CQC should assess 'culture' during inspections
The Care Quality Commission should focus more on the culture of the organisations they inspect and the “essential quality of care” provided and not just “easily measurable inputs”, an influential group of MPs has said.
The Commons’ health select committee today published a report on the healthcare regulator. It is the second in a series of annual reviews.
It concluded there were still issues with the regulator’s consistency of inspection judgements, use of resources and clarity of purpose.
The committee called on the CQC to undertake an open consultation on its methods, which should include asking how inspectors could assess the prevailing culture among staff within individual care providers.
Committee chair Stephen Dorrell said: “An inspection should be much more than a review of facilities and records. It should include an assessment of the quality of the professional culture within the organisation.
He added: “Care providers need to show they have robust procedures which foster a culture of challenge and response in which the requirement to recognise and address service shortcomings is a standard process for all staff in pursuit of their professional duties.”
The committee welcomed the CQC’s recent introduction of a bank of clinical advisers who can be called in to help with inspections.
However, it noted that only 13% of inspections had drafted in one of these individuals since the facility was introduced.
The MPs also called for an “overhaul” of the CQC’s governance structures “as a matter of urgency” to provide proper “strategic direction”.
The report vindicated a CQC non-executive director, Kay Sheldon, for contacting the Mid Staffordshire Foundation Trust Public Inquiry with her concerns about how the regulator was being run in late 2011, describing her concerns as “legitimate”.
Mr Dorrell said: “It is regrettable that [Ms Sheldon] felt compelled to approach the Mid Staffs Public Inquiry to secure a hearing for her concerns.
“It is essential that the CQC reforms its culture and working practices to address these shortcomings.”
Last year was a turbulent time for the regulator’s leadership. Its chief executive, Cynthia Bower, resigned in February on the same day that the Commons health committee published its first annual review of the regulator.
Its chair Dame Jo Williams resigned in September. She had faced calls to go since she tried and failed to have Ms Sheldon sacked.
In response to the report, current CQC chief executive David Behan said the regulator had already held a strategic review, which had included consulting widely on a “clear statement of our purpose and role”.
“We also set out our intentions to tailor the way we regulate different types of organisations based on what has the most impact on driving improvement. We will put people’s views at the centre of what we do,” he said.
Peter Carter, chief executive and general secretary of the Royal College of Nursing, said: “We know that the culture of healthcare organisations cannot be regulated, however, we agree with the report that the CQC can play a vital role in ensuring that organisations support staff in raising concerns without fear of retribution.
“We look forward to continuing our work with the CQC in this area to make sure staff are fully supported.”
He added: “It is significant that the CQC is now giving attention to the importance of staffing levels and highlighting the effects of inadequate staffing on patient care.”