'We've asked Manchester how to improve...' Liverpool's care home crisis as fewer than half rated as 'good'

Fewer than half of Liverpool’s care homes are rated as good or outstanding, with “recurring problems” across the city’s locations.

New data released by the city council has revealed how only half of registered care facilities in Liverpool have a recorded manager in place. This is the lowest rate in the Cheshire and Merseyside sub-region. More than a third of Liverpool’s care home market has not been inspected by the Care Quality Commission (CQC) since before the onset of coronavirus.

Documents released ahead of a Liverpool Council adult social care and health committee next week revealed how nursing care continues to be the “most challenging area” for the city. Additionally, five services have closed across the city in just nine months.

CQC data has recorded Liverpool’s care home providers as having just 49% of beds as good or outstanding. Overall, the Cheshire and Merseyside sub region is rated as poorer quality than the rest of the North West area.

According to the council report, the comparator core city, Manchester, is comparably much stronger with a rate of 77.5%. It added: “Officers have engaged with colleagues from Manchester City Council to understand more and the learning has been built into the approach in Liverpool.”

Within the region, only 50% of registered care homes have a manager in place, the lowest on record, while the quality of care drops off “significantly” for larger sites. Only a third of sites with more than 50 beds have a good or outstanding rating.

Analysis by the local authority said around 35% of care facilities hadn’t been inspected since before the pandemic, with only 30% in the last two years. Some sites are only only assessed and rated if they are high risk.

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In its report to the committee, health officials said: “We believe that there are lots of services in our footprint that have made significant improvements and their current CQC rating is not a true reflection of the service they offer.

“This results in people and their families declining offers of care because of the rating. Poor CQC ratings also result in difficulties for providers in securing credit with financial organisations, acquiring affordable insurance, being able to build their business, and attract quality staff.

“As the only assessments are of high-risk services, these are more likely to result in poor ratings so the overall ratings for services within the local authority footprint don’t show any improvement, in fact they may potentially decline further.” Continuing improvement has also remained a challenge for the city, with several providers not sustaining the work required.

Medicine and risk management as well as building quality have been listed as “reccurring problems” for the city’s care sector. Many homes are housed in old buildings not designed for this purpose, which leads to problems with fire safety, window restrictors and general maintenance issues.

Ahead of the committee meeting next week at Liverpool Town Hall, the scale of closures was also raised. The report added: “Service failure or unit closure continues to be a problem that takes resources away from our more proactive work.

“Five closures in the last 9 months, four of which were unplanned, means that staff time is prioritised to keep people safe and help them move to new places and ensure that service delivery is safely maintained throughout the transition process.”