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More stale news from failing regulator

Yesterday, by e-mail, I received my CQC “news” - a “monthly update for everyone interested in health or social care” or, more accurately, a look back at some of the “news” about CQC that anyone who really was interested would have already seen or heard weeks ago.

We are told of the “tough new regulation system”, “changes to our directory of services”, and that “care home closures protect residents’ safety”. All these issues have been fully publicised and discussed, and CQC’s performance, motivation and honesty have been questioned.

But there is something new if you can be bothered to “learn more” from the website. Following criticisms of the lack of information on the “new” directory, CQC say “We are aware that some of the details we used to offer are not currently available. Many of these will be restored soon along with some new information and search functions.”

“Coming in the next few weeks” (a conveniently vague timescale): ‘phone numbers’ (wow!), ‘old quality (“star”) ratings’ (never mind the age, guv, feel the quality), ‘historic inspection reports’ (one for the archivist here), ‘filter results by the type of care service’ and by “service needs’ (amazing what you can do with computers these days).

“Coming before the end of the year” (which year is that?): ‘name of the registered manager’, “lists of services offered at each location”, and “details of any conditions placed upon the licence”.

I don’t understand what the hold up is. Why couldn’t all this information have been put straight onto the directory as the new registration took place? Is there really a bank of temps laboriously copying information from the registration database onto the “new” directory of care services?

And the list of “information no longer available” is mystifying: ‘website address for providers’, ‘brief description’, ‘capacity (number of beds)’, and ‘type of provider (e.g. voluntary or local authority)’.

CQC and all of its predecessors have been very poor listeners. Ever since national regulation and inspection (RIP) began - and even before they began - I have been assiduous in offering positive ideas and well worked-out plans for inspection. I have responded to consultations. And, yes, I have also been an outspoken, regular and reliable critic of what I see as the failures and folly of tick-box, paper-based inspection, of long, incomprehensible inspection reports, of withdrawing from complaints investigations and - now - from real inspection itself, and of a top-heavy, grandiose bureaucracy.

But none of these commissions - NCSC, CSCI, and CQC - has ever responded; not to the positive offerings, to the consultations, or to the criticism.

CQC, like its predecessors, is a closed-off and blinkered bureaucracy, more concerned with its own survival than its important task. And therein will lie its downfall in its present form and under its current management. Even though it appears that CQC has been given a reprieve by this coalition government, my guess is that as soon as the registration farce has been fully muddled through, and when the Stafford Hospital Public Inquiry (due to start on November 8th) reveals more about how the top management was more concerned about “trust” status and cutting costs than the safety and wellbeing of patients, we will see at least one of the most senior managers at CQC given the bum’s rush by Lansley.

Cynthia Bowyer, the £200k+ p.a. boss of CQC, was Chief Executive of the West Midlands NHS Strategic Health Authority (“strategically” responsible and most definitely accountable for Stafford Hospital).

Speaking about the Public Inquiry, Ken Lownds of the Stafford campaign group Cure the NHS told the Conservative Party Conference "We need to understand how we can possibly have got to a situation, in a civilised society, in which demeaning vulnerable patients was considered something to be tolerated in the interests of efficiency targets - leaving them without water, crying for painkillers, and telling them to relieve themselves in their own beds."

Only when the many chiefs, heads and directors at CQC are removed, demoted or put to useful work, will the real purpose of CQC become a possibility. It will require a complete overhaul of the organisation to become a reality. As always, ACM will be only too happy to help . . . if asked.


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
October 2010

Come and meet John ar Carelive Uk Plymouth 18th January Click here