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CQC considers hidden cameras proposal

The health and social care watchdog in England is considering using hidden cameras to help carry out inspections of care homes.

The Care Quality Commission unveiled the proposal as one of a number of changes to the way it monitors care providers.

The new chief inspector of adult social care has outlined her priorities in a document published ahead of a public consultation next spring.

Andrea Sutcliffe - one of three chief inspectors appointed by the CQC - said the organisation would hold discussions over “the potential use of hidden surveillance”.

The document, A Fresh Start for the Regulation and Inspection of Adult Social Care, states: “We would… like to have an open conversation with people about the use of mystery shoppers and hidden cameras, and whether they would contribute to promoting a culture of safety and quality, while respecting people’s rights to privacy and dignity.

“Such a conversation should cover the use of these techniques by the public, providers, or CQC.”

Davina Ludlow, director of care home directory, warned about the possible impact on care users and staff.

“Whilst safeguarding is vital, so too is dignity and privacy,” she said.

“We urge full and meaningful consultation before digital spies infiltrate the care sector. Not only will covert surveillance impact on residents’ freedom, it may also have a knock-on effect on the motivation of staff.

“We need to train, support and inspire the next generation of carers, not create a big brother culture where people are afraid to do this vital job.”

Other proposals include awarding ratings to every care home and adult social care service by March 2016 to help people make informed decisions about their care.

Ms Sutcliffe, who started in her job last week, also wants to recruit an army of ordinary people with personal experience of the care system to help carry out inspections.

She said: “This is a fresh start for how care homes, home care, and other adult social care services are inspected and regulated across the country. I will be leading CQC’s new approach by making more use of people’s views and by using expert inspection teams involving people who have personal experience of care.

“We will always be on the side of the people who use care services. For every care service we look at, I want us to ask: ‘Is this good enough for my mum?’. If it is, this should be celebrated. If not, then as the regulator we will do something about it.

“Adult social care is the largest and fastest growing sector that CQC regulates and so it is imperative that we get it right.”

A spokesman for the Alzheimer’s Society said: “We welcome these plans to overhaul adult social care inspections at a time when public confidence in the care sector is at an all time low.”


Readers' comments (31)

  • I would ask Ms Sutcliffe if she would consider it good enough for her mum to be under continuing surveillance. I am appalled that this could even be considered - the residents in care homes deserve the same right to privacy as all others. There must be better ways to prevent/uncover abuse.

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  • How much lower can the CQC stoop? “We would… like to have an open conversation with people about the use of mystery shoppers and hidden cameras, and whether they would contribute to promoting a culture of safety and quality, while respecting people’s rights to privacy and dignity. Can I tell you now. THEY WON'T! They'll do the exact opposite and promote a culture of fear where staff feel they cannot trust their instincts in case a spy or a camera misinterprets their actions. Our institutions are in crisis and the CQC, Monitor, Ofsted etc just add to their problems. This is worth a read.

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  • is this, and the financial outlay they would require, the answer to poor management, inadequate training, overworked and highly stressed staff paid insufficient salaries and often expected to care for others in inadequate and poorly resourced facilities to run professional establishments responsible for providing care for vulnerable and valued members of our society?

    Perhaps these cameras should be tested on the home owners and managers first! who else would wish to work in such an atmosphere of mistrust?

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  • further to my comment above, it also seems to affirm beliefs that the health and social authorities and the CQC and those running the homes are incapable of doing their own jobs properly and thus placing the onus on the front line workers instead of leading and supporting them as they should.

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  • Brilliant! Why hide them?? I fully endorse every opportunity to show how good our practice is, and will easily resolve any malicious or unfounded allegations about staff, and provide hard facts for investigations etc. I cannot think of one reason why the whole of the care profession would not be absolutely delighted. Stick them in hospitals as well. If i were a patient I would be glad of that level of protection. Predictable whining debate going on ... hope you all contribute to the formal consultation!!

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  • tinkerbell

    Anonymous | 15-Oct-2013 5:11 pm

    I agree with you and am not against cameras being considered.

    Childrens nurseries now have CCTV so that parents can feel reassured that their children are in safe hands and rightly so.

    There are a lot of dedicated hardworking staff working in private care homes which are understaffed and where profit comes before adequate staffing levels. They are worked like donkeys and paid minimum wages with minimal sick leave and probably the most basic terms and conditions.

    I spoke with a dedicated, caring, hard working staff nurse the other day in one of these homes. She told me she is the only nurse in charge of 40 residents, most of them requiring all needs met, some with complex needs & challenging behaviours. There are 20 residents on each ward and she said she has 3.5 staff per ward. She is the .5 member of staff as she is the only qualified covering both wards. This isn't because someone has gone off sick, this is the norm in this private care home. A camera would prove how over stretched she and the staff are but also prove how dedicated she is to her residents and the need for extra staffing. She has nothing to fear from a camera observing her.

    When I recommended to the home manager they increase their staffing levels she replied 'recommend away, it ain't gonna happen'. Perhaps they put on extra staff when they know they have a CQC visit.

    Whilst the CQC et al continue to have problems with ensuring adequate inspection the residents are stuck in these care homes without a voice.
    Home staff are too frightened to speak out for fear of losing their jobs.

    There is no need for any residents dignity to be compromised. It is already probably being compromised no doubt on occasions due to totally inadequate staffing levels. The only way some of these private home business managers are going to improve standards is because there is proof that they are causing the problem by not providing the required staffing.

    I have been involved with another care home under investigation for the past 5 months because of the excessive amount of adult protection alerts that have been raised. They eventually had their staffing levels increased.

    If the CQC et al cannot provide the level of inspection required to ensure quality and dignity needs are met we can't just leave the matter as it is without coming up with alternative solutions.

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  • I don't suppose many would welcome cameras or even Smart Meters in their own home with some stranger watching over them to survey that they are obeying all the rules, and they could even be used to survey peoples' life styles to ensure they are not abusing their nutritional, physical and mental health and then claiming free care at the expense of tax payers on the NHS!

    even thinking such an idea as this, in what has become effectively the home of many of the elderly, is a disgrace. it needs more staff and better training and not perpetually bringing in new-fangled ideas to cover over your mistakes. look at speed cameras, they were quickly dropped by the government as soon as austerity measures came into force.
    time to get your whole act of healthcare together, the elderly have paid into the system and looked after others much of their lives and now it is their turn to be looked after in a caring, respectful and dignified manner they deserve!
    They are still valued members of the community as much as everybody else and don't you forget it!

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  • What is so glaring and incredibly disappointing is the complete lack of ANY consideration or mention for the rights of healthcare workers!! The cameras wouldn't stop at care homes.

    I am a good, honest and hardworking nurse in an acute setting. Have been for three decades. I have had years of verbal abuse, been spat at, and been punched and kicked by patients and their relatives. Nothing effective has ever been done to either prevent these things happening to healthcare workers or impose sanctions on those who offend.

    If care is poor anywhere, tackle the reasons. (see the excellent comment from Anonymous | 15-Oct-2013 2:25 pm for some of those).

    Don't spy on people going about their lawful business.

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  • Fire Andrea Sutcliffe and her mates for even suggesting that this despicable idea as an option.

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  • The legal starting point is that covert and secret monitoring and surveillance will amount to an unlawful infringement of a worker’s human rights in the workplace. Under the Human Rights Act 1998, individuals have the right to private life. The office of the Information Commissioner recommends that covert monitoring or surveillance should only happen in extreme cases, for clearly targeted purposes, and only for a limited period.
    Relevant appeal court cases on this subject indicate that secret monitoring and surveillance will only be lawful if it is “proportionate”. In order to be proportionate, an employer will need to be able to show that the interference with the individual’s rights was proportionate in all the circumstance. This means that limited secret monitoring may be appropriate if it is clearly and carefully targeted, and is only used for the period necessary to establish if the activity of concerns is actually happening, and to establish when and how the activity of concern is happening. Therefore, if, for example, the employer suspects an individual of stealing from his business, the relevant secret monitoring will only be proportionate if it focuses on the particular suspect, in the location of the suspected thefts, and for such period as is necessary to prove or disprove the suspicions. If a particular employee or group of employees is the subject of suspicion the monitoring should not cover other employees.

    Ms. Sutcliffe et al, you CANNOT ride roughshod over the rights of patients or employees. Stop wasting time on this nonsense. You will only end up in court. Turn your attention to the underlying causes of poor care. It isn't rocket science.

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  • tinkerbell | 15-Oct-2013 8:24 pm

    Anonymous | 15-Oct-2013 5:11 pm

    this seems to suggest that you show little confidence in your profession, your colleagues and in the standard of care if your support the CQC and these highly questionable measures.

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  • do we really have to accept that we are living in an era of increasingly public surveillance and intrusion into our personal lives - internet, intrusion and sharing of our personal data, camera surveillance wherever we go and now even in the private homes and intimate sphere of the elderly and some who may be suffering from memory loss and dementia who are unable to raise any objections. if it becomes reality it needs to be addressed to the EU court of human rights.

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  • for the protection of patients, home residents and the personnel looking after them.

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  • Oh My Goodness! Are they completely insane?
    This is fundamentally wrong. As a nurse I have absolutely no problem with being filmed in the course of my duties. I'd like to think that I am practicing safely and competently within my skills and experience. Nevertheless, what about consent from the patients and caregivers alike (family and staff)? People are at there most vulnerable in hospital and other care settings and in some instances unable to give agreed consent. Who on earth will validate the credibilty of the persons doing the filming?
    A nurse was struck of the register (and rightly) for secretly filming patients to highlight care concerns. Since when did it become best practice for the CQC to do this?
    By far the worst idea I have ever heard of. Anyone filming the patients I care for without their consent, I will remove from the ward and notify security. They can film me doing that with my full consent.
    However if they want to fit me out with a secret camera to record a day in the work of a nurse, more than welcome. You will find more CQC inspectors on the ward than you do nurses or HCA's on movie days. Perhaps you can film nurses being chastised by lazy managers? Who gets to know when the filiming will take place. We will know when nursing managers show up in appropriate dress and with their hair and make up done. Could you film the relatives of patients spitting and swearing at staff. Will the CQC let me use the video evidence when punched in the groin by a delirious patient or when a drunken relative poked me in the eye? Then the filming would stop.
    If filming is going to be introduced, then it should be on an informed 24 hour basis. The understanding being to staff, patients, family that is is going on and a condition of attendance for treatment. Failing that, cherry picked film is subjective, biased and inaccurate. Thoughts anyone?

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  • Anonymous is quite right. Great idea. Just see what carers and nurse have to deal with routinely in the course of a single 12 hour shift. But I want to see cameras with microphones also located in managers offices recording their every move and word.

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  • Great idea to the above. Film everything. I've nothing to hide. I love working as a nurse. Just make sure you have informed consent from patients. Make it public. You will be filmed!
    The worst idea, but it will have the best consequences. Let everyone see what goes on. May I be filmed having my break? Could handovers be recorded? Let everyone see how hard we work? Let the Matrons, ward manager, consultants and everyone else be filmed and recorded in a gargantuan time and motion study.
    Film and interview the patients too. Ask them about the HCAs, Nurses and Junior Doctors that are run ragged filling in the spaces that the seniors (?) are, well not there.
    Show it on national TV. Big Brother style.
    Nurses need not strike or complain ever again. Just film and record it all. Hospitals are public spaces and the public should see what is going on.
    The person who thought this up is a genius. Deserves an MBE, at least.

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  • tinkerbell

    Anonymous | 15-Oct-2013 11:20 pm

    No it doesn't show that at all. That is your interpretation and you are entirely wrong.

    The bottom line is a lot of care homes are exploiting not only the residents but the staff working in them. It's called cheap labour.

    Get out there and see it for yourself like I do on a daily basis.

    I don't have any faith that the CQC are up to the job and they are all but admitting this themselves.

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  • At Tinkerbell And Aym(1120)
    Have a look at this, pasted from another post.
    Cheap is what private nursing homes provide. When Aym resides in one, please post.

    I'm a nurse. I have elderly parents in a nursing home. Consequently, they are never happy and I'm never content, that they are never happy. Therefore as a relative I complain to the Nursing Home staff about everything that I'm not happy about because my parents are not happy about it. You see, it's a conundrum. It gives me a sense of control and proactiveness when I complain to the Nursing Home staff. Perhaps I'm trying to shed guilt?
    In my opinion, it is the way that private care and nursing homes are operated. Simply, threadbare. Certainly as much as the company/firm/plc can get away with. There will be a laminated poster in every doorway and corridor advertising the Marketing Department strapline of 'Who Cares Wins', 'Old memories and New Ones', 'A Sunrise in Twilight' and all that condecending nonsense. Fundmentally these care home companies put the gloss on and at simultaneously maximise profits and directors salaries by skimping on continence care. Furthermore, you are likely to find a staff to patient ratio that would make the worst NHS trust puff out the chest and collect an excellence reward.
    My mother used her call bell continuously. All the residents did. The system did not work. Installed in 1982, the electrician who fitted it was a resident/patient. He died in 1997. Had not worked properly in years, but the care home regional manager arrived to address my complaint in his £120k turbo Porsche.
    The crux of the matter is that it is private care. Therefore they have their own private interests at heart. Makes it easy for them to brush off what you care about. Complain away. They have your money, your loved ones money and the public money. But the latter will just make the altruistic healthcare providers that they are doing you a favour.

    Tinkerbell is bang on the button.

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  • "We would… like to have an open conversation with people about"......about sod all, coz the CQC won't take any opinions on board anyway.

    This is, on one hand a sh*te idea for all of the above reasons - the main one being:

    "This is WAR between the good honest kind hardworking public and the EVIL CARE HOMES WHO ABUSE EVERYONE AND TAKE OUR MONEY!!"......bollocks.

    On the other would show the public the crap that we do put up with at times.

    Either way, I work hard, my team works hard and our Homes are run well. Not every home out there is, but carers are gonna be scared even to just deliver care - even when its good - for fear that whatever is done, it will be scrutinized so that blame can be laid.

    We should all work as if we are being filmed (even when we are not) so that at least it reminds us to do good even when we aren't being watched.

    The CQC gets a vote of no confidence....again.

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  • tinkerbell | 16-Oct-2013 2:11 am

    Anonymous | 15-Oct-2013 11:20 pm

    if you are always so right and everybody and you are there daily why aren't you doing something about it?

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