Home care services face more inspections as CQC scraps generic model of regulation

Home care and learning disability services will face more frequent inspections to reflect greater risks to their service users while specialist teams will lead inspections of social care in an overhaul of regulation by the Care Quality Commission.

The regulator’s 2013-16 strategy, published today, marks the end of its generic approach to regulation, under which different services across health and social care have been inspected by the same teams of inspectors, equally frequently and against the same standards.

In future, services will be inspected by specialists and regulated against different standards, and inspection frequency will be based on the risk posed to service users. Providers looking to register services will also face tougher criteria to enter the market.

As already announced by health secretary Jeremy Hunt, the CQC will also bring back quality ratings of care services, abolished in 2010, and appoint a chief inspector of social care to take responsibility of its regulation of the sector.

Differentiated regulation

As proposed in its consultative strategy last year, the CQC will introduce a differentiated approach to regulating different health and social care services. While currently all services are regulated against the same essential standards of quality and safety, the CQC will develop new “fundamental standards” that will differ between different types of service. In each case, the standards will focus on five areas – whether the service is safe, effective, caring, well-led and responsive to people’s needs – and be embodied in a set of more specific measures that services will be assessed against.

While the majority of health and social care services are routinely inspected once a year now, this will change with services where users are deemed to be at higher risk of harm facing more frequent inspections. The CQC said this category would include home care, mental health services and learning disability provision, such as assessment and treatment units, the category of service that included Winterbourne View.

Specialist skills and improved staff training

Social care services will be inspected by specialist inspectors, who will receive more specific training through a new training academy for CQC staff. The regulator will also arrange for its staff to go on secondments in the sectors they are regulating, with professionals from those sectors seconded into the CQC to carry out inspections.

The CQC will also raise the bar for organisations looking to register to provide health of social care, with directors and managers required to explain how they will deliver safe, effective and high-quality care and to make a declaration that they will answer for the service’s performance against these standards.

This approach will be introduced first in learning disabilities and other “high-risk services”.

Mental Capacity Act and Mental Health Act responsibilities

The CQC also promised to strengthen its approach to safeguarding the rights of people detained under the Mental Health Act 1983 and its scrutiny of the Deprivation of Liberty Safeguards and providers’ use of the Mental Capacity Act 2005.

It promised to provide staff with more training on mental capacity, involve more people with direct experience of care in its Mental Health Act work and enhance joint working between staff who regulate mental health services and those employed to monitor the treatment of detained patients.

When changes will happen

Besides the increased bar for registration, many of the changes will come into force first in the NHS, reflecting the government’s priorities to improve hospital care in the wake of the Mid Staffordshire trust scandal. Many of the changes to social care regulation will come into force in 2014 or 2015.

Further details will be provided in the CQC’s business plan for 2013-14.

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