Fewer than three out of four of the 14,000 health and social care sites inspected by the Care Quality Commission met all essential standards around quality and safety.
And one in a hundred merited urgent intervention from the CQC - which has powers ranging from issuing formal warning notices to suspending or cancelling registration.
The figures - which cover NHS and independent healthcare, social care and primary dental services - are revealed in the CQC’s first quarterly market report, which is aimed at providing insight into the systematic reasons for poor performance and monitoring emerging areas of concern.
Chris Day, one of the lead authors for the report, admitted the figures were “disappointing” but said the report - based on inspections between June 2011 and March 2012 - would establish a baseline.
“It is a concern that providers are not meeting essential standards but what we are doing in this report is trying to highlight real areas of risk…we hope providers take a step back and look at their organisations and see how they measure up,” he said. Flagging common concerns allowed organisations to look at their performance in these areas, he added.
Overall, 73 per cent of inspections found all essential standards were met - 77 per cent for NHS organisations and 82 per cent for independent healthcare providers. But that figure dropped to 72 per cent for adult social care. The CQC carried out 17,000 inspections at 14,000 locations - some were inspected more than once and only the results for the latest inspection were included.
NHS Confederation chief executive Mike Farrar said: “This snapshot of the results of targeted inspection activity over recent years provides some useful pointers as to where organisations commonly fall short.
“NHS organisations will want to look closely at these results to identity what they should be doing to improve standards and ensure compliance.
“It is important to note that the number of organisations deemed to be falling short so seriously that the most drastic action was required is small. However, this is another salutary reminder that the NHS must not drop the ball on caring for patients as it faces significant financial and organisational pressures.”
Peter Carter, Royal College of Nursing chief executive, said: “It is shocking that more than one in four locations inspected in this report have failed to meet even essential standards of quality and safety. We are reassured that the CQC has taken action to address these failings; nevertheless, this presents a long overdue wakeup call for the government.”
The report highlighted key problem areas, common to health and social care, around:
- medicines management where 17 per cent of inspected providers failed to meet the essential standard.
- staffing, where 11 per cent failed. This included both the numbers of staff available - where quality of care could be compromised - and the support staff receive
- record keeping (13 per cent failed) including incomplete or out-of-date records, issues around how they are stored and whether records show risks had been identified and managed.
The report also looked specifically at maternity services and staffing, reflecting a number of cases where the CQC had identified and responded to concerns. The report highlights the rising birth rate, increasingly complex births, and that midwife numbers are not keeping up with the increasing numbers of births.
The South East and London had the highest proportion of trusts with lower than average ratios of midwives to births. London also failed to meet the Nursing and Midwifery Council ratio of one supervisor to every 15 midwifes.
The Royal College of Midwives called the report ‘deeply concerning’ and called on the government to take action. Deputy general secretary Louise Silverton said: “This supports and highlights all we have been saying for many years about the shortage of midwives and the need for serious investment in maternity services.
“A failure to have adequate numbers of midwives leads to mistakes and lower quality care. It is also not just the ratio that matters but also the skills and experience of the staff. We recognise investment in midwifery training but this will be wasted if the newly qualified midwives cannot find jobs.
“Once qualified they need support from experienced midwives whist they consolidate the skills learned during their training. Many of these midwives are those whose jobs are currently under threat.”