Quality of care suffering, says regulator

CQC chief executive David Behan: ''We don't want staff taking at people, but talking to them''

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The quality of services provided to people across the health and care sectors in England is beginning to suffer, according to the regulator.

The Care Quality Commission's (CQC) warning comes after it looked at data from more than 13,000 inspections.

The regulator said staff pressures and the rise in complex cases seen in the ageing population meant everyone from hospitals to care homes was struggling.

Overall, one in four services failed at least one of the 16 key standards.

Among the most commonly failed areas were the standards relating to dignity and respect, nutrition, care and welfare and the workforce, which covers both numbers and skills of staff.

The regulator said the pressures on the system meant staff were increasingly unable to focus on the individual needs of people for whom they were caring.

Instead, they were essentially running through to-do lists in the way they approached their responsibilities.


The CQC said it had created a culture in places that were struggling where the "unacceptable becomes the norm".

It said it was taking enforcement action in places where the most serious failings had been identified.

CQC chief executive David Behan said despite the pressures there was no excuse for poor performance.

Sector-by-sector breakdown

  • NHS - The regulator looked at all 291 providers from hospitals to mental health services. In total, 22% failed at least one standard. It came amid ever increasing demand for care, the report said.
  • Social care - Inspections covered care homes, nursing homes and the help provided to people in their own home. Some 28% failed at least one standard. Problems were most acute in nursing homes, the CQC said.
  • Independent healthcare - Dominated by private hospitals that are increasingly involved in NHS care. But the most worrying performance seen in mental health, learning disabilities and substance misuse. A fifth failed at least one standard overall.
  • Dentistry - The industry had been growing over the past decade, the CQC noted. NHS care accounts for 58% of the market. In total, 12% failed on at least one standard.

"Health and care services need to rise to the challenge," he added.

The stock-take is the most comprehensive yet provided by one regulator.

It covers every corner of the health and social care sectors with the exception of GP practices, which will come under the regulation regime from next year.

The 13,000 inspections cover a third of the health and care sectors.

They incorporate NHS services, such as hospitals and mental health services, care homes, nursing homes, home help, dentistry and the independent sector, which includes private hospitals and charity-run services.

Broken down by sectors, the report showed 22% of the NHS had failed on at least one standard, 19% of the independent healthcare, 28% of social care and 12% of dentistry.

It is the first year the CQC has had such comprehensive data and so a comparison with 2010-11 is not possible.

However, the regulator said during its inspections the picture emerging was one where providers of care were finding it more difficult.

The report comes just a day after the Patients Association warned about standards of care after publishing a dossier of 13 "appalling" cases of care given to NHS patients.

Katherine Murphy, of the Patients Association, said the findings were "scandalous", adding patients were receiving substandard care across the country every day.

And Peter Carter, general secretary of the Royal College of Nursing, said the CQC warning echoed what the union's members had been saying.

"We hope that this report acts as a warning that cutting staff at a time when the country's health care needs are becoming more complex is a recipe for disaster."

Health Secretary Jeremy Hunt said: "While there is much to praise about the NHS and social care today we still need to do much more to raise standards of care across the board.

"I've made it absolutely clear that quality of care needs to be valued as highly as the quality of treatment. And that there can be no hiding place for those providing poor care or sub-standard practice."

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