The Care Quality Commission released their annual assessment of health care and social care in England today, 20 October 2023.
CEO of the Homecare Association, Dr Jane Townson OBE, commenting on CQC’s State of Care 2022/23 report, said:
CQC's State of Care report highlights the urgent need for reform and investment in the care sector. Whilst there are many examples of exceptional care, failure of quality and safety is visible on multiple fronts.
When the Homecare Association formed in 1989, there was no regulation of care. Until 2003, when care regulations were first introduced, our Code of Practice was the only quality standard in homecare. Concern for quality standards and regulation in homecare is thus part of our DNA.
Many of our members invest heavily in ensuring high-quality services. Whilst the national average for outstanding ratings in homecare is 4%, some of our larger members have achieved an average of over 30% outstanding ratings. And an elite group of smaller members has achieved 100% outstanding ratings. Such high performance requires a strategic commitment to quality, outcomes, and customer service. It also requires investment in pay and terms and conditions of employment of care workers; training; supervision; and clinical and quality governance.
Every week, we receive calls on our helpline from members raising concerns about what they see happening around them. Examples include allegations of unsafe discharge from hospital; call-clipping; people with advanced health needs left in the care of providers with poor quality ratings because they are cheap; commissioning of complex clinical work to providers without an appropriate level of registration; council homecare tender documents stating that low price will score more highly than quality; and councils pushing high volumes of work to unregistered providers.
We question CQC’s assertion that care quality is broadly similar to previous years. Many homecare providers have not received an on-site CQC inspection for over 5 years, despite continuing to pay their registration fees. So how can CQC know with certainty?
We welcome CQC’s oversight of Integrated Care Systems and local authority commissioning. Regrettably, though, the government has given CQC no enforcement powers over these public bodies. The jury is out. Without accountability or consequences, though, it’s hard to see how this will make a difference.
The Homecare Association is committed to supporting providers to deliver quality care. We are also committed to supporting CQC in developing its new Single Assessment Framework. We want to ensure that CQC’s new approach leads to improved outcomes for people drawing on services.
At the end of the day, quality care costs money.
We call on the government to invest adequately in homecare, so we can ensure the highest standards of quality and safety in care.