By Vivienne Russell | 22 January 2014
The government should reconsider plans to give the Care Quality Commission oversight of the financial health of adult care providers, MPs on the health select committee said today.
Issuing a report following its annual accountability hearing with the regulator, the committee said essential reforms had been implemented and the new management was turning the CQC around.
But it raised concerns about moves to add financial checks to those the regulator carries out on care standards. The Care Bill proposes giving the CQC powers to monitor the finances of social care providers whose collapse could trigger a crisis in the local delivery of care.
The committee said this would be a ‘significant challenge’ for the regulator and it would need to ensure it recruited people with the correct skill set.
‘The CQC regulates care quality and not financial performance,’ said committee chair Stephen Dorrell.
‘We recommend that the government should reconsider the proposal that the CQC should widen its remit in this way.’
However, this finding was challenged by CQC chair David Prior. He said: 'I do not believe that it is possible to separate finances from issues of quality - they are two sides of the same coin.
'In adult social care we will work with partners on this issue. In the NHS it is very important that Monitor, the Trust Development Authority and CQC work closely together. If an organisation is struggling financially it is likely to be struggling to maintain quality. The committee notes we are now ready to undertake a programme of substantial reform: this is underway and we will keep the committee informed of our progress.'
Overall, the committee was positive about the changes that have taken place at the CQC in recent months. The regulator has had a turbulent time since its began work in 2009, attracting criticism for failing to spot failings in Mid-Staffordshire, Winterbourne View and Morecambe Bay.
There has been a wholesale change of leadership at the watchdog and three chief inspectors have been recruited for the three areas of hospitals, primary care and social care.
The MPs today recognised this progress, praising the CQC’s ‘renewed sense of purpose’.
‘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,’ said committee chair Stephen Dorrell.
‘[It] now understands that it exists to ensure that care providers meet basic standards and to intervene when they do not.’
The MPs also considered the CQC’s move to a ‘smoke detection’ surveillance system, through which potential problems are probed more deeply when a range of indicators suggest something might be going wrong.
‘Underpinning the new inspection regime with a detailed surveillance system is a necessary way of monitoring providers. It is particularly welcome that the CQC will include data on staffing levels within the indicators and the committee is keen that this should include key information such as the ratio of registered nurses to patients on hospital wards,’ Dorrell said.
‘For the surveillance system to be successful, the CQC must demonstrate that it can pick up on problems before they become known to the general public. If surveillance is perceived as slow, or reactive, it will not enjoy public confidence and credibility.’
Responding, CQC chief executive David Behan said: 'The report notes the progress we are making in improving the way we regulate health and adult social care services and that we are clear about our purpose and our role in encouraging services to improve.
'I'd like to recognise the efforts and dedication of CQC's staff and the help we have had from our partners in bringing about these important changes. We will reflect on the Committee's recommendations and respond in full.'
