Tuesday 21 November 2017
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Childrens safety is paramount but old people can be forgotten

“Whatever its faults as a regulator, Ofsted does recognize that children’s homes need inspecting twice a year. By what twisted logic and lack of principled direction does CQC believe that care homes for adults do not need inspecting at all?” asks John Burton, Head of the Association of Care Managers.

To its credit, since taking over the inspection of children’s homes from CSCI, Ofsted has continued to inspect all homes (even the “outstanding” ones) twice a year. In contrast, first CSCI reduced the inspection of “adequate” to “excellent”care homes to between once a year to once every three years, and now CQC have given up on regular inspection altogether. The new CQC policy is to wait until something bad happens and only then will it be deemed necessary to have a “site visit” - and, even that doesn’t necessarily mean a full inspection.

So, the safety and wellbeing of children in children’s homes is a great deal more important than the safety and wellbeing of adults (who include people with mental and physical and learning disabilities, the very old and frail, people with dementia, and people who need constant and highly skilled support and nursing care). That’s official government policy, is it?

And we learn this week from CQC’s proposal on fees that this lack of inspection and the absence of any meaningful information on the CQC website is going to cost residents, on average, well over £100 a year. What for? What possible use is CQC to a resident of a care home or to his or her family? Is this value for money? Is this fair?

CQC’s fees to care homes are passed on to residents. A self-funder must put aside more than £2 a week to pay to run CQC. The fees paid by approximately 250,000 care home residents will just about pay the salaries of the top three earners in CQC. They receive NOTHING in return.


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