Care regulator 'struggled to deliver'

 
Surgeons operating The commission monitors hospitals and care homes

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The health regulator which inspects hospitals and care homes in England has "struggled" since its creation two years ago, a report says.

The National Audit Office found the Care Quality Commission had carried out just 47% of planned reviews between October 2010 and April this year.

The CQC took over the work of three previous regulators in 2009 and has had to implement new monitoring systems.

It said it had been a "challenging period" but that it was now "on track".

The commission is responsible for checking if hospitals and care homes meet minimum standards.

It took over from the Healthcare Commission, the Commission for Social Care Inspection and the Mental Health Act Commission.

The NAO said this shift had "created disruption for providers and confusion for the public".

An additional problem was a lack of staff.

Start Quote

There has been too much focus on box-ticking and not enough on crossing the threshold and assuring the quality of care”

End Quote Margaret Hodge, Commons public accounts committee chair

As of the end of September, 14% of posts were unfilled - including 100 inspectors' posts, with the CQC affected by government recruitment constraints, which have now been relaxed.

In its report, the NAO added that the process for registering care providers - one of its core jobs - "did not go smoothly".

The CQC did not meet the timetable for two of the three tranches of registrations, it said. And inspectors were diverted from assessing providers in an attempt to meet that timetable.

This and the staff shortage meant that the commission had completed just 47% of its planned assessments between October 2010 and April 2011.

The NAO concluded that the CQC had not, so far, achieved value for money - and said both the commission and the Department of Health were responsible.

'Considerable upheaval'

It is not the first time the CQC has faced criticism.

In September, MPs said patients had been put at risk by the fall in the number of inspections of hospitals and care homes.

At the time, Prime Minister David Cameron urged the regulator to act on the MPs' criticisms.

THE CQC IN NUMBERS

  • £139m spent in 2010-11
  • 21,600 organisations currently registered
  • 14% of vacancies unfilled as of 30 September 2011
  • 47% of registrations not completed on time
  • 47% of planned inspections not carried out October 2010- April 2011

Its work also came under scrutiny after abuse at the Winterbourne View residential home near Bristol came to light.

Publishing this latest report, Amyas Morse, head of the NAO, said: "Against a backdrop of considerable upheaval, the CQC has had an uphill struggle to carry out its work effectively and has experienced serious difficulties.

"It is welcome that it is now taking action to improve its performance.

"There is a gap between what the public and providers expect of the Care Quality Commission and what it can achieve as a regulator. The commission and the Department of Health should make clear what successful regulation of this critical sector would look like."

CQC chief executive Cynthia Bower said: "Not everything has gone smoothly, but we have learned, reviewed what we do and made changes.

"We are a young organisation and we are still evolving - but I firmly believe that we are making real progress."

A Department of Health spokesman said it was currently reviewing the CQC, and the findings of its review would be published in 2012.

But Margaret Hodge, chair of the House of Commons public accounts committee, said the NAO report raised concerns about whether the CQC was "up to scratch".

She added: "The findings are deeply worrying and highlight significant failures that put patient care at risk.

"There has been too much focus on box-ticking and not enough on crossing the threshold and assuring the quality of care."

 

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  • rate this
    +1

    Comment number 28.

    Yet again another government care department chants the usual mantra "Lessons will be learned". The only one they need to learn, and put into practice, is the 6 P principle. Proper Planning Prevents P*** Poor Performance.

  • rate this
    -1

    Comment number 27.

    More rules little enforcement alot of high paid penpushers in comfy offices on high salaries talking about it i expect,Enforce the rules carry out snap inspections and take strong action against those who are not up to standard get the job done

  • rate this
    +1

    Comment number 26.

    The reason for failures is the usual failure of very poor public service management. The majority couldn't organise a vegetable stall. From the top to the bottom of the management layer they want to sit behind their desks or go to meetings to network, etc. What they should be doing is walking the job and listening to the public then, perhaps, they might find out the failings.

  • rate this
    +6

    Comment number 25.

    As usual with government, they underfund, then blame when things go wrong.

    To solve the problem, they create a new regulator, which they underfund, then blame when......
    Cameron was and is a super spin doctor, and it must feel good to blame someone else.

  • rate this
    +1

    Comment number 24.

    In this day, the quality of care is dependant on how it is recorded in patients notes, not what care is actually seen given. It takes far longer to read and for the nursing staff to document patient care, than actually giving it. The CQC is heavily influenced by the combination of groups that made up the CQC, hence they are looking at the social side more than the clinical.

  • rate this
    +9

    Comment number 23.

    As usual with government, they underfund, then blame when things go wrong.

    To solve the problem, they create a new regulator, which they underfund, then blame when......

    Regulators feel threatened by the criticism, so use punitive inspections, so providers focus on meeting the needs of regulators, rather than caring for people, which leads to neglect, so more regulation....

    stop this cycle!

  • rate this
    0

    Comment number 22.

    Agree with perdot. Perhaps we are focused too much on inspection. If we had a decent health service (oh we do, it’s the envy of the world, we don’t need any lessons from anyone else), that put patient care first, maybe we would not need so many inspections. There seems to be something fundamentally wrong with a care system that only delivers care when under the spot light of inspection.

  • rate this
    -1

    Comment number 21.

    All regulation is reactively-moderated and must obey the house rules.Or else.
    What a great idea!

  • rate this
    -2

    Comment number 20.

    I expect, as with many of these 'organisations' the staff are either underqualified and overpaid or just on the thing for a prolonged jolly, coupled with the painful political correctness that is ever present in public sector jobs I doubt they could even get off their seats without a further enquiry. Bet they were on strike wednesday thought...

  • rate this
    -1

    Comment number 19.

    16.sandy winder "Why should the poor in the private sector pay for the well-off in the public sector?"

    Well, because we will strike if they don't.

  • rate this
    0

    Comment number 18.

    "Another public sector area found to be not fit for purpose"

    Another VITAL public sector are not properly funded by this thieving government and expected to perform miracles with woefully inadequate resources.

    Seriously Sandy - find your "facts" somewhere other than right-wing, reactionary, Little Englander tabloids.

  • rate this
    +1

    Comment number 17.

    It is appalling that hospitals, care homes and the like allow their, already low, standards to plummet if they are not checked by inspections. It appears that there is no inbuilt conscience within these institutions. As I said............ Appalling!

  • rate this
    -4

    Comment number 16.

    Another public sector area found to be not fit for purpose. How surprising? And they expect higher salaries, pensions and perks like more sick days off than everyone else. Why should the poor in the private sector pay for the well-off in the public sector?

  • rate this
    +7

    Comment number 15.

    I had dealings with CSCI, one of the forerunner organisations to the CQC. I found that organisation to be as much use as a chocolate tea pot, so why am I surprised by the incompeteence of the CQC.
    My mother was admitted to hospital from a care home and the hospital notes said, "poorly nourished, dehydrated", oh, and she needed her leg amputated above the knee.
    Regulation and inspection, a joke!

  • rate this
    +2

    Comment number 14.

    Again we hear the old chestnut of " We are learning lessons " The fact is your are getting paid for a job you are not doing so how about giving back your pay until you get it right. Why not learn lessons at your own expense and not from the public purse or worse at the expense the public health. You should have 6 months to get it right from now if not GO!

  • rate this
    +2

    Comment number 13.

    10. RichardGrey

    Which government was it that got rid of Community Health Councils?

    These Councils visited every hospital and other NHS facilities annually often twice each year. Their reports would be brought before the monthly Health Authority meeting and it was usual for any corrective proposals to be implemented.

  • rate this
    +2

    Comment number 12.

    What a surprise! Another quango found wanting! The next step will be to 'scrap' the CQC and present us with another quango filled with govt. cronies, mostly failed hospital managers. WE ARE FOOLS if we believe that these groups actually change anything. As someone mentioned, when we start employing more hospital workers rather than managers things may improve!

  • rate this
    +9

    Comment number 11.

    This is a warning for the future. Privatise health and social care provision, put in a weak regulator and it is inevitable standards will fall. For the government regulators represent red tape and bureaucracy so they never have the resources or powers they need to be effective. There are too many cases to quote here but the record of regulators in social care is lamentable. No excuses acceptable.

  • rate this
    -2

    Comment number 10.

    Is it any surprise?

    This is a Condem "organisation" designed to privatise the NHS.

    You get what you vote for - inept "government"

    None of the Condem organisations are fit for purpose. And they haven't started yet!

  • rate this
    +5

    Comment number 9.

    In response to Whisper. Sure there are some well meaning workers at the CQC hamstrung to some extent by government intervention, or lack of.

    However that does not excuse the woefully poor performance of; regulation, inspection, prosecution of offenders that CQC has overseen since inception.

    Inspections that do go ahead have little or no positive effect on the health and well being of patients.

 

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