BBC investigation: care inspection cuts hit frail and elderly

BBC investigation: care inspection cuts hit frail and elderly

Following the latest survey of care inspectors and workers, unions have slammed cuts to care inspections and called for urgent ministerial talks. The issue was the subject of a new series of BBC Radio’s File on Four, which highlighted how abuse at care homes goes unmonitored.

More than three-quarters of union members in the Commission for Social Care Inspection no longer have confidence in the government’s new care inspection regime that has slashed care home and homecare inspections by almost half (47,341 in 2005-06 to just 26,676 last year).

In a joint-union survey of members working at the CSCI 76% of staff (two-thirds inspectors) did not feel ‘confident’ that new methods of checking care ‘provides a robust assessment of the risk to service users’. And some 81% of staff felt that more frequent inspections are necessary, rather than less.

On behalf of Prospect’s members in the CSCI, negotiator Rose Willis said: "This drive for deregulation with the introduction of ‘star ratings’ and self-assessment is dangerous. It is just not suited to care homes and home care providers responsible for some of the most vulnerable in society often at a time when they are facing the end of their lives.

"As the union that represents inspectors in another regulatory body, the Health and Safety Executive, we are all too aware of the impact swingeing cuts and a reduction in inspection activity has had as borne out by this year’s figures for workplace fatalities.

"We have no doubts with CSCI that less staff, coupled with less inspection and monitoring activity will result in a rise in cases of poor service and an increase in the length of time service users have to suffer before problems are identified."

The CSCI is moving towards a less rigorous inspection model that includes plans to axe over 350 posts. Under the new ‘proportionate’ ‘risk-based’ system for care inspection, care homes might only be inspected once every three years (previously, twice a year). Instead ‘annual service reviews’ are now scheduled, whereby inspectors assess a self-evaluation formed filled in by providers with no site visit necessarily taking place.

At the same time CSCI will not investigate complaints from service users or family representatives – instead under the new procedures these are referred back to the service providers’ own complaints procedures. Vulnerable service users will find it too difficult to register concerns, complaints won’t automatically be followed up, and patterns of concern won’t be identified until it is too late, say CSCI staff and service users.

UNISON national officer for social care, Helga Pile, said: "Cutting the amount of care service inspections, staff numbers and channels to register complaints can only ever leave our elderly and vulnerable service users even more at risk. We urgently need a ministerial review, because clients will suffer in silence as fewer inspections make it harder to identify problems on the ground. This is why our members are telling us the care system is going backwards."

Chief Executive of The Relatives and Residents Association, Dr Gillian Dalley, said: "We are very concerned that care services’ regulation has been weakened in recent years with the reduction in the frequency of inspections of care homes and the huge cut in the overall budget for regulating social care. Like the public at large, we want more and better inspections rather than fewer."

Melanie Cullen of the Royal College of Nursing said: "CSCI say the new inspection regimes are better but in fact they are just driven by the need to reduce costs. Our members say the changes will put vulnerable people at greater risk. Funding to the regulators is set to further decrease in 2008-09. The public need health and social care to be comprehensively regulated and inspected and government must provide adequate funding for this."

In a letter today, unions have called for a moratorium on job cuts and urgent talks with Care Minister Ivan Lewis to resolve growing concerns from clients and practitioners.

*UNISON, the Royal College of Nursing, Prospect and Unite are the unions representing staff at the Commission for Social Care Inspectorate. The campaign is also supported by The Relatives and Residents Association.