CQC has made progress but further improvement needed, audit suggests

The National Audit Office says the Care Quality Commission has made progress but needs to gain access to more routine information about social care providers and build a new organisational culture

The Care Quality Commission (CQC) does not have access to enough good quality information about adult social care for it to monitor the risk of poor care or trigger inspections in care homes, an audit has shown.

The independent regulator of health and adult social care services in England faced criticisms in 2011 and 2012 from a range of bodies including the National Audit Office (NAO), the Public Accounts Committee, the Department of Health and the Francis Report.

It was criticised for its weaknesses in strategic direction and leadership, insufficient skills and capacity, and failure to intervene quickly or strongly enough in failing providers.

According to a report published today by the NAO, the CQC has made substantial progress in its regulatory approach, but significant challenges lie ahead if it is to demonstrate effectiveness and value for money.

The CQC has made changes to its structure and leadership and developed a new regulatory model that strengthens the way it expects to monitor and inspect hospitals, adult care providers and GPs.

By mid-April 2015 it had reached its initial target to recruit 300 inspectors by the end of that month.

Furthermore, the report finds that the commission is using data more effectively to plan inspections, in particular for acute trusts, which is a response to the conclusions of Sir Robert Francis’ report into the failings at Mid Staffs.

However, in contrast to the national data available for hospitals and GP services, the NAO says the CQC does not have access to good enough routine information about adult social care for it to monitor risk or trigger inspections. The commission needs more complete data about regulated bodies, particularly in the adult social care sector, as well as better quantified indicators of its own performance, it says.

The NAO report also says that while progress has been made in recruiting new staff, the CQC still does not have sufficient people for all its work.

CQC chief executive David Behan said he was ‘greatly encouraged’ that the NAO recognised the commission’s progress and said it will ‘seriously’ consider the report recommendations to ensure it improves further.

‘We appreciate that our model is still maturing, having inspected less than 10% of providers by the end of the period of time that the NAO's report focuses on. We hope that providers, and importantly people who use their services are seeing the benefits of our inspections so far, which allow us to root out bad practice and to identify and celebrate what is working well better than ever before. We are confident that this, and being open about what we are finding, will lead to real change and improvement.’

Simon Bottery, director of policy and external relations at the older people’s charity Independent Age, said routine information about social care providers would enable the ‘CQC to make intelligent risk assessments of care homes and home care agencies, and help the CQC to prioritise its inspections on those most at risk of providing poor care.’

He added: ‘The report shows that, unlike in health care, the CQC remains heavily reliant on its inspections to make an assessment of safety and quality in care homes and home care agencies.  While these inspections have improved significantly, lack of staff means that the schedule is falling behind and it will be October 2016 before all providers have been inspected. This is a real concern for older people using care services.’

Read the report in full here.

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