Care Quality Commission staff have been challenged to sign up to an agreed mission statement for the organisation or leave by chief executive David Behan. Behan said CQC staff currently had three or four different ideas about the purpose of the organisation, which was “unsustainable”.
The CQC has been criticised by MPs for not having a clear purpose and there have been doubts over how far it should be involved in supporting providers to improve. Behan told the National Children and Adult Services Conference on Friday that he was determined to identify an agreed purpose and role for the organisation by the end of the year, as part of his work on the CQC’s strategy for 2013-16, which is currently out to consultation.
“Once we’ve got to the end of this year I want to say to staff, ‘that’s what our purpose is, we’re not going to have three or four, if you don’t agree that’s fine, you can go and do something else.”
Poor morale among staff has been an ongoing problem at the CQC and its predecessor, the Commission for Social Care Inspection, but its latest staff survey showed an upturn in morale.
The draft strategy proposes the following definition of the CQC’s purpose: “We work as part of health and adult social care system with a common purpose of driving improvements to the quality and safety of care services. Uniquely CQC provides assurance that services meet national standards of quality and safety.”
Behan said that the CQC had been “chased off the territory of improvement” despite this being written into its purpose in the Health and Social Care Act 2008, the statue that established the organisation. However, he added: “You can’t regulate quality into care; quality is provided or commissioned; all we can do is comment on whether it’s there or not.”
Behan also said he would be reviewing the skills mix of CQC staff and considering how far there should be a move towards having more specialist inspectors of different types of service. The CQC is currently recruiting 200 health and social care professionals on a short-term basis to boost the CQC’s inspecting capacity and provide specialist expertise.
Behan also restated his ambition to take a differentiated regulatory approach to different types of service, which would see a move away from its current model of inspecting all NHS, social care and independent health services at least once a year. This could see higher risk, institutional services, similar to Winterbourne View, being inspected more than once a year.
He also said he had commissioned a review of what works internationally in the regulation of services.
“We get told that we need to go everywhere once or twice a year,” he told the conference,” he said. “I’ve not seen any evidence that that works better than a differentiated approach.”