Care Quality Commission

Care Quality Commission
Abbreviation	CQC
Formation	April 2009 (2009-04)
Type	Non-departmental public body
Legal status	Operational
Location	Finsbury Tower, London
Region served	England
Chair	David Prior
Chief Executive	David Behan
Budget	£166m gross expenditure (2012/13)[1]
Staff	2,147 whole time equivalents (2012/13)[1]
Website	www.cqc.org.uk

The Care Quality Commission (CQC) is a non-departmental public body of the United Kingdom government established in 2009 to regulate and inspect health and social care services in England. This includes services provided by the National Health Service (NHS), local authorities, private companies and voluntary organisations - whether in hospitals, care homes or people's own homes. In order to be granted registration, care providers need to demonstrate that they can meet, or are already meeting, the registration requirements. To maintain their registration they need to demonstrate an ongoing ability to meet the requirements.

Part of the Commission's remit is protecting the interests of people whose rights have been restricted under the Mental Health Act.

In June 2013, following a series of critical reports and facing 30 civil claims for negligence, it was announced that the organisation would be subjected to a public inquiry.^[2] David Prior, chair of the commission, admitted that the organisation was "not fit for purpose."^[3] Jeremy Hunt, the Secretary of State for Health, issued an official apology in the House of Commons for "the appalling suffering" of the 30 families involved.^[2]

History

Until 31 March 2009, regulation of health and adult social care in England was carried out by the Healthcare Commission and the Commission for Social Care Inspection. The Mental Health Act Commission had monitoring functions with regard to the operation of the Mental Health Act 1983.

The Health and Social Care Act 2008^[4][5] established a single, integrated regulator for health and adult social care - the Care Quality Commission^[6] to replace these three bodies. The Commission was created in shadow form on 1 October 2008 and began operating on 1 April 2009.

The CQC is not entirely independent. Although it describes itself as the "independent regulator of all health and social care services in England",^[7] it is in fact "accountable to the public, Parliament and the Secretary of State for Health."^[8] and much of its funding comes from the taxpayer.

Board

The board members are:

• Chair: David Prior, formerly a Conservative politician. Appointed 13 December 2012, effective 28 January 2013.^[9]
• Chief executive: David Behan, formerly Director General of Social Care, Local Government and Care Partnerships at the Department of Health, the President of the Association of Directors of Social Services, and Chief Inspector of the Commission for Social Care Inspection.^[10]
• Board members:
  • Louis Appleby, the National Clinical Director for offender health, formerly the National Director for mental health. Appointed 3 June 2013.^[11]
  • Anna Bradley, formerly chief executive of the National Consumer Council. Appointed 26 July 2012.^[12]
  • Camilla Cavendish, a journalist and associate editor for The Sunday Times. Appointed 3 June 2013.^[13]
  • Paul Corrigan, former health policy advisor to Tony Blair and former special advisor to Alan Milburn and John Reid. Appointed 3 June 2013.^[13]
  • Jennifer Dixon, chief executive of the Nuffield Trust and past board member of the Healthcare Commission. Appointed 3 June 2013.^[13]
  • John Harwood, formerly chief executive of the Food Standards Agency. Appointed 12 March 2010.^[14]
  • Steve Hitchins, formerly leader of Islington London Borough Council and a past board member of the London Development Agency. Appointed 9 July 2012.^[15]
  • Michael Mire, a senior partner at McKinsey & Company. Appointed 3 June 2013.^[13]
  • Kay Sheldon, formerly a Mental Health Act commissioner and past board member of the Mental Health Act Commission. Appointed 20 October 2010.^[16]

Previous board members have included:

• Chief executive: Cynthia Bower 2009-2012.
• Chair: Jo Williams 2010-2012.
• Chair: Barbara Young, Baroness Young of Old Scone 2008-2010.

Criticisms and controversies

Basildon and Thurrock University Hospitals NHS Foundation Trust

In November 2009 Barbara Young, then the CQC chair, resigned from the commission when a report detailing poor standards at Basildon and Thurrock University Hospitals NHS Foundation Trust was leaked to the media. The report found that "hundreds of people had died needlessly due to appalling standards of care."^[17] One month earlier the commission had rated the quality of care at the hospital as "good."^[18][19]

Winterbourne View

Winterbourne View was a private hospital at Hambrook, South Gloucestershire, owned and operated by Castlebeck. It was exposed in a Panorama investigation into physical and psychological abuse suffered by people with learning disabilities and challenging behaviour, first broadcast in 2011.^[20] One senior nurse had reported his concerns directly to CQC, but his complaint was not taken up.^[21] The public funded hospital was shut down as a result of the abuse that took place.^[22] Cynthia Bower, then the chief executive of the commission, resigned ahead of a critical government report in which Winterbourne View was cited.^[23]

Ash Court

Ash Court is a residential nursing home for the elderly in London, operated by Forest Healthcare.^[24] In April 2012 hidden camera footage was broadcast in a BBC Panorama exposé which showed an elderly woman being physically assaulted at Ash Court by a male carer and mistreated by four others. The standard of care at the nursing home had been rated "excellent."^[25][26] The victim was an 81 year old woman suffering Alzheimer's disease and severe arthritis.^[27] Although the commission's primary function is to enforce national standards including safeguarding the vulnerable and "enabling them to live free from harm, abuse and neglect" the CQC responded by stating that they "should not be criticised for failing to protect people from harm" and could not be expected to spot abuse "which often takes place behind closed doors."^[28][29]

Grant Thornton report

In August 2012 chief executive David Behan commissioned a report by management consultants Grant Thornton.^[30] The report examined the CQC's response to complaints about baby and maternal deaths and injuries at Furness General Hospital in Barrow-in-Furness, Cumbria and was instigated by a complaint from a member of the public and "an allegation of a "cover-up" submitted by a whistleblower at CQC."^[31][32] It was published on 19 June 2013.^[33]

Among the findings, the CQC was "accused of quashing an internal review that uncovered weaknesses in its processes" and had allegedly "deleted the review of their failure to act on concerns about University Hospitals of Morecambe Bay NHS Trust." One CQC employee claimed that he was instructed by a senior manager "to destroy his review because it would expose the regulator to public criticism."^[33] The report concluded: "We think that the information contained in the [deleted] report was sufficiently important that the deliberate failure to provide it could properly be characterised as a 'cover-up'."^[34] David Prior, who joined the commission as chairman in January 2013, responded that the organisation's previous management had been "totally dysfunctional" and admitted that the organisation was "not fit for purpose."^[3]

On 20 June 2013, Behan and Prior agreed to release the names of previously redacted senior managers within the Grant Thornton report, who it is alleged had suppressed the internal CQC report. The people named were former CQC Chief Executive Cynthia Bower, deputy CEO Jill Finney and media manager Anna Jefferson. All were reportedly present at a meeting where deletion of a critical report was allegedly discussed. Bower and Jefferson immediately denied being involved in a cover-up.^[35] The Guardian newspaper reported on 19 June 2013 that Tim Farron MP had written to the Metropolitan Police asking them to investigate the alleged cover-up.^[36]

Related issues

• Criticism of the National Health Service

References

External links

• Official website