Debate on the performance of the National Care Standards Commission

We asked if inspections by the National Care Standards
Commission have helped to raise service standards, and whether
people have any examples of how the commission’s work has had a
positive or a negative effect.

To read a recent Community Care article featuring the
views of former inspector John Burton, and NCSC corporate policy
director Trish Davies
click here

These are the responses we received:

As Bolton Adult Placement we have found that NCSC
inspections have simply been a paper trail with adult placements
caring for one person in a domestic home being inspected in the
same way as large residential homes. In many cases the inspectors
did not meet the service user, who was out at the day service when
they called. In one case the inspector did not inspect the bedroom
and yet demanded to see written evidence that equipment had been
serviced – this in a house where there is no specialist

The requirements in the reports have been completely
inconsistent. For example, although all adult placement carers have
the same paperwork supplied by the adult placement scheme, some
have been told it is not adequate, others have not. There are many
other inconsistencies. 

The first round of inspections were not done until February. The
second round of unannounced inspections were done in March when
carers were told that the inspector was calling in for a coffee and
a chat. These “inspections” cost the adult placement scheme
£50 each! There has been no recognition by inspectors that an
adult placement worker visits each placement every month, and has a
detailed understanding of all aspects of the carer provided.
Inspectors made it clear that they did not wish to meet with us or
for us to be present during inspections.

In conclusion, the NCSC has brought a steep increase in our
workload and much anxiety to adult placement carers without any
increase in quality for the service users.”


From my observations of a residential home for
older people, the NCSC inspection has had little positive impact on
the lives of the residents. I have reluctantly concluded that the
reasons for this are

1. The Inspection process is not rigorous. In the field of higher
education, when claims are made about standards for the purposes of
an inspection, these are not accepted at face value. Evidence is
required. Whilst this can lead to excessive bureaucracy it does
mean that claims and supporting evidence can be scrutinised for
their validity. My experience of a NCSC inspection was that the
reassurances of  the manager were seen as sufficient evidence – 
there appeared to be little exploration or checking.

2. It does not appear that the NCSC has a real concern for the
quality of life of residents. The reality of day to day living at
the home and what this means for the hopes and aspirations of the
residents was not checked out. That a list of activities existed
was sufficient. Whether this was accessible and meaningful to the
residents was not of concern.”

Hilary Walker

The NCSC does not accept criticism from within
and will take disciplinary action against anyone speaking out. I
agree with a number of John Burton’s points.

The way that change to NCSC has been managed was poor.
Information was slow to be given to inspectors. Much of it was
inaccurate and the message given was that your former practice was
bad. The NCSC has a thoroughly disillusioned workforce, and further
change will ensure morale remains on rock bottom.

The IT system is unreliable and has lead to scandalous
inefficiencies. An enormous amount of time and work has been lost
through this.

In many ways the new body has weakened protection. Many health
authorities could call on experts on infection control, estates,
engineering, medical physics, pharmacy and other specialisms. All
that has been lost and not replaced. Inspectors are being asked to
make judgements in areas where they are not competent.

There is such a reliance on “the third way” of partnership with
providers and “the virtuous cycle” of inspection, that requirements
are not being enforced and service users are at risk because of an
unwillingness to prosecute providers of dangerous services.

A recent case has come to light of health and safety prosecuting
a home, in which a service user was badly burned by an unguarded
radiator. The Health and Safety Executive was quoted as saying this
was the second case that had been prosecuted.
When will something ask the question “why are NCSC not enforcing
standards to prevent injury before it occurs?”

Rather than “Speaking softly and carrying a big stick,” NCSC
talks tough, but leaves the big stick in the umberella


With eight years experience of supporting
vulnerable adults, and currently being in my second year of a three
year BA (Hons) degree in social work at the University of Salford,
I am fortunate to have acquired knowledge of who to contact in the
instance of bad practice etc.

I do however question with concern, whether the situation would
have resulted in the same outcome had I been a service user on the
receiving end. It seems equally concerning, that a decision was
taken to investigate, only after I had requested a point of contact
in order to take the matter further and above NCSC, something a
service user may not feel confident in doing. So the question
remains, who actually monitors the monitor? and where do we go if
the NCSC do not respond appropriately?

J. Kelly

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