CQC to target home care services

The Care Quality Commission (CQC) is to carry out a themed inspection programme of home care services. The programme will help the regulator develop new ways to ensure these services meet the essential standards people have a right to expect and that people are being treated with dignity and respect.

The programme will start in April and will cover about 250 providers of domiciliary care services. It will run alongside CQC’s planned reviews of these services and focus on three outcomes:

• Respecting and involving people who use services
• Care and welfare of people who use services
• Supporting workers.

CQC inspectors will be joined by professional experts and ‘experts by experience’ – people who have a personal experience of using home care services.

The programme will be supported by an advisory group, with members drawn from a range of organisations including the Equality and Human Rights Commission, Age UK, the United Kingdom Homecare Association and the Association of Directors of Adult Social Services.

As well as producing an inspection report for each agency we visit we will also produce a national report that sets out what we have found about quality and safety in these themed inspections.

These inspections follow a pilot programme of 30 inspections of domiciliary care services, where CQC has been trialling different methods to make sure inspectors clearly hear the views of people who use the services and their families.

CQC Chief Executive Cynthia Bower said: “Home care is one of the most difficult areas of care to monitor. Often the people who use home care services find themselves in vulnerable circumstances and the operation of home care is not as transparent as care in hospitals and other sectors because the interactions happen behind closed doors in people’s homes. That is why we want to focus on this sector of social care in this way.

“We know decisions made about commissioning are critical to those who provide and receive home care. External issues such as pressures on council budgets and the desire of people to remain in their own homes as long as they can, create challenges for those providing services, and may increase risks of unsafe care. This underlines the need for us to thoroughly analyse service delivery in this area.

"Alongside these issues, we share the Equality and Human Rights Commission’s concernsdue to be highlighted in its report published tomorrow. In this programme of reviews we will focus in part on dignity and respect, the safeguarding of people in vulnerable circumstances, and how well supported and trained home care staff are to undertake these most important care tasks. We have chosen these outcome areas as they are “gateway” issues that lead us into examining a range of rights based issues."

"We will use a range of ways of checking up on these services, including going into people’s homes, contacting people who use services and their families, talking to local groups who represent the users of home care services, and we will also ask people to fill in questionnaires."

A spokesperson from the Equality and Human Rights Commission (EHRC) said: “We believe this move by the CQC could be an important first step in addressing some of the concerns raised by our inquiry into home care, being published tomorrow. It reveals disturbing evidence that the poor treatment of many older people is threatening their human rights and concerns about how threats to these rights are detected. We look forward to being part of CQC’s advisory panel."

ADASS president Peter Hay added: "I am glad that CQC has taken on this important task at a time when every penny in the inspection pot has to be made to count, and when a number of recent and current reports indicate the urgency of the matter. ADASS wishes the Commission well in thissignificant and timely enterprise."

Age UK charity director Michelle Mitchell commented, “We welcome CQC's decision to carry out this themed inspection of home care services. As the EHRC has demonstrated, there needs to be greater public scrutiny over a service delivered behind closed doors to some of the most vulnerable older people in our society. Age UK will be supporting the CQC and believe this inspection programme will help to ensure that that high quality care, dignity and respect for those needing the service will be at the heart of all domiciliary care."