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CQC 'special measures' failure regime to be extended to care homes

Failing care homes could be put into a similar failure regime as poor-performing hospitals, the health secretary is to announce.

Jeremy Hunt will say that most of the hospital trusts that were put into special measures a year ago have shown significant improvements as he announces that the initiative is to be rolled out to include care homes and homecare services.

If these services fail to make improvements they could then face being shut down, Mr Hunt is to announce.

Putting hospital trusts in special measures was a move introduced as part of the government’s response to the Francis inquiry into the former care failings at Mid Staffordshire Foundation Trust.

A year ago, following a review into 14 other hospital trusts with higher than expected death rates, 11 trusts were put into special measures for a catalogue of failings and fundamental breaches of care.

The Care Quality Commission’s chief inspector of hospitals, Professor Sir Mike Richards, has said that since the trusts were put into the failure regime, most have shown major improvements in leadership, patient safety, compassionate care and staff engagement.

Following inspections, five of the trusts have been, or are expected to be, taken out of special measures, he said.

Four have made improvements but will be kept in the regime for an “extended period” and decisions on the final two will be announced later in the week, he said.

Mr Hunt will make a statement to Parliament outlining the progress that has been made in addressing the failings.

He will also announce the roll out of the scheme into care homes and home care services. From October these services across England will face a “tough” new inspection regime, he will say.

“The hard work by trust staff that has underpinned this progress should be recognised”

Mike Richards

The services that are rated inadequate face being put into special measures and if they fail to make improvements following this they could be shut down, he will add.

“Mid Staffs was a wake-up call which uncovered how staff in a minority of isolated hospitals believed poor care was somehow normal and acceptable,” he said.

“Thanks to a sharp focus on admitting problems rather burying heads in the sand, some of these hospitals have tackled their deep-rooted failings for the first time and are on the road to recovery.

“Everybody wants to know they can get safe, compassionate care from their local hospital,” he said. “The big difference special measures has made is that concerns of patients and staff are listened to and acted on quickly.”

In addition, Professor Sir Mike Richards said: “We have seen significant improvements in almost all of the 11 trusts that were put into special measures, with

Mike Richards

exceptional progress in two trusts and very good progress in a further three.

“The hard work by trust staff that has underpinned this progress should be recognised,” he said.

“Special measures brings a new focus on quality improvement in trusts which have previously struggled to provide high quality care,” he added.

Miriam Deakin, head of policy at the Foundation Trust Network, said it “should be a source of pride to staff and trust boards” that lasting improvements have been made to patient care and safety at a number of the trusts put into special measures.

She said: “The special measures regime has evolved considerably over the last year, and the focus on organisational buddying, support, sharing and learning is very welcome, and can be used more widely across the NHS.

“No-one in the NHS is complacent though,” she said. “We know there are still some improvements to be made, and those trusts leaving special measures today will see this as an important step on a journey of continual improvement and not the end of the road.”

The announcement of a special measures regime for care homes received a cautious welcome from Care England, which represents independent care providers.

Professor Martin Green, Care England’s chief executive, said: “It is important that this special measures regime is developed in partnership with the care sector and the time and public resources that are allocated to it, mirror those that were allocated to the health regime that inspired its creation.

“It is our hope that this regime will give new clarity and consistency in how failing services will be challenged to improve, and clearly define the process and timescales on when they will be removed from the market.”

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