MPs say Care Quality Commission’s main goal should be to ensure it is regarded as a guarantor of care standards
The troubled health and social care watchdog for England will never command public confidence unless it develops a clearer idea of its core purpose, MPs have warned.
The primary focus of the Care Quality Commission, which was set up in 2008, should be to ensure that it can be viewed by the public as a guarantor of acceptable care standards, according to the all-party Commons health select committee. At present, it has “a long way to go”.
Stephen Dorrell, the committee’s chair and a former Conservative health secretary, said: “It is extraordinary that here we are, five years on, and we are still discussing what its core purpose is.”
The CQC, which brought together three previous regulators, has faced sustained criticism for failing to act on poor care, or to achieve a proper balance between registering services, ensuring they meet minimum standards, and inspecting them rigorously.
Last year, the commission’s first chief executive, Cynthia Bower, resigned and its chair, Dame Jo Williams, said she would step down early. New appointments have been made and a strategic review launched to examine what the organisation’s key objectives should be.
Reporting on its annual accountability hearing with the CQC, the committee said the commission was going in the right direction but needed to do more to win public confidence.
“We are not going to go beyond saying that the organisation is in better shape than it was, but observe that it still has a long way to go,” Dorrell said.
As well as consulting on its key objectives, the commission should launch a consultation on its methods, the committee said. Although it had strengthened the inspection process by including expert clinical advisers, the committee was concerned that they had been used in only 13% of cases since the change was made.
Inspections should also include an assessment of the professional culture within a care agency and the overall findings should be communicated automatically to all “stakeholders”, including people receiving care and their families, the committee said.
“No one who relies upon a service should be expected to scour the CQC website for inspection results, or chance upon them in a local newspaper report,” Dorrell said.
The committee found that the CQC board member Kay Sheldon raised legitimate concerns about the management and governance of the organisation when she spoke out at the public inquiry into failings of NHS care in mid-Staffordshire. It was unacceptable that those concerns had not been addressed and acted upon beforehand.
At the accountability hearing last September, Williams – who steps down later this month – said there had been anxiety about the wellbeing of Sheldon, a user of mental health services. Williams apologised after being challenged by committee members.
Responding to the committee’s report, the CQC chief executive, David Behan, said the organisation’s strategic review was addressing key points, including purpose and role, better communication of findings and improved partnership with care providers.
“We have already begun to make some of these changes and will continue this process this year,” Behan said.
An email alert service on inspection findings had already been introduced.
“We have demonstrated through the consultation on the strategy an open and transparent approach. We will ensure that openness and transparency are at the heart of the way we develop.”
Mike Farrar, chief executive of the NHS Confederation which represents health service care providers, said Behan and David Prior, the commission’s chair designate, were bringing “strong expertise” to the body and were consulting effectively with care workers, patients and the public on how the CQC needed to change.