CQC failings
26 July 2024
The Secretary of State has described the regulator for health and care services in England ‘not fit for purpose’.
The comments follow an interim report by Dr Penny Dash who is carrying out an independent review into the Care Quality Commission (CQC). The report highlighted failings of the regulator, including inspection levels still well below where they were pre-Covid, a lack of clinical expertise among inspectors, and a lack of consistency in assessments.
We are pleased to see the new Government acting so swiftly on the failures at CQC. The Secretary of State has confirmed what families have been saying for years, that the CQC is not fit for purpose. We have been calling on the CQC for many years to act to protect people relying on care services, telling them how their lack of action is leaving people’s lives and dignity at risk. We hope now they will be forced into action. For the people we support, in the most vulnerable of situations, this cannot come soon enough. They desperately need the regulator to do their job.
What has gone wrong?
Failings at the regulator go back years. But during the pandemic, we saw a lot of trust lost in CQC. As they pulled back from regular inspections, CQC abandoned people relying on care services at a time people needed them most.
As regulator, CQC ask people drawing on care to tell them about their experiences. But when people do report their concerns about care to CQC, the regulator seems to bat them away, with stock responses like ‘we don’t deal with individual complaints’. It takes courage to speak out about poor care. The power imbalance is so skewed that people fear repercussions, such as visiting restrictions or even eviction. When they do speak out about poor care and the regulator takes no action, they feel let down, trust is lost and it adds to their feeling of powerlessness.
What are we hearing?
Our adviceline hears daily from people experiencing poor care. This can include people who have been abused, whose lack of care has left them in degrading conditions, whose lack of healthcare leaves them in pain. From being left for hours in used continence pads, to being given dirty dentures, people’s experiences of poor care seem to be getting worse as services and budgets get so stretched. People in such vulnerable situations need their regulator to understand what is happening on the ground and to act against substandard care. We have supported families who have been banging on the door of CQC, trying to get them to act on poor care. It should not be this difficult.
“To have a regulator that got it so wrong is worse than having no regulator” Kylie, adviceline client
Who else can people turn to?
There are very few other bodies to turn to for help. Safeguarding teams at local authorities are there for serious concerns such as abuse or neglect, but there can be quite a high threshold for what they will investigate (which seems to be getting higher as their budgets are now so stretched). The police are there for very serious incidents where a crime may have been committed. CQC must, of course, work with these other bodies. Not only to ensure individual concerns are acted upon at pace, but also so that a wider view is taken on what is happening in that setting, to protect others who may be at risk and to take necessary enforcement action against inadequate providers. As the regulator, CQC is the body with the powers and duties to act on concerns about care, to ensure minimum standards across England.
What needs to happen?
CQC cannot regulate from afar or on-line. They need to be crossing the threshold, going in regularly and unannounced to see with their own eyes what is happening on the ground. They need to be speaking directly to people using those services, their families and chosen representatives about their experiences. They must stop expecting families to do their job for them. And for people relying on care who have no relatives or friends to support them, they are in the most vulnerable situations and need their regulator to be on the ground.
It seems CQC have forgotten who they are there for. They seem to have become a spokesperson for care providers. Even when the new, interim CEO issued an apology last week for their failings, it was sent to and aimed at care providers. There was very little mention of the people those services exist for. Where was the apology for the people who have been failed by the CQC?
We are pleased that change is, finally, afoot. This is urgently needed. Social care is in crisis. People relying on care desperately need a good regulator. For older people who want to live the rest of their days with dignity, they need this now.
If you or a loved one are experiencing problems with care and need some support, check the helpful information on our website or contact our free adviceline.