A lot of people working within the social care sector have had misgivings about some of the changes that have been taking place at the CQC (care quality commission). The CQC is responsible for monitoring and registering care services (as well as health services, but I’m going to concentrate on care services because it’s what I know best) since its inception when it pulled together various previous regulatory bodies and picked up their functions.
There are a lot of lessons to be learnt for the future within the CQC as we draw to a point where lots of services across health and social care will be merging and we are pushed towards joint management. There is a lot to be wary of.
Private Eye has an expose’ piece in the current issue (dated 29/10-11/1, in the ‘In the Back’ Section p29). Unfortunately the piece doesn’t appear in full on their website so you will all have to go out and buy a copy (seriously, if you are concerned about the CQC it is definitely worth a read and to be honest, I can’t recommend Private Eye highly enough!).
I wanted to draw on some of the issues raised in the piece so forgive the lack of links for the time-being.
The investigation carried out by Private Eye was alongside ‘Compassion in Care’ which is a charity set up to counter abuse in care homes. The organisation was set up by Eileen Chubb, a former care worker who witnessed abuse and who lost her job because she was a ‘whistleblower’. The organisation campaigns for the vulnerable in care homes.
The report highlights a number of concerns related to the CQC particularly how they have either ignored and in one case ‘upgraded’ via the now defunct star-system homes in which proven maltreatment has occurred.
As the Eye says
‘Only last month we reported how – just two months before a hospital nurse described a care home resident as suffering ‘the worst care of neglect’ she had seen, the CQC had wrongly promoted what had been a failing home, run by care home giants Southern Cross, back up to a two-star ‘rating’.
I don’t have the time to relay all of the information and quite unbelievable lack of teeth of the CQC in the face of appalling care services as relayed by the Eye but it makes for frightening although worryingly not surprising reading to me.
Another part of the article refers to the leaked staff survey results published in Community Care and that backs up informal discussions I have with some good friends who currently work in the CQC.
The Eye states that
‘CQC Insiders were worried that attempts to push through registration for all homes and agencies ahead of the 1 October deadline was compromising safety in the homes themselves’.
This absolutely mirrors the conversations that I have had with CQC friends, including being told that they were told to concentrate on these registrations at the expense of visiting homes where issues may have been arising –much to their own chagrin.
The other concerning conversation I had with said friends was that the CQC seemed to be increasingly reliant on local authorities ‘quality assurance’ teams to check on the local residential, nursing and domiciliary services. We can only guess at what might happen to some of these teams as the local councils make massive cuts. I don’t know if they will be able to provide as strong a service as they might in less frugal times.
The Eye pulls up the report and interviews given by the head of the CQC last month stating that 34 homes and 8 agencies were closed after they took ‘enforcement’ action as a way to prove their ‘strong arm’ regulation as well as 51 other services which had closed after poor ratings.
This is an area that Private Eye has been investigating and has tried to push CQC to provide details of these ‘enforcements’ as there was nothing about them in the CQC’s annual report published in April 2010. Private Eye and Compassion in Care have tried to find details of the deregistered homes b ut the information has ‘disappeared’ from the CQC website and they have been stalled in their attempts to investigate.
Cynthia Bower, the Chief Executive of the CQC in her previous incarnation was the West Midland Strategic Health Authority which was responsible for overseeing the Mid-Staffordshire Foundation Trust Hospital. It is quite staggering that the responsibility for protecting standard of care for those who are arguably some of the most vulnerable in society should be under her charge.
I’ve railed against ‘desk based’ assessments which were happening prior to the existence of the CQC where inspectors do not actually visit homes that have previously scored ‘well’ in inspectors but rather rely on ‘self-assessments’. It is a national scandal that we have no reliable and functioning way of monitoring care homes and that the CQC itself is relying on local authority quality assurance visits when it should be setting the gold standard itself.
The piece ends with the comment that while the CQC hasn’t responded to the piece, John McDonnell MP will be raising the issue in the House of Commons so hopefully they will respond to him.
I rail where I can but the difficulty I sometimes face is time and that often homes are able to ‘put on their best face’ for social workers when we visit. We have limited roles usually in reference to one particular resident.
I have to say that all the personal contact I have had with CQC inspectors has been exceptional – when I have picked up concerns at a care home and contacted them directly but it is clear that the time is not allowed in the same way that it had been previously.
We are back to penny pinching and cost-cutting.
Thank you to Private Eye and Compassion in Care for investigating these issues. They should be on the front page of every national newspaper rather than tucked away in the pages of Private Eye – but I have a lot of time and faith in Private Eye to be honest. They have some of the better investigative journalism in my very simplistic terms. Go out and buy this edition, all the editions and subscribe!
We cannot let it lie.
- Closing Care Homes (fightingmonsters.wordpress.com)
- 1,600 elderly and disabled people forced to move after care home closures (telegraph.co.uk)