Need for training and specialist services as report predicts huge rise in sufferers

Scotland's care watchdog has warned that nursing homes for the elderly are failing to deliver specialist dementia services, amid concerns about the UK's "demographic time bomb".

Liz Norton, director of adult services regulation in care homes for the Care Commission, said staff are not adequately prepared to support current dementia sufferers, let alone deal with the predicted influx of new patients.

Norton's criticisms came in the wake of a report published last week which showed 58,000 people in Scotland have been diagnosed with dementia, though this figure could almost double by 2031.

The report, from the London School of Economics, coincided with the Care Commission's annual quality review, which contained a damning indictment of care homes for the elderly.

In the first comprehensive picture of care in Scotland since the establishment of the regulator in 2002, it was revealed that care homes for the elderly had accounted for 800 of the complaints upheld, or 57% of the total, Although the watchdog's report did not examine the provision of dementia services, Norton said she was extremely concerned about the issue. She said: "There are not sufficient specialist services for people with dementia and there needs to be much more activity in that area. The elderly population is going to grow exponentially and we need to prepare for that."

Dementia already costs Scotland £1.4 billion a year, with an average cost of £25,000 a year for each sufferer.

Norton added: "The majority of staff in care homes need to be upskilled in a whole range of ways. The workforce needs to become more competent and better qualified.

"We have been slow off the mark to care for dementia and slow to think about the demographic changes. We need to be taking action, not wake up to the demographic time bomb hitting us."

Scotland has almost 40,000 care home places, ranging from large corporate-owned premises to small private "cottage" buildings. The Care Commission, which will be working in partnership with Alzheimer Scotland to provide training on palliative care to home staff, believes an optimum size is emerging.

Norton added: "The concept of care homes all started from families saying elderly people should not be in these massive long-stay hospitals. We closed them down, so we should not be creating big institutions like them again."

Kate Fearnley, policy director at Alzheimer Scotland, agreed that low-skilled care home staff were a problem. "Without the right staff skills, people with dementia may end up inappropriately drugged because staff don't know how to handle their behaviour," she said.

According to professor June Andrews, director of the Dementia Services Development Centre at Stirling University, simple design changes to care homes can make a positive impact for people with dementia.

She said: "From choosing decent floor coverings - not patterned carpets - to painting access doors a bright colour and out-of-bounds doors the same colour as walls or putting clearly visible signs on the toilets: these can reduce the burden of care by removing the stress."

Andrews added that only 90 out of almost 1000 care homes have consulted the centre for staff training.

Next month, the Scottish Executive and local councils will invest £30 million in the independent care home sector. The Executive has also published Delivering For Mental Health, which sets out plans to improve mental health services.

Deputy health minister Lewis Macdonald said: "The Care Commission was set up to raise standards in and will be taking action against providers who are not coming up to scratch."