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England's first care home diabetes audit

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England’s first Care Home Diabetes Audit, published today, has revealed a worrying lack of support for many of the estimated 37,625 people with diagnosed diabetes living in care homes.

The audit, carried out by the Institute of Diabetes For Older People (IDOP) and supported by other organisations, including Diabetes UK, paints a picture of a care home sector ill-equipped to meet the rising challenge of diabetes.

The audit has highlighted a lack of diabetes-specific policies and procedures, far too many untrained staff and ineffective links with NHS services, such as footcare teams.

Disappointingly, just 23 per cent of care homes responded to the audit. This means that the true picture is likely to be even worse than the official audit findings as non-respondents are likely to be less engaged with the issue.

Some of the key findings of the audit include:

  • Over a third (35.17%) of residents do not know about signs and symptoms of hypoglycaemia, which is when blood glucose levels fall dangerously low
  • 17% of homes had no system in place to check whether those who self-medicate had taken their medication
  • 36.7% homes had no policy for screening Type 2 diabetes – this means that patients could be admitted to, or living in, a care home with undiagnosed diabetes
  • Nearly two thirds (63.2%) of homes had no designated staff member with responsibility for diabetes management

Barbara Young, Chief Executive of Diabetes UK, said: “The findings of this first England-wide audit of care homes are deeply worrying. They show that far too many older and vulnerable people are being denied basic standards of diabetes care and this is something that needs to be addressed urgently.

“With the number of people with diabetes projected to rise over the next few years, even more people with the condition will be entering our care home system or develop diabetes during their time in it and, if nothing changes, their health will continue to suffer, putting their lives at risk, as a result of a systemic failure to train people properly and deliver consistently good standards of care.

“We know that many people in care homes do not have regular access to a healthcare professional and are often looked after by unqualified carers who, due to a lack of training, may not have even a basic understanding of diabetes. Other issues such as dementia, other co-morbidities, and frailty can also complicate the management of diabetes.

“The lack of attention given to the specific needs of people with diabetes in care homes around their care is a significant gap in the regulatory framework. Unlike the provision of dementia care, where a minimum number of staff are required to be trained in order to provide care to meet Care Quality Commission (CQC) standards, there are currently no mandatory requirements for diabetes skills or training.

As part of the Joint British Diabetes Societies, we are working with the CQC to strengthen the regulatory framework around diabetes in care homes. We want to see full national implementation of the standards recommended in our 2010 report Good clinical practice for care home residents with diabetes and we want mandatory demonstration of this as a CQC requirement for registration of care homes.”

Diabetes UK is calling for:

  • Full national implementation of the standards recommended in our 2010 report “Good clinical practice for care home residents with diabetes”
  • Mandatory demonstration of this as a CQC requirement for registration for care of people with diabetes
  • Clinical commissioning groups to put plans in place to improve diabetes care for older people resident in care homes
  • Good quality training for care home staff. Diabetes UK provides RCN accredited ‘Diabetes Awareness Training’ for professional carers and offers on-line education, in addition to other providers of diabetes education.

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