THOUSANDS of elderly people in English nursing homes are being given the wrong dose of medicine or the wrong drugs altogether, according to the Commission for Social Care Inspection (CSCI).

A report published yesterday suggests that almost half of England’s nursing and care homes fail to meet national standards on medication, with some staff poorly trained and records not properly kept.

In recent years there have been concerns that elderly people were being sedated deliberately — subjected to a “chemical cosh” — so that they caused fewer problems to staff.

A report last month by Paul Burstow, the Liberal Democrat MP for Sutton and Cheam, said that up to 25,000 elderly people were being sedated without good medical grounds and there had been a rise in the number of adverse drug reactions.

Although the CSCI report makes no direct finding on the practice of “chemical coshing”, it concludes that more than 5,000 out of 11,500 homes for older people fail to meet national minimum standards outlining the best practice for dealing with medication. More than 3,000 of 8,000 homes for younger adults also failed to meet the standards. The CSCI said that some of the 210,000 people who lived in the 8,000 homes deemed to be failing had severe disabilities and serious long-term illness, which meant that the correct medication was vital to make sure that they had a good quality of life.

The study highlights significant geographical variations in performance and indicates that council-run homes perform significantly worse than voluntary and private homes. Dame Denise Platt, chairwoman of the CSCI, said: “Giving people the right medicine in the right doses at the right time is critical. It is vital that all care homes treat this issue with the utmost seriousness. They have a duty of care towards the people in their homes.”

The report claims that there have been few improvements since a similarly critical report in 2004.

“Homes do not appear to have learnt from past failings and expenditure on training does not seem to have had any impact on this area of quality,” the report says. “Of particular concern is the very high percentage of homes, which having achieved the minimum standard, then slip back and fail.”

Dame Denise said it was vital that homes kept proper records and made sure that staff were trained to handle drugs. “Homes must also keep medicines safe on behalf of their residents, as people can differ in the degree to which they can administer their own medicine.” Some people were fully sufficient while others relied totally on the support of nursing and care workers, she said.

The report recommends that all care homes and children’s homes urgently review their practices in managing medication.

It also suggests that they should set up staff training programmes and joint initiatives with NHS primary care trusts.

It said that the National Patient Safety Agency had developed tools to help NHS organisations to learn from their mistakes, including drug errors,and that these guidelines should now be available to homes in the private and voluntary sector. Organisations representing the elderly said that the report revealed the potential danger for older people in some care homes.

“It is vital that older people with complex medical needs receive the proper treatment,” said Jonathan Ellis, policy manager at Help the Aged. “It is also crucial that older people have their medication reviewed annually to ensure that those treatments are still safe and appropriate for them to take.

“Care staff have a duty of care to ensure that older people get the proper medication they need on time. Poor management of medicine means that older people will end up paying the price with avoidable ill health and poor quality of life. Taking medicines unnecessarily for long periods of time can run the risk of severe adverse reactions, which, in extreme cases, can be fatal,” he said.

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