The Care Quality Commission’s risk-based approach to regulating care services has been called into question, following revelations of abuse of people with learning disabilities in a specialist hospital.
Last night BBC Panorama revealed a pattern of abuse at the Winterbourne View hospital in Bristol. The abuse was reported to the CQC in December last year but the regulator took no action.
Under the current inspection framework the CQC takes a risk-based approach to regulating social care and health services such as Winterbourne View in which it focuses inspections on providers where information suggests there may be problems. Community Care has revealed that inspections of adult social care have fallen by 70% since the current regulatory framework came into force last October.
“It raises questions from me about the way they are picking up on information and their whole risk-based approach,” said Jane Livingstone, chief executive of the Association for Real Change, which represents people with learning disabilities and their service providers.
“If this abuse is not being picked-up the system cannot be working,” added Anthea Sully, director of the Learning Disability Coalition.
A CQC statement in response to the Panorama programme read: “We regard information from whistleblowers as essential intelligence which is vital to the way we assess risk and monitor compliance with essential standards of quality and safety.” The CQC is undertaking a review to establish why the information was not acted upon sooner.
Alison Giraud-Saunders, co-director of the Foundation for People with Learning Disabilities, said the whole regulatory system needed redesigning. “A local citizen-led service to support change and to challenge these services where necessary may bring local people closer to those who need support.”
Livingstone, who was an inspector at the time inspectors were based within local authorities, backed a greater localism in inspection.
However, Martin Green, chief executive of the English Community Care Association, said the risk-based approach could potentially work but that the CQC had failed in managing its implementation. “The bottom line is there needs to be a very hard look at the functioning of this regulator because it’s not delivering what it is supposed to be delivering,” he said.
Sully added that there were also problems of overlap between the responsibilities of the CQC and the local authority, South Gloucestershire, as the lead local safeguarding agency. The CQC said that it thought the allegations of abuse raised by a member of staff in December were being handled through the local adult safeguarding board, but this board did not meet until February.
“We need to make sure that there’s not this falling-between-two-bodies issue clearly it was an urgent situation which needed to be dealt with urgently,” said Sully.
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