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.