CQC looks ahead to yesterday’s plan
CQC executives have seen the future and the “vision” as revealed to them will work as their strategy for the next five years. Unsurprisingly for people who have had an otherworldly experience, they have been touched by make-believe, convincing themselves that the (re)introduction of a money-saving inspection model at the very time their budget is being cut is just a happy coincidence.
Rarely has credulity been stretched so far. It all got off to such a rocky start. Before the strategy had even been published, the Commission had tabled proposals for higher registration fees, effectively asking care homes to buy a more expensive pig in a poke – one that proved to be a declining level of service.
Providers are entitled to feel short-changed: facing a bill for a BMW, they now find themselves behind the wheel of a Lada. And a second-hand one at that. This asymmetric connection between income and output will be cemented by a discredited inspection regime. Ignoring the old adage, never go back, CQC will exhume reactive inspection, the design that so eroded confidence five years ago that it was buried in an unmarked grave. Despite a makeover as an “insight model”, it hasn’t changed its spots: this exemplar of unlearning the lessons of history remains, as one critic put it, “inspection on the cheap”.
What is being paraded as evidence of progress in fact represents a retreat from the security provided by routine scrutiny. Henceforth, inspection frequency will be decided on the basis of “intelligence” that is, by CQC’s own admission, “not yet robust enough” and quality ratings that could be out of date by the time they are published. More carpet slippers under the desktop than boots on the ground. Unreliability writ large.
Even the “valued” Experts by Experience are taking a hit. The Commission trumpeted the outcome of its re-tendering exercise as “a very, very good piece of procurement”. Unfortunately, one of the contractors didn’t get the memo; it promptly slashed Experts’ wages, propelling many of them towards the exit. Meanwhile, working on the assumption that its own inspectors “can’t be everywhere at once”, CQC moved to recruit the curtain-twitchers of Neighbourhood Watch. A match made in heaven, some might say.
Notwithstanding its commitment to “fairness”, CQC has spurned the chance to reform ratings reviews. By confirming that inspectors’ judgements are exempt from challenge, it has endorsed a process that has more in common with Stalin-era show trials than traditional British justice. However, that could soon be academic. As the comprehensive assessment programme is degraded by a risk-based confection, consequent reductions in service-based inspections will inevitably undermine the credibility of the rating system.
The Commission’s appetite for empire building – it accumulates responsibilities in much the same way that Imelda Marcos collects shoes – appears undiminished by economic reality. Overblown ambitions are singularly inappropriate in these straitened times; nothing – repeat, nothing – should be allowed to divert regulators from their primary purpose. As watchdogs, they are there to monitor, not perform tricks; they need to rein back the self-aggrandisement and concentrate their energies on getting the basics right – consistently. And they must never forget that it isn’t their own money they’re spending.
Version 4.2.9erblown ambitions are singularly inappropriate in these straitened times; nothing – repeat, nothing – should be allowed to divert regulators from their primary purpose.
As watchdogs, they are there to monitor, not perform tricks; they need to rein back the self-aggrandisement and concentrate their energies on getting the basics right – consistently. And they must never forget that it isn’t their own money they’re spending.