Care home regulation 'not fit'

Written By Unknown on Sabtu, 01 Desember 2012 | 21.24

1 December 2012 Last updated at 07:16 ET

Regulation of the care sector is not fit for purpose, care minister Norman Lamb has said as he unveiled proposals on English care homes for consultation.

He also said there was a "significant lack of corporate accountability for the quality of care".

One suggested measure involves companies having to open up their books to inspectors to ensure they are financially sound.

Proposals were drawn up after the collapse of Southern Cross last year.

The country's biggest provider had thousands of elderly residents at more than 750 care homes across the UK.

Mr Lamb said its demise showed the need for "greater oversight of providers' finances".

Speaking to BBC Radio 4's Today programme, he widened out his concerns to include the recent case of abuse uncovered at the Winterbourne View care home in Bristol: "I think there is a significant lack of corporate accountability for the quality of care that is provided in care homes and in private hospitals and that's something that I'm determined to address.

"I've been looking at that in terms of the government's response to the horrors of Winterbourne View. And I just have a sense that the whole regulatory model for the care sector is not actually yet fit for purpose."

Rent bill

There had been concerns about Southern Cross's business model for years and it struggled to balance the books as local authorities reduced the amounts they were spending on social care.

Continue reading the main story

When a patient or service user is moved from one care setting to another due to providers failing, it can have catastrophic effects on their mental and physical health"

End Quote Dr Peter Carter Royal College of Nursing

The firm was brought down by having to pay a £250m rent bill as councils made cuts.

After its collapse, other operators had to step in to take over the care of more than 30,000 people.

The Department of Health has started a consultation on how to prevent such a situation happening again.

One proposal is to give regulators the power to go through the books of the biggest providers and challenge them to prove their business models are sound.

Regular checks

Mr Lamb said there did not appear to be any current providers who were in the same financial state as Southern Cross was just before its collapse, "but you have to keep this regularly under check, because the level of anxiety people suffered as a result of what happened with Southern Cross is completely unacceptable".

If things go wrong, a "much more planned and controlled exit" was needed, "so that no-one is adversely affected", he added.

"We want to make sure every person receiving care and support will continue to get the care they need if a provider exits the market, regardless of whether they are paid for by the state or pay for care themselves.

"Southern Cross demonstrated that we need greater oversight of providers' finances and better plans to support people if their independent provider goes out of business."

Regular requests for information about company finances would be made by the regulator, and Mr Lamb stressed that it would also challenge business models that were very complex or looked unsustainable.

'Tackle the crisis'

Shadow health minister Liz Kendall said Labour was concerned about whether the proposed requirements on care home providers to provide financial information were sufficiently strong.

It would also examine whether the Care Quality Commission or Monitor, an independent regulator of NHS foundation trusts, had the skills, experience or resources to properly scrutinise the financial structures of companies, or the power to take effective action to prevent financial failure if risks emerge.

"However, the underlying challenge facing the government is to tackle the crisis in social care funding. There have been financial pressures for many years, but the government's cuts are now driving care services to breaking point."

Dr Peter Carter, chief executive and general secretary of the Royal College of Nursing, said the proposals were a "welcome step forward".

"For some time we have been concerned about the ability of providers to deliver high quality care and run on a sound financial footing," he said.

"When a patient or service user is moved from one care setting to another due to providers failing, it can have catastrophic effects on their mental and physical health."

In Wales, care homes are regulated by the Care and Social Services Inspectorate Wales (CSSIW); in Scotland, the Care Inspectorate is responsible for regulating care homes; while in Northern Ireland, care home standards are the responsibility of the Regulation Quality Improvement Authority (RQIA).

Last year, the Scottish government changed its regulations so that care homes faced at least one unannounced inspection each year.

The toughening up of the regulatory system was in response to concerns that the inspection regime was not up to scratch following the deaths of two former residents at an Edinburgh care home and the collapse of Southern Cross care home provider.


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