The Care Quality Commission (CQC) said today (8 October) that nearly 1,000 residential care homes do not have a registered manager in place, despite this being a requirement of the new Health and Social Care Act 2008.
Although it does not present a direct risk to the safety of residents, care homes without a registered manager may be less able to identify potential concerns and address them quickly, said the commission. It has placed conditions on the operators of all the care homes in question requiring them to put managers in place.
Under the provisions of the Act that came into force from last Friday (1 October), many care homes must have a registered manager who is appropriately experienced and qualified. This was also a requirement under the old legislation, the Care Standards Act 2000.
CQC announced today that so far it had newly registered the care providers operating about 20,000 adult social care service locations under the Health and Social Care Act. Just over 15,000 of these locations are residential care homes. Most of the others are home-care agencies and nurses agencies. However, around 1,000 care homes (operated by more than 500 different providers) had a condition placed on them that they appoint a registered manager by 1 April 2011.
Not all care homes need to have a registered manager – CQC said that registered providers who manage their own services on a day-to-day basis do not need to also register as managers.
Cynthia Bower, CQC’s chief executive, said: “It has been recognised in the care sector for some time that there is a shortage of experienced and qualified managers. While we have been undertaking the enormous task of re-registering thousands of care services, the scale of this has become clearer.
“The lack of a registered manager does not necessarily mean that people are receiving poor care, but we know from experience that care services without leadership can struggle to address any problems that may arise. Good-quality care is led by good management.
“We know that some providers struggle to find suitably qualified people to take on this role. The sector as a whole needs to take a robust approach to seeking solutions to the shortage of registered managers. It cannot be allowed to continue indefinitely.
“We will use our enforcement powers in the best interests of people who use services. If a care provider is genuinely trying to appoint a registered manager and the quality of care is good, it might not be in the service users’ best interests for us to take enforcement action immediately. But if we find that people are being put at risk because there is no registered manager, then we will take action.”
Under the new Act, CQC has registered about 9,400 providers of adult social care (with a total of 20,000 different service locations), and 600 providers of independent healthcare (with 1,500 locations such as hospitals and cosmetic surgery clinics).
A further 600 providers across adult social care and independent healthcare are resubmitting their applications after their original applications were incomplete or it was unclear which registered activities they needed to register for. A further 430 have not yet been asked to apply, because they were registered near the end of the old system under the Care Standards Act 2000 and consequently are the last to transfer to the new one.
A further 1,300 providers have not yet applied for registration. CQC said they included those who had proved difficult to contact, some of whom may no longer be operating; all of them would be followed up to establish whether they needed to register or not.
In addition to the conditions relating to the lack of a registered manager, providers of about 200 adult social care and independent healthcare service locations have had conditions placed on their registration in relation to various other compliance issues.
The names of providers with conditions on their registration will be published in due course, after they have had the opportunity to exercise their legal right to make representations to the commission.
Ms Bower thanked care providers for their co-operation: “This has not been an easy process for providers or for CQC. We were set a very tough challenge by government to get everyone into the new system in a very short space of time. Now we can move onto the crucial and continuing task of monitoring the quality and safety of care across the sector.”
NHS trusts came into registration last April under the new Act, which CQC says is an important step forward in ensuring that people receive joined-up care. It is the first time that healthcare and adult social care services have been regulated under the same legislation and the same essential standards of quality and safety.
CQC has tough enforcement powers to drive improvements where it finds standards are not being met, including issuing a warning notice, carrying out a prosecution, and suspending or even closing a service.