I was interested to see that Mark Easton in his BBC blog, touched on the issue of residential care and the confusion in the regulatory system.
He talks about a man, Dave, who needed to place his mother in a care home and looked to the CQC ratings and saw two stars (good) and his mother found herself in an awful care home.
She moved to a better place but the post goes on to say how
Ministers are pushing ahead with plans to replace regular national inspection with a “localism” model, relying on residents and their families alerting the authorities to problems.
Whoah. So now care home regulation is going the way of volunteers and ‘big society’. This is frightening stuff. I know the CQC has been being wound down, in effect, for years. There are fewer inspectors and they inspect less frequently.
Local authorities ‘quality assurance’ teams who may have picked up the slack are being disbanded in the face of enormous cuts in local authority funding from the central government. Our teams are being decimated (or if you want to take the term literally – more than decimated).
Easton has a telling – and chilling quote from the CQC
As the CQC explains: “We rely on people who use services and those who care for and treat them to tell us about the quality and safety of services. This feedback is a vital part of our dynamic system of regulation which places the views, experiences, health and wellbeing of people who use services at its centre.
Again. A little stunned and frankly horrified silence on my part when I read this. It felt as if I was being punched in the stomach and that the people who rely on a decent and human system of care homes are being kicked in the stomach by the government and the death of the regulatory system as well.
Feedback is very far from ‘dynamic’. I’ve tried to raise issues myself with the CQC about concerns in residential homes that I’ve visited and when you finally track down the officer responsible, you might get a sympathetic mumble but little has actually been done – oh, except in one instance where I managed to trigger a massive safeguarding alert which encompassed ALL the residents of said home. Maybe a regular inspection could have highlighted these issues before a social worker who only happened to be visiting by chance raised the alert (when I spoke to the inspector, she admitted she had never actually physically visited that home). Is this really the best way to proactively improve the quality of care homes? Is this what the ‘Excellence’ scheme is about? To encourage the CQC to be let off the hook as larger care homes tick more boxes.
This is a scandal. This is NOT as expectation that should be on residents and families who often feel incredibly vulnerable leaving their loved ones in a care home to pick up.
It isn’t easy to find the correct CQC number to make a complaint. Their website was actually redesigned to be far worse and far more user-unfriendly that I expect it was done by a work-experience student or the child of one of the higher tier managers who said ‘I know about computers.. I can do it’.
I really hope they didn’t spend public funds on that redesign.. information is much more difficult to find now – or perhaps that was the purpose (I’m saying that tongue-in-cheek – I’m don’t really believe in conspiracy theories – incompetence is usually the more obvious answer!).
Easton goes on to explain that
English councils are expected to improve their monitoring of care home standards just as they make cuts to adult social services, squeezing commissioning budgets and looking to find efficiencies in backroom quality assurance operations. The head of CQC, Dame Jo Williams, recently made the point herself: “The providers will be asking themselves: what can I do to cut corners?”
It is not just central government inspection of care homes which is being cut back. Ministers have also scrapped official assessments of how well local authorities commission care services. In future, councils’ responsibility to ensure good standards will be monitored by a new local consumer champion HealthWatch, which itself relies on local authority funding. The NHS Confederation has warned of “inherent conflicts of interest” with a council funded body scrutinising its paymasters.
So just when you thought things couldn’t get any worse.
This demonstrates that the ‘so-called’ Excellence scheme is a sham by a body that is not fit for purpose (namely the CQC).
We need to protect and provide support to vulnerable adults but no tools are being provided to support this and gradually the tools we had are being stripped away.
This is more difficult to stomach as Ofsted have a new inspection regime that demands that childrens’ homes are inspected twice a year and all inspections will be unannounced.
Why is the same system not introduced for vulnerable adults?
That is the question we should all be asking. Why does our society allow adults who are dependent on us to suffer so much in comparison and to be subject to second-rate, third-rate services and regulation of care homes?
We should be clamouring and demanding the same inspection mechanisms as given to children.
But people need to know about the changes in order to protest against them. Too many of these changes have happened stealthily and without much debate.
So slowly we are seeing the ‘big society’ that Cameron envisaged. It isn’t about community networking and organisation. It isn’t about volunteering and ‘making the community a better place’. It is about absolving the government of responsibilities.
Would we allow ‘friends and families’ to provide the base of inspections in childrens’ services or in hospitals? No. Why could and should we allow it in adult social care?
- Excellence Ratings for Care Homes (fightingmonsters.wordpress.com)
- Leading article: The dangers of a circuitous approach (independent.co.uk)
- You: Care Quality Commission report slams mental health care in Peterborough – Peterborough Today (news.google.com)
- Johann Hari’s manifesto for change in care homes (fightingmonsters.wordpress.com)
- One in three care homes found to be wanting as ministers announce new ‘excellence test’ (dailymail.co.uk)
- Scrutiny, CQC and ADASS (fightingmonsters.wordpress.com)