Adult care providers have seen a “frightening and unacceptable” 70% drop in inspections by the Care Quality Commission in the past year, prompting fears for the welfare of service users.
The sharp fall, revealed in a Freedom of Information request by Community Care, follows the introduction of the CQC’s new registration system for providers last October, and comes despitethe regulator saying that it expected there to be more inspections under the new regime.
“A 70% drop is absolutely frightening and unacceptable,” said Gary FitzGerald, chief executive of Action on Elder Abuse. “Whatever systems have been introduced to validate the quality of care, we know from [CQC predecessor] the Commission for Social Care Inspection that only face-to-face inspection works.”
Stephen Lowe, social care policy adviser at Age UK, added: “It’s impossible for regulation to be effective with those number of inspections because, even where services are good, if they are not inspected for several years, there is so much that can change to affect quality.”
Inspection levels were particularly low in October to December 2010, after the registration system was introduced, before recovering in 2011. But levels were still 55% lower in January to March this year, compared with the same time a year earlier.
The CQC said the drop in inspections reflected the demands on staff of implementing new registration systems for health and social care providers, which will soon be extended to GPs.
“However, as we move forward and refine our new risk-based methodology, the number of inspections is increasing month by month, although it has not yet reached a business-as-usual level,” said a spokesperson.
The figures follow an investigation into four care homes by Which? last month which exposed shocking treatment, including abuse and malnutrition.
Caroline Bernard, deputy chief executive of Counsel and Care, said such reports emphasised the need for robust inspection regimes, but the drop in CQC inspections suggested this was not the case in England.
The CQC has repeatedly emphasised that it is moving towards a more targeted regime where services are inspected more if intelligence, such as complaints from families, shows they are having problems. It has invested in computer systems to analyse concerns and identify problems.
However, care provider leaders raised doubts about this approach.
Ian Turner, chair of the Registered Nursing Home Association, said it was too early in the life of the new registration scheme to rely so heavily on outside intelligence. “We would like to see more visits to test the intelligence systems which they are building,” he said.
Colin Angel, head of policy and communication at the United Kingdom Homecare Association, raised doubts about the intelligence. “The impartiality of it is questionable,” he said. “It is also questionable whether it will be effective and timely in identifying genuine problems with regulatory compliance.”
The difference a year makes
Figures obtained by Community Care under the Freedom of Information Act show that the Care Quality Commission conducted 2,008 site inspections between the beginning of October 2010 and the end of March 2011, compared with 6,840 for the same period 12 months earlier.
Interview: John Burton, head of the Association of Care Managers
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