Inconsistent judgements by Care Quality Commission inspectors worried about “covering their backs” are leaving trusts facing action over issues as minor as a broken microwave, HSJ has been told.
The regulator has finished a consultation on proposed changes to how it judges compliance with its standards. In a series of responses released to HSJ, the NHS Confederation, Foundation Trust Network, Nursing and Midwifery Council and the Royal College of Nursing all highlighted inconsistency of inspectors’ judgements as a major problem.
The consultation set out plans to end the practice of issuing improvement notices, instead judging organisations as either compliant or non-compliant. It also proposed a shift in approach to look for non-compliance rather than to assure compliance.
FT Network director Sue Slipman said a “whole host” of organisations had faced serious intervention by Monitor over relatively “minor” issues, including a broken microwave and a “poison pen letter” making allegations which could lead to a foundation trust failing to meet CQC standards.
This had happened because if the CQC issues a compliance demand a trust will automatically be rated amber/red for governance by Monitor, whether the concerns are minor, moderate or major.
Ms Slipman said: “We don’t believe Monitor should be escalating [regulatory action] on the basis of a minor or moderate concern because we don’t have confidence in the judgement.”
She said the CQC had developed a culture of “people covering their backs” in the wake of the Winterbourne View case. The CQC had failed to act on calls from a nurse who had worked at the care home alerting them to the alleged abuse of patients. Inspectors were now reporting every minor infraction to ensure they could not be criticised.
The NHS Confederation also highlighted “inconsistency of assessments and approach between inspectors and different areas”, demanding a “more balanced and consistent approach to assessing compliance”. The RCN said inspectors should “have clinical expertise in order to be proportionate”.