation, where when poor care is reported, swift action is taken to intervene.

We also hear the impact of good care, and the difference it makes when people are supported to live well, with dignity. Quality care has the power to transform lives. We must create a care system where everyone can access good care. This requires political will, leadership and resources to reform a sector so vital to the country’s wellbeing. Tomorrow, any one of us could need it.