Tuesday, 3 October 2017

The Care Quality Commission


The CQC (Care Quality Commission) state on their website
“We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage them to improve.”

They are the ‘regulators’ who monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and they publish what they find, including performance ratings to help people choose care.

Like Ofsted in its relation to education, the CQC has a remit across all social care – providers and statutory commissioners.

Not so long ago we had the Healthcare Commission which was a non-departmental public body sponsored by the Department of Health.  The Healthcare Commission was set up to promote and drive improvement in the quality of health care and public health in England and Wales in 2004.  It aimed to achieve this by becoming an authoritative and trusted source of information by ensuring that this information is used to drive improvement.  It was abolished in 2009 and its responsibilities in England broadly subsumed by the Care Quality Commission.

The Care Quality Commission (CQC) is an executive non-departmental public body of the Department of Health.  It was established in 2009 to regulate and inspect health and social care services in England.  It was formed from 3 predecessor organisations
·         The Health Care Commission
·         Commission for Social Care Inspection (CSCI)
·         Mental Health Act Commission (MHAC)

The CQC's stated role is to make sure that hospitals, care homes, dental and general practices and other care services in England provide people with safe, effective and high-quality care, and to encourage them to improve. It carries out this role through checks it carries out during the registration process all new care services must complete, inspections and monitoring of a range of data sources that can indicate problems with services.

Part of the CQC’s remit is protecting the interests of people whose rights have been restricted under the Mental Health Act (MHA).

It is also imperative to remember that non-departmental public body (NDPBs) are not an integral part of any government department and carry out their work at arm's length from ministers. In the CQC’s bio its classed as an Execitive this means – they usually deliver a particular public service and are overseen by a board rather than ministers. Appointments are made by ministers following the Code of Practice of the Commissioner for Public Appointments. They employ their own staff and are allocated their own budgets.

But no one seems to monitor or regulate them.  What is more disturbing is that even the inspectors employed to monitor and inspect services seem to be all working from different worksheets.

It will not surprise anyone therefore that inspectors are not consistent in their Reports and Inspections.

By simply looking on their website I found two Inspections from two ends of the Country, both Services are “Celebrated” as Leaders in their Field, both services work with dementia care and both reports are near identical except for 1 is a charity and the other a fairly new organisation having only been operational for a year.  However, 1 is rated as Outstanding by the CQC and the other merely Good!

This is a clear demonstration of inconsistency within the CQC.

In a 3rd report on a service rated as Good, I found in the Summary of Findings that the Service was described as Safe and rated Good for “Is the Service Safe”.  Yet further in the report the Inspector noted that some Services users were left in Bed over 8 hours a day and with no drink or means to hydrate – how then is this safe? How then can this Inspector honestly rate the Safety of this Service as Good?

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