Tuesday 13 November 2018
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The cat is now out of the bag

 At last, the few lone voices claiming that CQC is “not fit for purpose” are being backed up by the media, MPs, and even some previously silent social care VIPs.

As one contributor to File on 4 (Radio 4 last week) put it, the CQC is “not fit for purpose”.

John Burton, the Head of the Association of Care Managers, says: the programme exposed - yet again - the failure of the English social care regulator to do its job for residents of care homes. (And this is at a time when the CQC is proposing to charge MORE for its non-existent inspections and its failure to respond to people who ask it for help.)

Amanda Sherlock, the CQC’s “Director of Operations”, evaded most of the questions put to her, blustered confusingly, and denied the facts. Eventually, when confronted with the CQC’s inaccurate and misleading claims about how they had shut down care homes that were poor, she resorted to apologizing for “data inaccuracies” and attempted to pass off some of CQC’s serious failings as “strictly a technicality”.

This Sherlock is no Holmes!
Amanda Sherlock has been a senior inspector since well before there was a national inspectorate. She has been through local authority inspection, the National Care Standards Commission, the Commission for Social Care Inspection, and now the Care Quality Commission.

She has led, tolerated or colluded with the slow death of care home inspection and the loss of many experienced and committed inspectors. And she’s still there defending the indefensible.

Inspectors do need to visit homes. Yes, like detectives, they have to pick up clues and follow them. They have to have the nous and experience to know when something is serious and to be able to see the wood for the trees.

This CQC Sherlock claimed that inspection could be done by sitting at a desk and waiting for the clues to be served up - usually by the home itself. One spectacular failure she blamed on a home for failing to provide information to CQC for two years to indicate that the home was not working properly. A variety of contributors to File on 4 gave instances of CQC ignoring the concerns of relatives and staff, and of failing to respond to very serious incidents, in one case leaving it for 5 months before visiting when it had been told of neglect and abuse.

No, CQC is simply not fit for purpose. When are the government and the social care establishment going to take action to protect residents and to restore the good reputation of care homes by inspecting them properly?

The Association of Care Managers calls for a new approach to regulation and inspection of adult social care:
Prioritise the quality of care and the rights and safety of the people who use the services – this is the primary purpose of inspection
Inspect services as often as necessary but at least once a year
Inspectors should aim to prevent bad practice rather than to condemn it after it has occurred and after residents have suffered
Inspectors should be locally based and known – and accessible - to the public and users of the services
Inspection reports should be written for the public
Inspectors should work directly with residents and relatives, staff and managers of individual homes, NOT with the provider groups and organisations
Inspectors should respond to and investigate complaints, and be willing and available to visit the service without notice and at any time
Inspectors should understand how the services work and be willing and able (when appropriate) to help services to improve
People who use services should have a formal and influential voice in the assessment of care.

We believe all of this can be achieved without increasing inspection fees. However, it will mean a total reorganisation of the CQC, dismantling the centralised bureaucracy and grandiose management structure, and setting up local Healthwatch inspection teams employing independent inspectors who will be judged by - and paid by - results.

ACM supports the effective inspection of care services, concentrating on the rights, safety and wellbeing of those who use the services.

John Burton, Head of the Association of Care Managers
November 2010