New research indicates that the inspection process of care homes, introduced in April 2002 to improve care home standards under the National Care Standards Commission, is failing fundamentally, and that a modified system is needed. This is according to a survey conducted of over 400 care homes in the UK by health and social care specialists at international law firm, DLA.
The report revealed that, following an inspection, 58% of care home providers are waiting at least two months for a draft report to be delivered, and a staggering 38% wait in excess of two months. Alarmingly this is also the case for care homes where inspectors have discovered serious matters needing urgent attention. These areas of concern are often not identified to the care home until the draft report is delivered many weeks, even months, after the inspection took place.
It is not possible to name care homes under investigation as cases are ongoing, however, there are incidents of NCSC inspections leading to police investigation and NCSC producing a report after the conclusion of the police enquires, well after it might have had any real value.
In September 2003 the National Care Standards Commission (NCSC), the regulator responsible for care homes and inspections, published its annual report and set a target within which to deliver a draft post-inspection report. This target will be ten weeks.
Keith M Lewin, specialist Health and Social Care lawyer at DLA, said:
“The NCSC’s target is preposterous. The timescale is a ridiculously long one in which to deliver a report, especially in cases where imminent action is required. If an inspector finds something which warrants urgent attention it should be raised immediately with the care home.”
The inspection process causes a significant drain on the resources of a care home: staff assisting inspectors, time taken in responding to pre-inspection questionnaires, reviewing draft reports and providing a considered, often detailed, response. Care homes and more importantly, residents, are owed a faster service and one that is faster than NCSC proposes as a “benchmark” for itself.
In April 2004 the Commission for Social Care Inspection (CSCI) will replace the NCSC as the regulator responsible for care homes and inspections. It will have the chance to improve the system, present a consistent approach and build a “partnership” relationship with care home providers.
Paul Ridout, Head of the Health and Social Care team at DLA said:
“There is much to be done in the way of bridge-building between inspectors and providers. Tighter regulation and a simplified system are needed to maintain and improve the standard of care homes. The CSCI must seize this opportunity and develop where the NCSC has failed.”
Following the worrying findings of this survey, DLA’s Health and Social Care specialists recommend a call to action:
• Annual announced inspections should be retained;
• Annual unannounced inspections should be scrapped;
• In place of the annual unannounced inspection, there should be “targeted” unannounced inspections responding to information gleaned, for example during an annual inspection, from a complaint or by tip-off;
• Provision of feedback forms at the conclusion of all inspections should become a legal requirement;
• The regulator must not make a complaint about, or make a requirement of, any matter not mentioned in a feedback form;
• There should be formal written reports only where circumstances are identified which require significant adverse comment;
• When written reports are to be generated, a draft report should be provided to the care home operator within 14 days of the end of the inspection;
• There should be continuity of the inspectors responsible for given care homes.