Care Quality Commission staff have been left demoralised and concerned for the safety of services by high workloads and inadequate training, a survey of Unison members has found.
The CQC has pointed out that the results reflects the views of less than 10% of the workforce, and vowed to publish the results of its own staff survey, due later this year. For its part, Unison has said there have been improvements at the CQC since the survey was conducted, from October to December 2011, mainly because of the recruitment of an additional 230 inspectors.
However, the survey is the latest in a string of negative verdicts over a number of years from staff at the CQC and its predecessor, the Commission for Social Care Inspection. The latest survey was in the style of a CQC inspection report, with 16 “essential standards” set for the CQC as an employer and Unison members asked to comment on whether they had major, moderate, minor or no concerns about its performance against them.
On workload, the union found that 58% of staff had major concerns and 27% moderate concerns. While caseloads for inspection staff should be 30-40, many reported having double this figure, and feared they would not be able to get to know all of the services for which they were responsible. “This puts me and the organisation at risk of missing a serious issue. I am worried that I could be the next Winterbourne View person,” said one respondent, in reference to the CQC’s failure to respond to a whistleblower at the Bristol learning disability hospital.
The survey also raised further concerns about whether CQC inspectors were receiving sufficient training to monitor the full range of services in their portfolios, which typically include care homes and hospitals. This issue was raised in the House of Commons public accounts committee’s critical report into the organisation, published last week.
Forty per cent of respondents to the Unison survey had major concerns and 30% moderate concerns about the level of training they received, with particular gaps in sector-specific training, leaving inspectors feeling ill-equipped to inspect particular types of service.
Unison made 28 recommendations in the light of the survey including an increase in staffing, a workload management system that kept caseloads down to 35-40 services and a move away from generic caseloads to staff inspecting services based on their past experience.
Unison national officer for social care Helga Pile said she welcomed the increase in inspector numbers, adding: “It’s bound to make a difference. Where we’re not sure is whether that’s going to be enough.” She said Unison members were concerned about CQC’s capacity to take on new responsibilities, such as the registration of GPs from next year, or respond to demands for snap inspections from the health secretary, as happened recently over abortion clinics.
“We take the issues raised here very seriously and are concerned that any of our staff feel unsupported at work,” said a CQC spokesperson. “However, the survey only considers the views of 206 staff – less than 10% of our workforce. We also have some concern over the survey’s directional style of questioning. We will be carrying out our own staff survey later this year, which will be independently and professionally verified, which we are confident will attract a larger and more representative response.”
She said the recruitment of extra staff would mean inspectors would each be responsible for fewer services. “They will be able to spend more time getting to know the services, checking the information they have on each, and responding quickly to concerns about the quality of care,” she added. “We hope that these changes will make a difference to the staff who have expressed concerns about workload.”
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