Hunt overhauls regulation of social care in wake of Mid Staffs

Star ratings to return under chief inspector of social care leading specialist teams within CQC, while providers will also face "duty of candour" to report mistakes, says health secretary.

Social care providers will receive performance ratings from specialist Care Quality Commission inspection teams working under a new chief inspector of social care, as part of the government’s response to the Mid Staffordshire public inquiry.

The regulatory overhaul, announced today by health secretary Jeremy Hunt, will also include “a duty of candour” on providers, requiring them to report cases where care they have provided is believed to have led to death or serious injury.

“The health and care system must change,” said Hunt. “We cannot merely tinker around the edges – we need a radical overhaul with high-quality care and compassion at its heart.”

Adult social care staff will also be expected to comply with a new code of conduct and minimum training standards, published today by Skills for Care and Skills for Health, alongside the government’s response to the Mid Staffs inquiry, chaired by Robert Francis QC. However, the government rejected Francis’s call for adult care staff and healthcare assistants to be compulsorily regulated to help root out poor care, an omission slammed as “deeply disappointing” by Alzheimer’s Society.

‘Star ratings’ to return

Hunt announced that social care providers regulated by the CQC would receive an aggregated rating on their overall performance, as was the case from 2008-10. This follows a recommendation to reintroduce an aggregated rating for care providers from a government-commissioned review by think-tank the Nuffield Trust, which reported last week.

This will be overseen by a new chief inspector of social care at the CQC, who is likely to be appointed later this year. The CQC will also ditch its existing generic model of inspection, in which inspectors have portfolios that include hospitals, care homes and home care agencies, with social care services inspected by more specialist teams.

The duty of candour, which Francis recommended should apply to healthcare providers, will also be implemented in social care. This would require providers to inform service users or their families if they believe care failings have led to serious injury or death and provide an explanation.

Regulation of care staff rejected

The government rejected Francis’s recommendation to regulate healthcare support workers (HCSWs), including those working in care homes and specialist hospitals, through a centrally-held register, on the grounds that this would “not guarantee public protection”.

However, Alzheimer’s Society chief executive Jeremy Hughes attacked the decision, saying: ‘Too often we hear that dementia care in hospitals and care homes is unacceptable. Real professional standards and registration for the healthcare assistants who so often provide personal care does not constitute a box ticking exercise and to suggest as such is a deeply disappointing compromise of patient safety for cost or convenience.”

Instead, the government published the long-awaited code of conduct and minimum training standards, developed by Skills for Care and Skills for Health for HCSWs and adult social care staff, including personal assistants employed by service users.

The CQC will assess providers on the extent to which staff comply with the code and training standards. Despite the government’s rejection of compulsory registration of this group of staff, the Health and Care Professions Council is considering introducing a “negative register”, which could see staff prohibited from working as a result of serious breaches of the code of conduct.

Related articles

Social care ‘star ratings’ set to return after review gives backing 

Care staff struggling to meet dementia needs, warns CQC 

CQC moots chief inspector of social care role in wake of Mid Staffs 

Support workers face compulsory regulation on back of Mid Staffs probe

Mid Staffs inquiry is a wake-up call for social work too


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