Is the CQC failing care homes?

A scathing review into the Care Quality Commission (CQC) has found significant internal failings which has led many to ask ‘is the cqc failing care homes?’

The review was published as part of an interim report into the effectiveness of the CQC.

One of the main roles of the CQC is to conduct thorough inspections of health and adult social care services in England. This allows CQC experts to assess whether adult social care providers such as care homes deliver safe, effective, and high-quality care.

However, this recent review raises concerns about the regulator’s ability to effectively fulfill its mandate and protect vulnerable individuals in care homes.

In this blog we will take a closer look at this independent review of the CQC and analyse what this means for care seekers that are trying to evaluate the suitability of a care home.

What does the CQC do and why is it significant?

The CQC is the independent regulator responsible for monitoring, inspecting, and regulating health and adult social care services in England.

It evaluates and ranks care homes and other related services based on four key ratings:

• Outstanding – This top rating indicates that the service is delivering care that goes above and beyond the usual standards.
• Good – This rating indicates that the provider is meeting all required standards and delivering quality care.
• Requires improvement – This rating means the service is falling short of expectations, and the CQC has suggested specific areas for improvement.
• Inadequate – This rating signals serious issues with the care provided, prompting the CQC to take corrective action against the responsible person or organisation.

Securing a positive rating from the CQC is crucial for a care home's reputation and ongoing operation. These rigorous inspections, conducted at least every three years, serve as a widely recognised benchmark for quality care. New care homes face an even shorter timeline, with assessments mandated within the first year of opening.

To assess a care home's impact on residents' lives and the overall quality of care provided, CQC inspectors look at five key areas: safety, efficacy, compassion, responsiveness, and leadership. Through a meticulous examination of these fundamental aspects, the CQC aims to determine if the home is effectively meeting the needs of its residents.

For more information about the CQC, check out our blog ‘The Care Quality Commission (CQC) - Demystifying Care Terminology.’

What this means for care seeker

It is difficult for the average person to evaluate whether a care home will be right for them or a loved one. Even if a care home outwardly appears to meet all the requirements a person may have, it is difficult to tell whether this will translate into a high standard of living for its residents.

One of the main ways that people have traditionally determined whether a care home will be right for them is to look at the CQC rating.

If a provider receives a good or outstanding rating, then care seekers could be assured about the quality of a care home. On the other hand, if a care home was deemed as requiring improvement or inadequate, then this served as a major red flag for care seekers. Consequently, a poor rating could potentially destroy a care home's reputation and business.

However, if the CQC is deemed to be ill-equipped to rate these services accurately, then this makes the process of finding a quality home much more difficult for care seekers.

So, in light of the July 2024 interim report into the CQC, the question remains is the CQC failing care homes?

Independent review of the CQC highlights significant failings

To answer this question, it is first necessary to highlight some of the key findings in the independent review of the CQC.

According to the report led by Dr Penny Dash, chair of the North West London Integrated Care Board, 'significant internal failings’ are hampering the CQC’s ability to identify poor performance at hospitals, care homes and GP practices.

It raised serious concerns about the CQC’s ability to accurately assess the quality of health and social care services across the nation after it criticised the watchdog for its inability to swiftly identify and address services in dire need of improvement.

The report highlighted a lack of clarity around how ratings are calculated, and cited poor operational practices within the CQC in terms of how assessments were conducted. It also cited a significant backlog in new provider registrations, and uncovered challenges with its IT systems and provider portal.

According to the report, the CQC's credibility in the health and care sectors has suffered greatly largely due to internal problems and a lack of expertise in the field.

Furthermore, the report revealed that these problems have served to hinder local capacity and potentially compromise patient care.

Is the CQC failing care homes?

The independent review into the CQC seems to suggest that it is failing care homes, due to inefficient processes and operational problems. If this is true, this means that care homes offering a high quality service to their residents may not always receive the recognition they deserve. Similarly, care homes that require significant improvement may be slipping under the radar.

So, when considering whether the CQC is failing care homes, the real question is whether the current review mechanisms and criteria are adequately reflecting the true quality of care being provided. If they do not, then this negatively impacts both providers and care seekers.

Reaction to the independent review of the CQC

The review of the CQC has prompted many of those that work within the health and social care sector to voice their concerns and highlight the challenges they have encountered in their interactions with the CQC.

Commenting on the review of the CQC, Debbie Harris, founder and managing director of Autumna, said: “Those of us supporting frontline care providers have known for a long time that the issues the CQC has faced with introducing its new regulatory framework have meant it is failing both providers and consumers of care.

“Providers have had their businesses put in jeopardy because they have been unable to get their operations reinspected, while inconsistent inspections have made it challenging for them to maintain compliance and improve their services.

“Today’s findings and the government’s commitment to improvement provide the perfect opportunity to explore alternative solutions to complement the regulatory provision.”

You can read the full statement here in our blog.

The CQC review has also prompted Wes Streeting to say that the CQC is “not fit for purpose”. He added: “I know this will be a worrying development for patients and families who rely on CQC assessments when making choices about their care.”

Martin Green, chief executive of Care England has welcomed the findings published in the interim report. He said: “It is clear that Dr Dash has listened to the voices of care providers, resulting in a clear set of recommendations.

“This report acknowledges the severe and systemic problems that sit at the very heart of [the] CQC and gives a specific set of steps that the regulator must take to improve performance and re-establish the sector’s long-eroded trust.”

The responses to the findings highlight the need for serious improvement within the CQC.

While a CQC rating can potentially give care seekers a good idea of a care home's quality and standards, the interim report reveals that the CQC score alone is not always a reliable benchmark for assessing the overall quality of care provided.

However, the challenges with the CQC are not new. For many years now, many of those in the frontline of the care industry have known that the ratings provided by the CQC are not always as holistic as they could be as the clip below demonstrates.

Alternatives to the CQC

So, if the CQC alone is not a reliable indicator of quality, then what are the alternatives to the CQC?

OpenScore

At Autumna, we have developed a system that allows care providers to demonstrate their standards and quality of care in real-time.

Unlike the CQC ratings, OpenScore is made up from multiple data sources and ranks care providers with a score out of ten.

It gives greater control for care providers and builds trust among care seekers.

OpenScore evaluates care providers based on several key factors, including dining options, reviews, infection control, and environmental, social, and governance (ESG) practices. It also assesses providers on criteria such as cost transparency, data accuracy, management quality and regulatory ratings such as those provided by the CQC.

Scores are categorised as follows: 0 to 2 is considered poor, 3 to 4 is satisfactory, 5 to 6 is good, 7 to 8 is very good, and 9 to 10 is excellent.

When searching for care providers in the Autumna directory, you will notice that some care home profiles include this rating. This provides a clearer insight into the quality of the care home and helps care seekers make a more informed decision about the quality of a care home.

It is also worth noting that OpenScore covers care homes across all areas of the UK and not just England as is the case with the CQC.

Other care regulators

There are other care regulators that oversee care in different areas of the UK.

In Northern Ireland, the care sector is overseen by the Regulation and Quality Improvement Authority (RQIA).

In Scotland, care home standards are inspected by the Care Inspectorate and in Wales, this responsibility falls to the Care Inspectorate Wales (CIW).

How to find a quality care home

So, in light of the CQC findings, how do you find a quality care home for your loved one?

It is clear that relying solely on CQC ratings may not provide a full picture, so consider the following steps to ensure you make an informed decision:

Review independent ratings and reports

For some care providers, OpenScore can provide a valuable metric to measure the quality of a care home. It aggregates data from multiple sources to provide a broader assessment of care quality. This can offer a more nuanced view of a care home's performance across several key metrics.

Conduct thorough research

Start by researching care homes in your area using online directories like Autumna, which can provide detailed profile ratings and information about a care home. Our directory allows you to filter care homes based on factors such as care type, preferred location, activities, medication support, nearby services and more.

Visit care homes in person

Schedule visits to potential care homes to observe the environment firsthand. Pay attention to cleanliness, staff interaction with residents, and the overall atmosphere. Ask questions about the daily routines, staff-to-resident ratios, and the level of personalised care provided.

Seek feedback from residents and families

If you can, speak with current residents and their families to get an honest perspective on their experiences. Their insights can provide valuable information about the care home's strengths and any potential areas of concern.

Trust your instincts

Finally, trust your instincts. If something doesn’t feel right during your visit or interactions, it is worth exploring other options. A care home should inspire confidence and comfort, knowing that your loved one will be well cared for.

For more information on selecting an appropriate care facility, check out our blog on Choosing the best care homes: a comprehensive guide.

Comprehensive directory of care homes

If you have ever asked yourself the question ‘is the CQC failing care homes and care seekers?' then finding the right care home becomes all the more critical. Autumna has made this process much quicker and easier by creating a comprehensive directory to help care seekers to find high-quality care facilities within minutes.

For personalised assistance with local care services you can also connect with our helpful advice team on 01892 335 330.