“As the outcry at CQC’s failure to inspect care homes intensifies, we are in danger of harking back to former regimes of regulation which may have been better but were far from perfect” says John Burton, Head of the Association of Care Managers (ACM).
While paying more than £100 a year for inspection, residents of care homes get nothing from the current regulator. Most of the monitoring information about care homes is provided to CQC by the managers of the homes themselves. But we should remember that this was a trend (not inspecting and relying on self-assessment) that was started by CSCI with three-yearly intervals between inspections and the reliance on AQAAs (self-assessment).
CSCI let down residents and relatives by withdrawing from dealing with complaints, and their inspection methodology increasingly relied on form-filling rather than direct contact with the homes. Indeed, CSCI began the decimation of the hands-on inspection workforce; it concentrated on process rather than outcome; it expanded the hierarchy and bureaucracy, and, in doing so, it further distanced inspection from the real life and work of care homes.
The Association of Care Managers (ACM) welcomes the effective inspection of care services, concentrating on the rights, safety and wellbeing of those who use the services. Effective inspection is vital for residents AND managers and staff. ACM upholds the highest standards of management and care, and believes that all care homes need independent outsiders to verify that the care is good, and to support residents and relatives when there are issues that cannot be satisfactorily resolved internally.
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 or passing new legislation. 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.
For more information about ACM, please contact
Kate Hawkins, Hawker Publications Ltd. Culvert House,
Culvert Road, London SW11 5DH
Tel: 020 7720 2108 ext 201
Fax: 020 7498 3023
John Burton, Head of the Association of Care Managers