Care watchdog struggled with unrealistic goals, say MPs

Care Quality Commission had to cut inspections to divert resources to registering dental practices

The health and social care watchdog was set an impossible working brief but failed to raise the alarm before an inevitable collapse in the number of inspections it carried out, an inquiry by MPs has concluded.

Inspection activity by the Care Quality Commission plunged 70% in the second half of 2010-11 compared with the year before, after it was forced to divert resources to registering dental practices, according to the Commons health select committee.

Finding that the commission was set up with unclear and unrealistic objectives, that timescales and resource demands were not thought through and that the process of registering care providers was untested, the committee said: “The CQC failed to draw the implications of these failures adequately to the attention of ministers, parliament and the public.”

The report caps a torrid summer for the commission, which was established in 2008 to provide a single regulatory body for health and social care services in England.

The organisation has faced criticism for failing to raise an alert over the plight of Southern Cross, the leading care home chain that is now being wound up, and for failing to act on a whistleblower’s concerns about the regime of abuse subsequently exposed at Winterbourne View, the private learning disability hospital near Bristol that has since been closed by its operator, Castlebeck.

Plans put forward by the commission for an excellence kitemark, for which social care providers would have to pay extra, have been roundly rejected and are expected to be ditched.

The select committee says a “significant proportion” of evidence given to the inquiry expressed concerns about the commission’s work. “The overall impression is one of frustration with the CQC and a lack of confidence in its ability to execute its main functions efficiently.”

Stephen Dorrell, who chairs the committee, said the decision to shift resources into registering 8,000 dental practices, in order to meet a statutory deadline of April this year, had distracted the commission from its core function and distorted its priorities.

Ministers have now agreed to defer for 12 months the registration of GP practices, which had been due for completion by next spring. The commission has asked for a 10% increase in its budget, which was £161m last year, to cope with the workload, but the select committee is “noting” rather than backing the request.

Asked if he was surprised that the CQC’s leadership remained in place, Dorrell said: “I welcome the fact that the leadership in place has now made clear that it is doing some things that, in the view of the committee, should have happened some time before.”

The CQC, which has undertaken to visit all care providers annually, said inspection figures were now rising rapidly. Between April and June, it had published 2,527 inspection reports on NHS and social care providers, compared with 886 between October and December last year. An additional 100 inspectors were being recruited.