CQC to probe standards of home care

Standards of home care in England will be investigated by the Care Quality Commission to shine a light on services that operate “behind closed doors”.

The regulator today announced a thematic review of domiciliary care, which will look at the quality of care, how far services involve and respect users and the support and training given to workers.

The review, based on inspections of 250 providers, comes amid widespread concerns about the state of home care uncovered by the Equality and Human Rights Commission’s current inquiry into the sector, which is due to report tomorrow.

An interim report from the EHRC found instances of people having their human rights breached when receiving home care, as a result of short appointment times, high staff turnover and a lack of training.

Cynthia Bower said the CQC shared the EHRC’s concerns. Explaining the reasons behind the review, she said: “Often the people who use home care services find themselves in vulnerable circumstances and the operation of home care is not as transparent as care in hospitals and other sectors because the interactions happen behind closed doors in people’s homes.”

However, the United Kingdom Homecare Association raised concerns about the CQC’s comments on launching the inquiry. While welcoming the new methodology under which the inspections will be conducted under, which places “considerably more emphasis on the experience of people who use home care services”, UKHCA policy and campaigns director Colin Angel said: “We are, however, disappointed with the lack of balance in the commission’s public announcements, which may jeopardise the public’s confidence in care unduly.”

The association has repeatedly warned that standards of care are driven by council commissioning decisions and overall funding levels. Service users’ dignity and safety were being put at risk by council cuts, a survey by the UKHCA found earlier this year.

Angel raised doubts about the effectiveness of the review on the basis that the CQC no longer assesses councils’ commissioning function. He said this left the “regulator largely commenting on symptoms, without identifying the underlying cause of hurried and sometimes undignified home care”.

Bower acknowledged these concerns. “We know decisions made about commissioning are critical to those who provide and receive home care. External issues such as pressures on council budgets and the desire of people to remain in their own homes as long as they can, create challenges for those providing services, and may increase risks of unsafe care. This underlines the need for us to thoroughly analyse service delivery in this area.”

The review will be carried out by CQC inspectors, professional experts and people with experience of using home care, and followed by a national report on the results.

It will be supported by an advisory group including the EHRC, the UKHCA, Age UK and the Association of Directors of Adult Social Services.

For the latest news and practice on domiciliary and residential care go to You Care, Community Care’s microsite for the sectors.

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