Coroner says CQC inspection not fit for purpose
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- Published: Thursday, 31 October 2013 07:37
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The West Sussex coroner, Penelope Schofield, has ruled that neglect contributed to five of the deaths, at Orchid View in Copthorne, near Crawley. She said the home, then run by Southern Cross, was "mismanaged and understaffed". Ms Schofield also criticised the Care Quality Commission (CQC), which gave the home a "good" rating in 2010, a year before it closed down.
During the inquest the coroner asked the CQC why inspectors did not close it instead of issuing a warning. CQC inspector Edward McLeod told her that the processes meant there was no quick fix. The coroner told him: "Members of the families would probably find that totally unacceptable."
She added: "How much more evidence did you need for this appalling state of affairs?" Mr McLeod said: "Care homes do have a certain amount of time to achieve compliance." And he added: "To close a home is a big step, a traumatic experience." The inquest heard the CQC produced two reports on Orchid View in 2011 and issued the warning.
At the final day of a five-week inquest into the deaths, which were all "unexplained", the coroner, Mrs Schofield, said the problems at the home were from the top down and started at an early stage, but nobody did anything to address them. She said it was "disgraceful" Southern Cross was allowed to run the home in the way it was, for about two years. Referring to the CQC's rating of the home, she said: "I question how this could be the case and I question whether the inspection that did take place was fit for purpose. It's a heart-breaking case. We all have parents who will probably need care in the latter part of their lives."
Andrea Sutcliffe, the CQC's chief inspector of adult social care, said she had ordered a "root-and-branch review" of the organisation's actions in relation to Orchid View. She said she was shocked at the descriptions of care at Orchid View in 2010 and 2011. ‘It was completely unacceptable and lessons needed to be learned,’ she added. Ms Sutcliffe said she had already outlined changes to how care homes would inspected, monitored and regulated in the future.
Whistle-blower Lisa Martin, who first informed police of problems at Orchid View, said she felt she had no choice but to come forward. Speaking outside the inquest, she said: "I had witnessed too much poor management and care to vulnerable adults. I couldn't live with the knowledge any longer and felt I had no choice but to tell the police."
She said she knew she had done the right thing morally, but said she had not worked for two years and the case had had a huge impact on her life. Speaking of her former colleagues, she said: "They shouldn't be allowed to work in the industry." The government should launch an inquiry into how whistle-blowers are treated in the wake of the Orchid View care home scandal, Tory MP and health select committee member MP Charlotte Leslie said.
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