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Care Quality Commission

Volume 744: debated on Thursday 14 March 2013


Asked by

To ask Her Majesty’s Government what actions they propose to take in the light of the findings of the Care Quality Commission’s home care inspection review Not Just a Number.

My Lords, the Government were encouraged that almost three-quarters of the domiciliary care agencies inspected by the CQC for the review were found to be meeting essential standards.

As the regulator of health and adult social care, the CQC has a range of powers to ensure that services are safe and of good quality. The CQC has the Government’s full support to take firm action where it finds services are unacceptable or failing.

I thank the noble Earl for his response and welcome the CQC’s positive findings on the 75% of home care services it inspected. However, the 25% of failing providers are a cause for deep concern, particularly as regards the number of late or missed calls and their complete failure to have systems to document, assess or monitor the quality of care they are supposed to deliver. Where there is a live-in carer, late or missed calls can at least be managed in some way, even if the cared-for person cannot be got out of bed. However, if people are on their own, the consequences are deeply distressing and can be very serious. What information does the department have nationally across the sector about this very worrying issue? What action is being taken to address the problem? Should we not ensure that all providers are required to keep records of the numbers, reasons for and remedial actions taken for missed and late calls, including refunding charges to self-funders or to the local authority?

My Lords, the noble Baroness is quite right: there is no room for complacency in this area. Care has to be right every time, not just three-quarters of the time. I noted from the CQC’s report that, although it recorded a number of common issues undermining the majority of good home care from a significant minority of providers, many of these were fairly minor. However, the noble Baroness has alighted on a very important failing among several of the agencies inspected. I do not have national information on late and missed calls but in the work that we are doing with local authorities, providers and, indeed, the CQC, all of whom share responsibility for driving improvement in services, this will inevitably be an area of focus for it.

My Lords, does the Minister agree with me that while the examples of good practice are very welcome, what was most surprising was the comment on safeguarding, which noted that many services are not meeting the requirements of good practice in relation to reporting to local authorities and have out-of-date procedures? Bearing in mind the plethora of advice from the Department of Health, what do the Government intend to do to bring these services into line as these are the most serious cases, where people are in real danger?

My Lords, strengthening adult safeguarding arrangements is a key priority for the Government. We are committed to preventing and reducing the risk of abuse and neglect to adults who are in vulnerable situations and generally to supporting people to maintain control over their lives. As the noble Baroness may know, we are legislating to put safeguarding adults boards on a stronger statutory footing. That will better equip them both to prevent abuse and to respond to it when it occurs.

My Lords, does my noble friend recall occasions within recent years when the Care Quality Commission discovered blatant breaking of the law and was unable to take any steps? What happens when that occurs and no repercussions follow?

My Lords, the Care Quality Commission has a full range of powers open to it which enables it to take action where it discovers a major failing in the quality of care. We are not aware that that menu of options needs to be expanded. I will write to my noble friend as regards specific instances, having consulted the CQC, but I do not think that there is a general call to expand the CQC’s powers in this area.

My Lords, I am sure that the noble Earl will welcome this report, as my noble friend has, because there are many good news stories in it. I am sorry that I have had time to read the report only quickly. In the inspection, the Care Quality Commission looked for opportunities to maintain older people in their homes, rather than have them come into hospital; that is hugely important. The evidence is that if an elderly person turns up at A&E at 8 pm, they will be in hospital for many days, and that is not always necessary. Can we look more closely at how, in the care that is given, we can prevent people coming into hospital?

The noble Baroness is right to focus on that issue. There are a number of things that we can do. We will shortly introduce new minimum standards to improve training for care staff, which will help in that regard. We aim to double the number of apprentices in care services by 2017 because there is clearly a workforce imperative here. We are proposing to expand the current care ambassador scheme, which promotes a positive image of the sector. That again will assist in recruitment. We are also launching an online tool to support recruitment and provide information about working in care and support, all of which is designed to address workforce concerns and concerns around skills.

My Lords, will the noble Earl assure the House that the Government, when considering the report referred to by the noble Baroness, Lady Wheeler, will look at it in the context of another report published today by a House of Lords committee chaired by the noble Lord, Lord Filkin? Together, these reports pose one of the greatest challenges to our society, and it is very important that the Government take these matters as seriously as possible, for the benefit of us all.

I quite agree with the noble Lord. He will know that we have an Oral Question next week on the report published today by the noble Lord, Lord Filkin.

My Lords, last year the Government announced their intention to end the practice of domiciliary care visits being planned on the basis of a few minutes. In the current economic circumstances, can the Minister say how the Government plan to make that intention a reality?

My Lords, my noble friend will know that in the care and support White Paper we set out our intentions to improve quality standards in social care, increase the capacity and enhance the capability of the social care workforce, ensure that people have better information about care providers, and improve the performance of the regulator. Within that spectrum of actions, we will be looking carefully at how precisely to deliver that ambition to which my noble friend rightly refers.