Reforming CQC could be destabilising, says Burstow

The government has warned that it would be premature to reform the Care Quality Commission, despite sector leaders’ criticisms of the regulator’s role and remit.

Care services minister Paul Burstow said today it was still “very early days” in the lifetime of the regulatory system that came into force in adult social care last October and that overhauling the CQC’s remit could be destabilising.

His comments, at a speech to the King’s Fund today, follow calls for more resources for the regulator yesterday from CQC chair Jo Williams and mounting concerns from sector leaders over the regulatory system in areas including:

● The CQC’s failure to respond to a whistleblower who raised concerns about Winterbourne View last December, six months before BBC Panorama screened footage of abuse at the Bristol hospital for learning disabled people.

● Significant cuts in the number of inspections.

● Rises in regulatory fees.

● The alleged deficiencies of the proposed excellence award that will replace the quality ratings system for providers next year.

● The effective monitoring of providers in financial crisis, in the wake of the Southern Cross case.

Criticism from providers culminated in a vote of no confidence in the regulator at last week’s National Care Homes Congress.

More broadly, social care bodies have warned that the regulator’s remit, established under the Health and Social Care Act 2008, is too broad for its resources.

In particular, its responsibility to register all health and social care providers has shifted resources away from inspections. Yesterday, the House of Commons’ health select committee chair, Stephen Dorrell, said the CQC’s priorities were wrong, after taking evidence from Williams.

“It seems to me extraordinary that the registration of dentists is regarded as a priority at a time when it’s acknowledged that the regulation of care homes, domiciliary care and hospitals have major issues,” he said.

Nadra Ahmed, chair of care homes’ body the National Care Association, said she did not endorse the vote of no confidence in the CQC passed last week, but added that she had called on Burstow directly to reform the CQC’s remit.

However, Burstow said today: “The fact [the regulatory system] came into effect in October last year means it’s very early days and in some senses we need to make sure we don’t all lead to conclusions about whether it’s the right system.”

He said “ripping things out by the root and having yet another look” could be “more destabilising” than leaving the system as it is, but admitted there was “a big challenge there about regulation and we are looking [at it]”.

A CQC spokesperson said: “The CQC is still a relatively new organisation. We are pleased that the minister recognises that the new system of registration needs time to bed in. While we constantly review the way we work, it’s important for all concerned that there is a period of stability. We are confident that through regulation we will minimise the risk of people who use services receiving unsafe care.”

Regarding the vote at the care home congress, he added: “The CQC maintains a regular dialogue with care home providers and their representatives, so we are very disappointed that the National Care Homes Congress has voted in this way.”

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