The Care Quality Commission’s annual staff survey has exposed low staff morale and a lack of employee confidence in the organisation’s management.
The results, leaked to Community Care last week, showed just 16% of staff felt the health and adult social care regulator was well managed, 14% had confidence in the decisions made by the executive board and a mere 8% felt change was well managed.
The survey, answered by 1,473 staff, three-quarters of the total, also found that just 18% felt morale was high in their part of the organisation and a similar proportion felt it was safe to challenge the way things are done in the CQC.
Just 7% thought communication between different parts of the organisation was good.
However, a challenging relationship with staff is not a new phenomenon for social care regulators in England. The Commission for Social Care Inspection’s 2007 annual staff survey found more than two-thirds of staff felt the CSCI did not value employees and a similar proportion felt it did not manage change well.
However, the findings of the CQC’s latest survey spring from present day concerns. The CQC’s chief executive, Cynthia Bower, say they reflect the “enormous” scale of change the organisation has been through in its first 15 months, including merging three inspectorates into one body and introducing the first registration system for NHS providers.
She adds: “It has been tough and we’ve all felt the effects of that. I’m acutely aware that morale has taken a hit.”
However, the survey findings also reflect a very specific issue, namely the implementation of a new registration system for adult social care providers.
The CQC must register 24,000 adult social care providers from April to the beginning of October, under the new regulatory system brought in by the Health and Social Care Act 2008.
It has already faced criticism from providers over an alleged lack of communication over the process and admitted that it made administrative errors that led to delays in some providers receiving notice to register.
Initial figures suggested that the process was running smoothly, with over 90% of providers registered on time in the first round of applications.
However, a CQC member of staff, who spoke to Community Care anonymously, said registration had become the organisation’s “number one priority”, leaving less scope for inspectors to make visits to services.
Unison’s national officer for social services, Helga Pile, says there are widespread concerns among the union’s CQC members that the registration process is compromising their ability to keep users in regulated services safe.
“Members have said they feel this is a dangerous situation because they are being instructed to push all registrations through in order to meet the deadline – regardless of any quality concerns or safety issues they judge should affect the provider’s registration,” she said.
‘They feel this compromises them professionally and personally, and is diverting resources away from monitoring, risk assessing and inspecting services for quality and safety.”
Amanda Sherlock, the CQC’s head of operations, denies any link between registration and compromising safety. “Registration should be seen as an opportunity to evaluate our knowledge of service quality and there is the ability to undertake a site visit as part of the registration process if there are concerns about quality and safety.”
She says there has been no reduction in key inspections of services. Rather, the CQC brought forward inspections scheduled for July to September so they were completed before the end of June, so they could influence the registration process.
More generally, the CQC clearly faces a crisis of morale among staff. Pile says: “It’s sad but not surprising that some staff felt they had no option but to raise their concerns with Community Care. Morale is at rock bottom.”
She says that Unison plans to “escalate these issues within the CQC and in the wider public policy arena”. Bower points to positives in the survey results including findings that staff feel supported by their managers and that they have the right skills to do their jobs.
However, she vows to address the concerns, promising a review of how management communicates with staff, manages change and ensures effective communication between teams.
“We need to make sure that the executive team clearly explains its decisions to staff and that people feel able to speak up and challenge decisions,” she says. “The challenges are not over. But we have come a long, long way in a very short time and that is down to the commitment and hard work of our staff.”
The implication is that a more settled period for the CQC will see staff concerns recede. However, with government reviewing the future of quangos and planning to “slash red tape” for services as public expenditure cuts bite, a period of calm for the inspectorate may be too much to hope for.