NHS watchdog under fire over ‘significant’ fall in inspections

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PRESSURE grew today on a watchdog which monitors standards in the NHS and private care sector over claims it has so far failed to deliver value for money.

The Care Quality Commission (CQC) has come under fire for failing to follow up a whistle-blower’s warnings of abuse of vulnerable patients at the Winterbourne View care home in Gloucestershire and has faced further criticism at the inquiry into the Mid Staffordshire NHS trust scandal.

Today a report by the National Audit Office finds levels of inspections of care homes in England fell “significantly” following the introduction of the watchdog.

It cut back on inspection and compliance checks after it was set up in 2009 to concentrate its efforts on meeting timetables for registering care providers.

It completed fewer than half its target number of reviews of standards of care in the six months to April. The NAO said it was unclear how much of the blame the Department of Health should take for the under-performance.

The new commission had a “difficult task” in establishing itself on a £164 million budget, which was six per cent lower than those of the three bodies it replaced even though it had more responsibilities, it said.

Government recruitment restrictions led to 14 per cent of staff positions lying vacant.

Auditor General Amyas Morse said that the CQC has had “an uphill struggle to carry out its work effectively and has experienced serious difficulties”.

But he added: “It is welcome that it is now taking action to improve its performance.”

The findings were described as “deeply worrying” by the chairman of MPs’ Public Accounts Committee, Margaret Hodge, who said the report raised serious concerns over whether the CQC was up to scratch.

“We have all been shocked by the recent reports showing that some hospitals are failing to provide the most basic care to elderly and vulnerable patients,” she said.

“There has been too much focus on box ticking and not enough on crossing the threshold and assuring the quality of care.” Ms Hodge said it was “shocking” that the commission was unable to use its budget to recruit the staff it needed because of the halt on public sector recruitment and said the department must share some of the blame for shortcomings. Michelle Mitchell, charity director of Age UK, said the report showed the CQC had been under-resourced at a time when its workload had increased.

“The CQC has responsibility for ensuring safe and good quality services for people who need care, so it’s crucial that they are fully resourced to inspect and regulate the care system,” she said.”

Sue Slipman, chief executive of the Foundation Trust Network which represents elite foundation hospitals, said: “The CQC needs to shape up – it is clear that it is not working well at the moment.

“In parts of the country the CQC inspector judgements are disproportionate and the regime inconsistently applied.” CQC chief executive Cynthia Bower said that it was faced with the challenge of setting up an entirely new regulatory system and registering over 40,000 providers against tight deadlines, but was now “firmly on the right track” with more than 700 inspectors on the ground speaking to patients and staff and observing care.

“We are absolutely dedicated to protecting those who use health and social care services,” she said.

“We had to bring together the work of three organisations and bring in a new model of regulating health and adult social care.

“Not everything has gone smoothly, but we have reviewed what we do and made changes - often with support of others involved in health and social care.”