GDPUK.com - Health Committee condemns CQC’s workings

Health Committee condemns CQC’s workings

Details: Published: Wednesday, 09 January 2013 16:41; Written by News Editor; Hits: 2002

Stephen Dorrell MP, chair of the Commons Health Committee has described it as ‘extraordinary’ that the Care Quality Commission (CQC) had yet to define its core purpose. A report on the CQC’s performance found a ‘worrying disconnect’ between official inspection results and the real standards experienced by patients. It also failed to communicate the results of its inspections to patients, residents and their families, the report found.

The Committee’s conclusions and recommndations appear below.

Heath Select Committee’s Report on CQC

Conclusions and recommendations

1. The new Chair must, as a matter of urgency, overhaul the governance structures of the CQC. The Board must provide proper strategic direction to the organisation and hold the Executive effectively to account for their performance against defined objectives. The Chair must ensure that all members of the Board are encouraged to contribute fully to the operation of the Board and that they are always able to enjoy open and free access to the Chair. Board procedures should provide for regular assessments of its own effectiveness and they should also provide a clear process by which a Board Member can express concerns about the performance of the Chair.

2. We agree that the CQC's fundamental purpose is to ensure that health and social care providers meet those essential standards which ensure patient safety. The Committee remains concerned that the role and duties of the CQC are not sufficiently clear. Responsibility for patient safety lies at the root of high quality patient care, but is in danger of being obscured by other competing priorities. This is a particular concern given that the Government has abolished the National Patient Safety Agency and absorbed it in to the NHS Commissioning Board. We recommend that the Secretary of State should urgently work with the statutory regulators and commissioners of health and social care in order to simplify and clarify their respective roles. We further recommend that the Secretary of State should reconsider whether prime responsibility for patient safety should reside with the CQC.

3. In relation to social care there is too often a disconnect between the essential standards measured by the CQC and the experiences of residents in social care. In too many cases residential care homes which meet the CQC's essential standards are regarded as unsatisfactory by carers, relatives and residents. In reviewing their regulatory model the CQC must ensure that the 'essential' standards they enforce align with the expectations and experiences of patients, residents and relatives. We look to the new management team to work from the principle of 'first do no harm' and focus on this core issue with a much greater sense of urgency.

4. The first priority for the CQC is to apply its existing standards consistently and effectively. When the CQC is able to command public confidence that it has achieved this objective, the Committee will seek a progress report on this issue and on plans for the progressive raising of these standards in line with public expectation.

5. Commissioners ought to be able to turn to the CQC for evidence of the quality of care provided. The CQC Board and management need to show that they use the resources at their disposal effectively to deliver the necessary assurance to commissioners, patients and their families. The record shows that it has not so far been able to provide such assurance.

6. We welcome the fact that the CQC has undertaken a consultation with its stakeholders about the scope and purpose of the organisation. In view of its unhappy history, we believe that it needs to do more. We believe it should consult with stakeholders about effective means as well as desirable ends. We therefore recommend that before the accountability hearing in 2013 the CQC should undertake an open consultation designed to develop a clearer understanding of effective regulatory method.

7. We recommend that, as part of a general consultation about regulatory method, CQC should consult in particular on how to assess the culture of a care provider - in order to satisfy itself that a healthy open culture prevails amongst professional staff.

8. It is failures such as those witnessed at Morecambe Bay which undermine public confidence in the CQC's essential standards. Registration should be a challenging process for providers and not simply a bureaucratic formality. The CQC must undertake registration with the intention of finding shortcomings where they exist and ensuring that service providers swiftly address their failings.

9. Without joined up working the regulatory landscape will be burdensome and dysfunctional, but there is also an acute danger that 'when everyone is responsible, no-one is responsible'. There is an urgent requirement to define the role and responsibility of the CQC; within that definition of its role the CQC must operate autonomously of the other health and social care regulators and be accountable to Ministers and Parliament for its actions.

10. The Committee welcomes the greater use and availability of clinical expertise to support the work of inspectors. We note, however, that 87% of inspections carried out since this resource became available did not use it. We recommend that the CQC should develop a consistent methodology for their inspectors to follow which would help to regulate when and how clinical experts are allocated to inspection. We also recommend that the CQC should monitor the effect of the deployment of this resource on the quality and consistency of its inspections in order to ensure that its practice evolves in the light of experience. We will examine these issues again at the next accountability hearing and seek a progress report on the balance between generic and specialist inspection.

11. We recommend that the Executive Management of CQC should be tasked to ensure that its inspection planning includes sufficient resilience to be able to accommodate unexpected peaks of work, whether they result from the requests of Ministers or from other causes.

12. We recommend that the CQC should develop clearer guidelines for communicating the results of its inspections to interested parties. When inspections are complete, patients, operators, residents and relatives are all entitled to effective access of the results, both positive and negative which is prompt, accurate and complete.

13. While it is essential that proper procedures are established to support whistleblowers who report cases to the CQC, in most circumstances it will be important for staff in the first instance to raise issues through accessible procedures at their place of work. We have noted earlier in this report the importance which CQC inspectors should attach to making an assessment of the professional culture of organisations which provide health and social care. A key element of this assessment should be a judgement about the ability of professional staff within the organisation to raise concerns about patient care and safety issues without concern about the personal implications for the staff member concerned. An organisation which does not operate on this principle does not provide the context in which care staff can work in a manner which is consistent with their professional obligations. It should therefore be refused registration by the CQC.

14. If the CQC is to genuinely treat feedback from the public as free intelligence then it must show that it can act swiftly on intelligence when serious complaints are made.

You need to be logged in to leave comments.

s2sdefault