Over a third of nurses believe the Care Quality Commission does not take sufficient account of staffing levels, according to a survey conducted by the Royal College of Nursing.
Nurses also used the poll to raise concerns that the healthcare regulator’s inspectors do not have an appropriate level of expertise in order to carry out inspections.
The survey of around 5,000 college members found 35% did not believe the CQC sufficiently took into account the importance of staffing levels and skill mix when assessing healthcare providers.
The RCN added that many respondents criticised the consistency of the CQC’s inspections. In an accompanying report it also highlighted concerns that the CQC had been slow to respond to concerns and that too few inspections were undertaken.
RCN chief executive and general secretary Peter Carter said: “That more than 5,000 nurses completed this survey is indicative of the strength of feeling on this issue. Nurses have welcomed the recent changes the CQC has made to improve its efficiency in response to concerns, and it is essential that the CQC is now supported to continue to mature and develop into an effective regulator.
“However, it is vital that other honestly held concerns are addressed as a matter of urgency,” he added.
The RCN has made several recommendations for how the CQC can improve the service they offer, in response to the survey results. In particular, it highlighted a need for an increase in inspections and for these inspections to produce more detailed reports regarding staffing levels. It suggested annual, unannounced inspections which give staff opportunity to speak to the CQC without managers being present.
CQC director of regulatory development Philip King said the regulator would look “carefully” at the findings.
He said: “CQC inspectors do consider and report on staffing levels; our focus is on whether, at the time of the inspection, enough appropriately trained and experienced staff are on duty to ensure that care meets essential standards of quality and safety.”
But he added: “CQC does not determine minimum staffing levels for health and social care services; we expect providers to make these decisions themselves based on the specific needs of those using their services and taking into consideration guidance and recommendations from professional bodies and associations, including the RCN, around staffing levels and skills mix.”
The RCN report sets out 10 recommendations for change, which it believes will improve the “relevance and credibility” of the CQC. These include:
- The CQC provides much greater detail on staffing levels that inspectors see on their visits;
- The CQC ensures all hospitals and care homes have an unannounced inspection once a year and that inspectors talk to a range of both senior and junior staff without managers present;
- That there is a balance of unannounced inspections both during the day and at nighttimes;
- The CQC sets out a two week target for responding to those who raise concerns or “whistleblow,” with the CQC replying with a detailed explanation about how it will now proceed; and
- The CQC must support its current staff to maintain their nursing expertise and registration to help counter the perception of a lack of clinical expertise, as well as continuing its ongoing recruitment of inspectors who have up to date clinical backgrounds.