CQC’s dynamic system of regulation

When I saw Mark Easton’s report on BBC News at Six yesterday about the changes in the way care homes in England are to be inspected, it made me wonder – yes, yet again! – whether the world has gone completely off course, heading for a major collision.

Then I read Mark Easton’s blog ‘Care and the Community’ and the words used by CQC have thrown me completely.

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.

Dynamic system of regulation?  Dynamic?

Dynamism presupposes energy and effective action –   not exactly characteristics for which the CQC has ever been renowned.  Lethargic might be a more appropriate adjective to describe the CQC.

The CQC and its predecessor CSCI have been short of a dynamo – or even more than one – for  years, and there’s not much chance of new-found energy coming via a system of informal regulation which will rely on the already depleted energies of older vulnerable care home residents and their relatives.  It’s unfair to place such a burden on their shoulders.  But it will make it easier for care providers to cough out the old chestnut “well, nobody else has complained”.

Care Services Minister Paul Burstow said in Mark Easton’s report “…. we’re determined to actually make sure responsibility sits where it should be, with the commissioners, with local authorities and with the providers”.   Burstow almost implies that those commissioners, local authorities and care providers never had any responsibility in the past to ensure quality care in care homes.  So what were they commissioning, authorising and providing?  Crap Quality Care in the UK?

Anyone who has ever tried to shake awake either CSCI or CQC and to try to get some kind of dynamic action from them will be in a state of severe shock now.  It has never been possible in the past to get anything that resembles ‘concern’ from CSCI/CQC, so I have little optimism for the future.

Especially as the cuts currently being forced through in local authorities up and down the land will make dynamic localism an empty promise.

But if the plans to abolish councils’ legal duties to provide social care come to fruition, there will be no care homes.  There will be no care.  Social care will be gone into the hands of the private providers, available only to those who can afford to pay the charges of those private providers.  I wonder what it will be called if it becomes a discretionary rather than obligatory provision of care.    Local care?  Discretionary local care?  Survival of the fittest via neglect of the needy?

Is that a civilised way to support vulnerable adults in need of care?  It wouldn’t be allowed if it were cats and dogs we were talking about, so it should not be considered good enough for older people.

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4 Comments

Filed under care, care homes, growing older

4 responses to “CQC’s dynamic system of regulation

  1. Thank you for this share, as I may have missed it.
    I have added my 2d on the (rare) means to get in major media’s radar range, but will add here if I may:

    ‘relying on residents and their families alerting the authorities to problems.’

    Not much use if there is no accountability at the end of it. Presuming inspections are competent in the first place.

    I am at Parliamentary Ombudsmen (typically, even by this point, there are duplicating, competing and hence gap-strewn oversight systems staffed up the whazzoo) stage of a complaint that is now in its second year.

    Interestingly, with scores of folk and hundreds of man-hours consumed not ‘learning lessons’ that could be devoted to better care, the sheer complexity of the backside covering systems have caught up with them, and all oversight bodies are scrambling to explain how the owner of the care home also happened to be the senior partner of the GP surgery that ‘looked after’ the residents.

    Seems none of those involved in yet more systems and gold stars, etc had ever heard of, or considered things like ‘conflict of interest’.

  2. leo

    the whole regulating and inspection process is a shambles. The authorities in reality have very little authority with what they can inspect within a care home. Lets face it, within 5 minutes of an inspector entering a care home, the whole workforce know their there and an illusion is created. One or two day inspections are not sufficiant to pick up on ingrained bad practise.
    i know of a care home where many staff have complained to CQC over serious issues as short staffing which has led to clients being left in their own urine for many hours, management refusal to provide more staff or even assist themselves. Increased client falls due to poor staffing, etc etc.
    the authorities visit and management are clever enough to ensure that on paper (rota) the home is always fully staffed, on the day of the inspection management are on the floor assisting staff and have plausible (but untrue) explanations for why staff would want to complain, malicious reasons!! whats really gobsmacking, is that after their visit (local council) they responded by saying that they are dealing with worse homes at present!!!! so i can only imagine how bad standards have to be before action is taken.
    i am not the only one to think that the only way to really inspect the standards of any care home, is to have an undercover member of staff in place for at least a few weeks to a few months.
    if you read the cqc press release section on their website, have you noticed that the majority of their actions are against health trusts? this is because hospitals deal with many “normal” people who have full mental capacity and no their rights. Also mental health trusts where the mental health act carries a great amount of weight. the rights and protection of the older generation are being overlooked and sidelined and the current processes are not adequate.

    • careintheuk

      Thank you for your comments, Leo. It may not surprise you to learn that I agree with you! The whole process is a shambles at present – and I can’t see it getting any better if care homes and care providers are allowed to inspect themselves, in effect, and to pay a nice tidy sum of money to the CQC to apply for an ‘excellence’ badge of honour.

      If they all want to display a ‘badge of honour’, the best way would be to provide top-quality care, respecting the very reasons why anyone moves into residential care; select staff appropriately, with good training provided; pay a decent salary – rather than minimum wage – which would be one way of showing respect for staff; be honest, open and transparent when things go wrong. At present they all hide behind a shield, with reinforced steel joists protecting the management structure and local authority responsibilities – while the residents receive neglect rather than care.

      It is a disgrace.

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