The Care Quality Commission (CQC) has come in for somewhat of a bashing recently. But I didn’t think they would lie as well.
In response to a recent documentary exposing care home abuse, CQC said the following in their media statement:
CQC carries out an unannounced inspection of every care and nursing home in England every year – more often if we believe people may be at risk. This system of regulation can and does identify poor care which CQC then takes action to tackle.
What?!
A quick look at the five care homes I’d stayed in in the last year revealed last inspection dates as follows:
- Summer 2010 (in response to a specific incident, last “proper” inspection November 2007)
- January 2009
- November 2009
- February 2011 (in response to specific allegations)
- December 2009
Not one was inspected in the past 12 months. 0%.
Personal experience with looking for care homes for a relative confirmed the impression that most care homes have gone well beyond 12 months without an inspection.
I smelled a rat. So I asked CQC how many homes it had indeed inspected. The response came. Answering a slightly different question, CQC admit they did 13,082 inspections of care homes over the last 12 months. There are 17,756 care homes. So at least 26% of homes didn’t get inspected. I say “at least” as where CQC identifes problems at a care home they conduct more than one inspection. (hence why I think their FoI response is disingenuous.)
Let’s look at these once again.
- “CQC carries out an unannounced inspection of every care and nursing home in England every year – more often if we believe people may be at risk.”
- Of the 17,756 English care homes, CQC did 13,082 inspections over the last 12 months.
Is it me, or do the figures not add up?
Where did this come from?
The sad thing is we always knew CQC would be an appalling, incompetent mashup.
It was formed from a merger of the Healthcare Commission, the Commission for Social Care Inspection (CSCI) and the Mental Health Act Commission a couple of years ago. Having worked with CSCI, who were at least trying to do things right, me and other service users raised the concern that it would follow the sad precedent of the subjugation of disabled people’s rights following the Disability Rights Commission being subsumed into the Equality and Human Rights Commission. Sadly, we were right. Our concerns that social care would always be lower priority than healthcare were realised.
It didn’t help that the new body was given new, overarching registration standards. These same standards applied to all bodies registered – from acute hospitals, to dentists and care homes. The result being the emphasis on residents rights was lost, and the regulations simply weren’t specific enough for the situation. We lost rights in the change.
Then CQC sacked 70% of its inspectors so that it could register dentists. They adopted what they acknowledge as light touch regulation. They ceased grading care homes, and largely stopped inspecting them. The majority of care home reviews became based on self-declaration by care home managers. Inspections became very rare. Now, precisely which poorly performing care homes would state this to the regulator do you think?
Abuse
All this came to a head during the very sad and distressing Panorama documentary of the systemic abuse of people with learning difficulties at Winterbourne View. CQC became a very public whipping boy, held accountable for a lot of what happened. Much criticism resulted, including a select committee and the PM criticisng CQC for reducing inspections. Many made a comparison with the seminal Silent Minority documentary exposing the “care” of people with learning difficulties in institutions in the early 1980s. (Documentary available to view online – very distressing too.)
Meanwhile, there’s been blood on the carpet and accusations of gagging orders on staff etc. CQC has become a toxic brand. It’s been desperately attempting to reinvent itself, so far (in my view) failing miserably.
Consequences
If it wasn’t so serious, this would be funny. The reality is, though, that people are suffering as a result of this disgusting shambles. Care home residents are some of the most vulnerable, most disadvantaged, most disempowered people in this country. Abuse is the norm, not the exception in my experience; it just varies in degree. Without an effective regulator, the thousands of people in care homes up and down the country suffer even more abuse, poor treatment, curtailment of life opportunities.
CQC are ineffective, stuffed up, an ineffective regulator who lie about themselves to try and stop the torrent of legitimate criticism aimed their way. They are beyond redemption and need replacing.
(With grateful thanks as always to the wonderful Crippen for his inciteful cartoon 🙂
CQC have now clarified, after pressing by me, that 10,808 of the 17,756 care homes in England were inspected during the previous 12 months (some more than once.) That’s just under 61%.
To put it another way, over 39% of care homes weren’t inspected in the last 12 months.
That’s a bit different from this statement where they say:
60% != all
Just sent in a complaint to CQC under their complaints procedure.
See excellent article in Private Eye today, courtesy of @marty_rhys, showing how the Department of Health are letting CQC off the hook over the shameful Winterbourne View debacle. He also wrote an article exposing CQC’s failure to act on alerts at Winterbourne last year. (PDF file)
CQC’s press office have been in touch. They’ve asked me to amend the above article. I’ve refused.
They state that their original press statement is based on a board decision made in February this year (2012) (Annex A of the first document, under item 10 in the 15 Feb papers):
They started implementing this policy in April 2012. Therefore they, and we, won’t know until April 2013 if they have succeeded in their intent.
They then issued the press release in question on 23rd April 2012, only three weeks into their new policy,
That’s a bit previous, isn’t it? It’s not true. They might intend to do so over the next 12 months, but that’s not what they have been doing. They are being disingenuous and giving a false impression as to their existing performance.
If it said “CQC has recently decided to carry out…” or “CQC intends to carry out…” that would be more reasonable. As it is, it’s just plain untrue.
To ask me to change the existing article is also very unwise and shows a lack of insight. I shall now send it on to various publications.
Sources: response to my FoI request, tweets from CQC Press Officer
“At least once a year we propose to inspect all care homes, domiciliary care providers and hospitals”
Which is rather different from “we propose to inspect all care homes, domiciliary care providers and hospitals at least once a year”.
I’m not sure I understand – is the difference that “at least once a year…” implies they will do all the inspections in one go?
No, “At least once a year we propose to X” implies that once a year they sit around a table and say “let’s do X”. At least once a year I propose that we redecorate the living room. I’ve been proposing it for a good 5 years now; it still hasn’t been done.
“We propose to X at least once a year” is what they intended to mean, I suspect.