Interview: John Burton, head of the Association of Care Managers.

The Care Quality Commission must become far more effective, says John Burton, head of the Association of Care Managers. Vern Pitt asks him why

The Care Quality Commission must become far more effective, says John Burton, head of the Association of Care Managers.
Vern Pitt asks him why

John Burton is on a mission to ease the stifling burden of regulation which he claims is chaining care providers to their desks.

The head of the newly-formed Association of Care Managers is campaigning against the shift away from inspection to what he believes to be time-consuming, over-bureaucratic self-assessment.

The change was initiated by the Commission for Social Care Inspection and is continuing under its successor body, the Care Quality commission.

Burton, whose association represents the managers of registered providers, says: “Over the past few years, the regulatory system has converted managers in care homes from people who actually work with the staff and the residents to people who sit in the office.”

He’s not alone. The association has gained 200 members, each paying a £100 annual membership fee, since being established in January, and Burton believes his outspoken stance will gain it many more.

Burton has been in the sector since 1965, managing a variety of services and working as a local authority inspector during the 1990s.

“The standards are less rigorous than they used to be,” he says.

Burton points to the recent conviction of Rachel Baker for the manslaughter of Lucy Cox, a resident at the Parkfields care home in Butleigh, Somerset, in January 2007.

Baker, who gave Cox an overdose of drugs, was by then addicted to painkillers and had been stealing medicines prescribed for residents since 2005.

Burton points out that Parkfields received a two-star (good) rating from the CSCI following an inspection in June 2006, and claims this illustrates an ongoing lack of rigour in the regulatory system.The CQC says Baker “went to great lengths” to hide her misuse of drugs from the CSCI.

Burton also feels the system is poor value for money. “Each resident is paying roughly £2 a week for regulation. If you are living in a three-star home it won’t be inspected for three years. What you are paying for is for the manager to spend a lot of time feeding information to the [CQC],” he adds.

To fix these issues Burton argues the system needs to be more localised. “Inspectors’ names and phone numbers should be on the wall in a home,” he says. This, he says, would make them more responsive and able to address individual complaints better. The CQC is not mandated to hear complaints. “A regulator which will not respond to individual complaints is not worth anything,” he says.

Whether the system is local or national Burton says it’s crucial the quality of inspections improves.

“There are some very good inspectors but there are also quite a lot who don’t have a clue. Some are being drafted in from outside social care, people who have not got much experience of care homes,” says Burton, adding that he’d like to see more home managers being recruited as inspectors.

While they are still in charge of homes, however, he urges managers to be critical of the CQC. “I would encourage care managers to be much more difficult but they are rightly very worried that they will be picked on,” he says.

Although he only works for the association for one day a week, Burton sees his role as being able to voice managers’ concerns without fear of reprisal. “[People are saying], ‘at last somebody is saying what we are all thinking’,” he says.

While the Association of Care Managers may be a new face, in John Burton it seems to have already found itself a loud voice.


The CQC responds

“We haven’t been approached by this organisation but would be more than happy to establish a constructive dialogue so that we can discuss its views in more detail.

“We are committed to getting the balance right between self-assessment and our own inspection and review findings. We think most providers would agree that an element of self-assessment is a key factor in improving standards.

“Although we don’t deal directly with complaints, we welcome feedback from service users, families, carers and others that we can take into account in monitoring a service’s performance.

“Under the new system every service will get a full planned review, including in most cases an inspection, at least every two years, and more frequently if we consider it necessary. There will also be random inspections whenever we have particular concerns. We anticipate that there will be more inspections.

“All our inspectors have relevant experience. We are currently making changes to our structure that are aimed at providing additional inspectors for both adult social care and health, underpinned by significant investment in staff training.”

Read about the CQC’s first year

This article is published in the 6 May issue of Community Care magazine under the heading ‘Inspection quality must be improved’

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