By Debbie le Quesne

Archive for the ‘special measures’ Category

Inadequate ratings – how does a business ever come good again?

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Right at the start of this month three Hartlepool care homes were rated inadequate by CQC.

During unannounced inspections at all of the homes in January and February 2015, inspectors found that they were “failing to provide care which was safe, effective, responsive or well led.”

Under CQC’s new programme of inspections, all adult social care services are being given a rating to help people choose care – outstanding, good, adequate and requires improvement. The signposting could be a big help for the general public in assessing how good firms are at compliance exercises, but what effect does such branding have on the care providers who have fallen foul of the new Standards criteria?

My concern is that some with less than ‘outstanding’ ratings could still deliver good care, while being poor at some compliance exercise. What’s more, I fear that a ‘requires improvement’ result could ultimately spell disaster as the need to improve grows against less capacity to generate funds to make them happen.

According to the CQC website the purpose of such measures are to:

  • Ensure that providers found to be providing inadequate care do not continue to do so.
  • Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
  • Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to cancel their registration.

Okay, I understand. But a question asked of me continues to haunt me: How does a home, when rated inadequate, improve? The pressure is racked up considerably for such providers as failure to improve initiates a special measures process.

It seems to me that perhaps we should be taking a lesson from education where additional resources are made available to failing schools.

Not so it seems with social care. In this scenario special measures could potentially involve multiple agencies all making their separate demands. For example, as well as the CQC rigour, there could be additional issues with Health and Safety, Infection Control and, of course, the local authority inspectorate. Each could legally demand their own response, while no doubt referrals from authority commissioners would be frozen.

The question which was put to me is a valid one and deserves more than a ‘should do better’ answer.

With potentially less income, a planned raft of reforms essentially drafted as directives by CQC, and inevitable low morale, there appears to be only one miserable conclusion unless extra funding is magically spirited out of the ether. Fact: Investment is needed to improve and perhaps the reason for failure has been the inability to do just that.

Of course, in some rare cases, the scenario could be very different, but my professional experience tells me that money troubles are generally the precursor to falling standards.

Support for schools that fail comes in various forms and in some cases a new management committee is drafted in. Resources for recovery are by the bucketful.

The public sector does seem to have an unfair advantage over private care business in this respect even though both are dealing with public ‘consumers’.

My answer to the question is typically political as I pose another: How is anyone supposed to do much more as potential for generating extra revenue is diminished?

Care providers are an ever-resourceful, creative and inventive breed.

My organisation is there to advise those who find themselves needing help and while we can’t predict winning Lottery numbers, please remember we have access to a huge pool of wisdom and professional advice from our membership and those agencies with which we work.

Bring on the coffee and cheering chocolate now please . . .