From where I stand . . .

Posted on October 2nd, by geoff in Caring Times, CT blog. 2 comments

By Caring Times editor GEOFF HODGSON

A group of residents’ families have criticised the Care Quality Commission’s refusal to review the ‘good’ rating it awarded to the care home where the residents live. The families, who believe the care home deserves an ‘outstanding’ rating, say they made their criticism public without any prompting from the provider concerned. The story will be told in detail in the November issue of Caring Times.

Neither the families nor the regulator are necessarily wrong in their differing assessments; they are each using different methodologies and assessing different things. We may assume the families concerned visit their loved ones at the home very regularly and witness the care delivered over a long period. Their loved ones will tell them how well they are looked after and the relatives can directly observe the positive and supportive relationships between residents and staff. They can see and smell the food and experience themselves the quality of the physical environment in terms of cleanliness, heating and light; and in consequence they have judged this care home to be outstanding.

In contrast, the CQC inspectors are in direct contact with the care home for a relatively short period of time and so their observations are necessarily constrained, but they examine and assess much more than is the case with a visiting relative. Staffing ratios, training levels, care plans, record keeping and a myriad of other inputs are scrutinised and put into the mix. In this case the regulator decided that the care home was merely ‘good’.

So the perception of the quality of a service may depend very much upon where you stand. The relatives might agree with me that outstanding care can be delivered in a shepherd’s hut on a mountainside; it will be limited of course but what care is given can still be outstanding in its nature if delivered with competence and compassion. But compassion, like care itself is an abstract and cannot be quantified. Regulators are by definition authoritarian and they derive their authority from measured inputs, so they go around measuring everything they can.

But I think that day-in, day-out observation by relatives gives their evaluations more real time relevance than the ‘snapshot’ nature of a CQC inspection and I cannot help but wonder if it is an appropriate use of public money to fund a ratings system run by the regulator when there are already alternatives in place which give top weight to judgments made by residents and their relatives.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

2 responses to “From where I stand . . .”

  1. Bob Ferguson says:

    Residents – and therefore their relatives – are forever changing, often in quick order. As a constant – authoritative rather than “authoritarian” – and objective presence, CQC is best placed to deliver truly independent judgements. And no public money is involved; CQC is fully funded – as near as damn it – by providers’ fees.
    The roots of this family’s complaint lie in the limited criteria against which CQC will consent to review its ratings. It is a process that denies appellants natural justice. CQC must be compelled to change it, perhaps through the agency of the Small Business Appeals Champion – if and when such an appointment is ever made.

  2. John Burton says:

    You won’t be surprised to hear that I agree with you, Geoff. “Quality ratings” were never a good idea and some people may be fed up with reading my consistent, lonely and long-standing opposition to them.
    CQC (and their predecessor, CSCI) use them as an excuse to inspect higher rated homes less. Residents still pay for CQC even when they are receiving no service. Providers are naturally happy to be inspected less and to receive the commercial boost of a higher rating.

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