Andrea Sutcliffe, Chief Inspector of Adult Social Care at the Care Quality Commission
The appalling lack of care we witnessed on last night’s Channel 4 Dispatches programme about Bupa care homes is utterly unacceptable and has no place in today’s society. None of us would want someone we love to be subject to such inhumane treatment and it is heart breaking for the people and families affected.
There is no excuse for this sort of care. Providers paid to look after people in the most vulnerable of circumstances need to meet their responsibilities to deliver the safe, high quality care people using their services and their families have every right to expect.
CQC did not need a Dispatches undercover investigation to know about the poor standards of care at Crawfords Walk. We rated the home as Inadequate last year and following our inspection in March this year, were already in the process of taking action to enforce improvements. We have been very clear with Bupa that failure to meet the conditions we have set will result in further action, including prosecution.
The programme suggested that Bupa had tried to deceive CQC during our inspection about staffing levels by having more staff on shift (on the second day of our two-day unannounced inspection) and warning workers not to share concerns about understaffing. The expert on the programme was rightly outraged by this apparent deception but if it was deliberately done, it failed. Our careful review of the needs of the residents, staff availability and observation of practice revealed that we did not believe there were enough staff on duty to meet people’s needs and Bupa already knows this.
Bupa has a clear responsibility to make the care homes they manage worth living in. The evidence from last night’s programme and our own inspections show that this obligation is not being met in all their homes and I truly believe Bupa has betrayed the very people it is paid to look after. My inspectors should not be arriving at 6am in the morning to find older people washed, dressed and back in bed or asleep in chairs because it suits the home. That’s not respectful or treating someone with dignity and compassion. That’s about running the home to suit the institution not the needs and choices of the people living there.
Bupa has taken action in relation to individual members of staff but it is the culture of the home that also needs addressing. And that culture starts with the expectations, support and priorities of the corporate team. I know that many of Bupa’s homes provide a good standard of care and others have improved over the last year. But Crawfords Walk is not the only Bupa home CQC has rated poorly and there needs to be a concerted effort on behalf of the senior team to address these concerns.
The Dispatches programme rightly caused anger among viewers — much of it properly directed towards Bupa and the staff filmed. Some was directed at CQC with people questioning what we had done and what more would we do.
For Crawfords Walk — we are already taking action and have warned the company of the consequences of failing to comply.
For poor services across England — currently we have 3% (663) of services rated Inadequate and 21% (4,896) rated as Requires Improvement. All of them know where their failings are; what they need to do to improve; and what the consequences are if they do not. We know from experience that a third of services rated Inadequate will stop operating and of those remaining, 75% improve while roughly half of the Requires Improvement services improve, indicating more needs to be done.
Our proportion of enforcement action has steadily increased over the past two years, including five prosecutions of providers and more in the pipeline. We will not hesitate to use our legal powers against any provider, regardless of their size or name that cannot or will not improve a service, to remove it from the market.
Can CQC do more? Yes, we can. We published our consultation proposals last week for further improvements in our registration and inspection processes, for example, to register at a corporate level of an organisation, like Bupa so that we can truly hold to account all those who are responsible for the quality of care. I am also determined to pursue a change to our regulations to lift the restrictions on reporting enforcement actions underway which prevent us from sharing this important information with the public.
There is good care in England thanks to thousands of dedicated, committed staff and providers. But we know that more than one in five services is not delivering the good care people have every right to expect and deserve. As the regulator, CQC has a part to play in setting expectations, monitoring services, inspecting, rating and taking enforcement action. But we cannot rely upon regulation alone to ensure that 25,000 adult social care services meet these expectations. That takes a collective effort of staff, providers, commissioners and funders working with the regulator, listening and responding to the voice of people using services, their families and carers to really make quality matter.