The Care Quality Commission has gained a “renewed sense of purpose”, according to a Commons health committee report.
Committee chair Stephen Dorrell said “The CQC has been a case study in how not to run a regulator, but essential reforms implemented by the new management are turning the CQC around.”
However, the committee’s report had a number of recommendations for how the watchdog could be improved.
In the committee’s last report there was a recommendation for the CQC to write to care home residents and their relatives with details of their inspection findings. The CQC said it would consider this action. The committee expressed disappointment that the CQC was only “going to consider” this measure and said it should adopt and implement this policy by no later than 30 June.
Inadequate staffing levels should be a trigger for inspection and in some circumstances, prosecution, according to the committee. The report states: “It is essential that those providers that fail to achieve adequate staffing levels are aware that they are in breach of fundamental standards and therefore liable not only to inspection but also to regulatory action including prosecution.”
At a previous accountability hearing with the committee in October, CQC chair David Prior indicated that the regulator would be willing to take on responsibility for patient safety, which currently resides with NHS England. The committee welcomed this and its report stated that “it is illogical to split different aspects of patient safety between NHS England and the CQC and this reform would simplify the regulatory environment.”
According to the MPs, the regulator should not oversee the financial performance of adult social care providers. Instead, Monitor should take on this responsibility. Mr Dorrell said: “The CQC regulates care quality and not financial performance. We recommend that the government should reconsider the proposals that the CQC should widen its remit in this way.”
The committee also expects the CQC to provide regular updates to Parliament on its progress in recruiting 150 extra inspectors.
Mr Dorrell said that the decision to introduce a fit and proper persons test for the directors of care providers but not for the chairs of trusts and foundation trusts was “perverse”. He added: “We do not believe this exclusion will be understood by patients or the public.”
The report notes that some people have expressed concern that the new inspection model will focus too closely on hospitals, primary care and social care at the expense of community, ambulance and mental health services. The committee concluded that the CQC was right to establish “clear priorities” but that it expected the CQC to give detail on how its new regime will be extended beyond hospitals by the next accountability hearing.