THEY charge in excess of £400 a week but are accused of giving elderly residents crumbling accommodation, poorly trained carers and inadequate facilities in return. Today, Scotland on Sunday can reveal the Scottish nursing homes officially judged this year to be the worst in the country.
More than 400 homes have been inspected this year – about half the total – 23 of which fell far below the standards expected and six of which were found to have serious failings, according to research involving this newspaper and the Care Commission.
Problems witnessed by inspectors included residents being left in food-stained clothes, and living in shabby and dirty conditions surrounded by litter and discarded cigarette ends, sometimes forced to share a bathroom with several others.
Despite the poor conditions, homes typically charge fees of at least 20,000 a year.
The problem care homes can now be flagged up after major changes to the inspection regime that allow the public to see grades awarded by inspectors. This newspaper worked with the Care Commission to get all the national figures analysed to produce tables of the best and worst.
Ronnie Hill, the Care Commission's lead director for grading, branded the weakest homes as "failing" and warned they would be the subject of further inspections.
Politicians and campaigners for the elderly said they were "angry, upset and disappointed" at the revelations.
Some care homes said the Care Commission was to blame, accusing the regulator of increasing paperwork and ignoring "excellent" standards of care.
All Scotland's 940 care homes, are regularly inspected, but this is the first time the Care Commission has highlighted the best and worst.
The sector, which includes private, council-run and charity-run homes that offer residential and nursing care, caters for 35,000 people. Under the new grading system homes are judged on four areas: care and support for residents, quality of the environment, staffing, and quality of management.
Grades range from one to six, with one being unsatisfactory, two weak, three adequate, four good, five very good and six excellent.
And it is not all bad news for the sector: 30 homes were found to be of the highest expected standards, scoring "very good" or "excellent". The majority earned gradings of "adequate" or "good".
But 23 have so far been judged "unsatisfactory or weak" in all of the four areas, with six scoring more than one "unsatisfactory" grading. They are:
• Craigielea Residential Home in Brodick, which was judged "unsatisfactory" in all categories by the Care Commission, and was the worst-performing care home in Scotland.
• Nightingale Grange Care Home in Bo'ness, which was "unsatisfactory" in the quality of environment, staffing and management and "weak" in quality of care and support.
• Dalarran Nursing Home in Langholm and Ellenvale Care Home in Coatbridge, which both scored "unsatisfactory" in their quality of staff, management and environment, and "weak" in their quality of care and support.
• The Village Nursing Home in Cumbernauld, which scored "unsatisfactory" in quality of staffing and management and "weak" in care and support and environment.
• Whim Hall Care Home in Peebles, which was "unsatisfactory" in care and support and environment and "weak" in staffing and management.
At Whim Hall, inspectors found residents' clothing "stained with food" and "food served… cold" as well as dust in the kitchen and bedrooms.
At Craigielea, inspectors found the home had space for 10 residents but only one functioning bathroom.
At Nightingale Grange inspectors found residents were "bored" with "not much to do". Some toilets did not have seats and a few were cracked.
At the Village Nursing Home, residents believed their "human rights were being breached" because they were not allowed to watch war films or pop music on TV.
Hill said: "The quality of care is, on the whole, good or satisfactory. It is now possible to focus on those homes that are unsatisfactory and weak. These homes simply are not good enough."
Last night, Scottish Conservative health spokeswoman Mary Scanlon, said she was "angry, upset and disappointed." She added: "I cannot understand why the Care Commission is so lenient on those homes which have repeated recommendations and requirements."
Elizabeth Duncan, director of Help the Aged in Scotland said: "There are excellent homes that get dragged down by the poor homes. It should be a care sector we have every confidence in."
But care managers defended their homes. A spokesman for Whim Hall said: "We have now appointed a new manager, who has already started driving forward major improvements."
A spokeswoman for Craigielea said: "The inspectors are not bothered about the people, it's all about the paperwork. Our residents look upon this as their home."
Dr Salma Uddin, director for Nightingale Grange, said the home had just been taken over and was being "systematically changed". She added: "The Care Commission inspections are very tick-box. That's not how you care for people."
Mary McInnes, director of nursing for Dalarran, said: "As far as we are concerned the standard of our care is excellent. The problems were to do with the fabric of the building and 90% of the points have been addressed."
A spokeswoman for Ellenvale said the inspection system was "unfair". She added: "We feel the inspection was subjective and not an accurate reflection of the care provided."
The Village Nursing Home did not comment.