Registration delays at CQC impact on vulnerable people

Vulnerable people are waiting months for care services because of long delays in the Care Quality Commission’s processing of registration applications from providers.

The waits for services to be registered are stretching up to six months and delays of up to four months are “commonplace”, said provider groups. The CQC has apologised for the delays, which it blamed on high volumes of applications.

Lee House, a care home in Wimbledon has had a new six-bed wing standing empty since July last year. “We still have people waiting to come into a home when they have been assessed as needing care,” said Helena Little, director of care at Abbeyfield, the charity which runs the home. “They could be in their own home or they could be in the hospital. When they are in the hospital it’s very likely that they will not get their first choice of coming to one of our care homes because the registration isn’t ready.”

Her experience is far from unique. Colin Angel, head of policy and communication at the United Kingdom Homecare Association, said he received complaints on the issue every couple of days.

Martin Green, chief executive of the English Community Care Association, said he had heard of older people being forced to move in with relatives because they had sold their house to pay for a residential placement but their prospective care home had not been registered. In another case, patients with brain injuries were left trapped in hospital because a specialist unit was ready, but not approved, he said.

All providers must apply to have any new service registered with the CQC to prove it meets safety and quality standards, and they also must apply to register variations to existing services, such as a new wing to a care home.

Nadra Ahmed, chair of the National Care Association, said: “[The delays are] holding back improving services for vulnerable people. Every provider who is developing is doing so to a higher spec.”

“Clearly there are going to be people who are ready to use a care service who will not have their needs met because services are unable to expand in the area,” said Angel.

A spokesperson for the CQC said staff were working overtime to clear the backlog and temporary staff had been employed, and that it was streamlining processes to improve efficiency. He said: “There have been a total of 8,600 applications since October, including those for new providers, new managers and variations to providers’ existing registrations. Applications have been coming in at the rate of about 100 a day.

“We have apologised to providers for the length of time it is taking to process their applications, and we regret the impact the delays may have on people who need to use these services.”

Raina Summerson, chief executive of Agincare, which is currently dealing with three long-running applications has sent a letter from lawyers to the CQC saying “they are failing in their duties”.

“When you know you have a huge job to do and you know it’s going wrong you do something about it and there is no signal they are doing anything about it,” said Summerson.

The CQC aims to complete registrations within 120 days, but it recently told providers that, for an interim period, applications would be taking an average of 120 days because of the backlog.

The four-month timescale has been roundly condemned by providers who have said that, even if it were met, it would be too long to allow new businesses to start-up, and that a timescale of eight weeks would be more appropriate.

The CQC said that delays have been caused by errors in applications, such as missing supporting documents, incorrect fees, criminal records bureau checks not being attached or being out of date, or an incorrect application form being used.

However, providers called on the CQC to streamline their registration processes. “I think they have devised systems which they could not possibly have delivered on,” said Angel.

Green said the level of service delivered by the CQC on registration was not good value. “They should just get off their back sides and start delivering something,” he said.

Abbeyfield: Lee House care home

The Lee House care home in Wimbledon has had a wing with six beds ready since July last year. Provider Abbeyfield could not lodge its application to vary the terms of its variation until the beginning of November 2010. This is because the CQC put a stop on applications to vary services while it re-registered all providers last year, under the system brought in by the Health and Social Care Act 2008.

In January, the CQC informed Abbeyfield its registration fee cheque was too large. Helena Little, director of care at Abbeyfield, said the amount was based on earlier advice from the CQC.

Abbeyfield is yet to receive a letter from the CQC acknowledging that its application is being processed and it is likely to take a further four months for the registration to be completed once this is received.

Little pointed out that providers were given a four-week window to lodge their applications for re-registration last year.

“Having put that pressure on us they are unable to deliver on their timescales for variation,” she said.

Agincare: Takeover on hold

Raina Summerson, chief executive of Agincare, is currently dealing with three long-running applications for registration. Summerson is particularly concerned with two homes in Poole, currently in administration, which Agincare is in the process of buying. She fears the bank, which accepted that registration might take three months, will require the homes to be closed and sold if the deal cannot be done soon, which would mean that 60 older people would have to move.

Agincare applied to register the homes as part of its business on 4 and 11 of November respectively. But the applications have been delayed because the CQC insisted on re-registering the incumbent managers, who were already registered with the regulator. Summerson said it has taken the CQC weeks to countersign requests for fresh CRB checks for the managers, and she did not expect the registration to be completed within the CQC’s 120-day timescale.

“When the system becomes not about welfare and protection, but about onerous processes and obstacles, there really is something wrong,” says Summerson

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