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CQC has overcome a ‘lack of direction’

CQC has overcome a ‘lack of direction’

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The Care Quality Commission(CQC), which has recently been slammed as “a case study in how not to run a regulator” is now better able to protect the public, the Health Committee claims. 

A report released by the Committee earlier this week states reforms implemented by the regulator’s new management have led to drastic improvements. 

In 2013, the CQC introduced risk-based regulation, as well as a system which will give providers OFSTED-style ratings ranging from ‘inadequate’ to ‘outstanding’. Chief Inspectors for general practice, hospitals and social care were appointed. 

The CQC also introduced a new surveillance system which includes a large range of indicators related to quality of care. The CQC refer to the indicators as ‘smoke detectors’.  

When the regulator suggests a provider is outside the expected range of performance then further examination and inspection will be triggered.

'Historic failures'

But 2013 was also the year of the Grant Thornton report which claimed the CQC gave “false assurances” of the quality of care at a trust, culminating in accusations of a “systematic cover up” when documents relating to the trust were destroyed. 

Anna Jefferson the CQC’s head of media was cleared of any wrongdoing by an internal inquiry. The Health Committee believes this points to “serious historic failures” the regulator is now moving past. 

The 2013 accountability hearing with the Care Quality Commission report published by the Health Committee states that the regulator is now “ready to undertake a programme of substantial reform to develop and improve its regulatory functions”. 

However, the report did reveal concerns over how effective registration, surveillance and inspection will be rolled out beyond hospitals. 

Stephen Dorrell MP, chair of the Health Committee said: “Putting in place systems to inspect hospitals and care homes proved too much for the CQC in previous years. Inspections were superficial and produced reports which bore little relation to reality, but the CQC now has a coherent plan to make sure providers are properly examined.

“Giving inspection teams the time and tools to understand what is really happening in hospitals, GP surgeries and care homes is fundamental. The CQC is now doing this by recruiting specialist inspectors who can understand and interpret what they observe during inspections.”

However, the Health Committee did reveal worries over the CQC’s new responsibility to oversee the financial performance of adult social care providers. 

'Financial struggles'

“The CQC regulates care quality and not financial performance. We recommend that the government should reconsider the proposal that the CQC should widen its remit in this way,” said Dorrell. 

He added: “The Department of Health has asked the CQC to oversee the introduction of the fit and proper persons test for the directors of care providers, but perversely the test will not be applied to the chairs of NHS Trusts or Foundation Trusts. We do not believe this exclusion will be understood by patients or the public.”

CQC chair David Prior agreed that the fit and proper persons test should also apply to NHS trust and foundation trust chairs. 

However, he added: “I do not, however, believe that it is possible to separate finances from issues of quality – they are two sides of the same coin. In adult social care we will work with partners on this issue. 

“In the NHS it is very important that Monitor, the Trust Development Authority and CQC work closely together. If an organisation is struggling financially it is likely to be struggling to maintain quality.” 

CQC’s chief executive David Behan said: “I am pleased that the Committee has recognised that CQC is now better able to protect patients, people who use services and their families from the risk of poor care. 

“The report notes the progress we are making in improving the way we regulate health and adult social care services and that we are clear about our purpose and our role in encouraging services to improve. We will reflect on the Committee’s recommendations and respond in full.”

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