Care watchdog faces new questions over inspection failures


The care regulator faces further serious questions over its failure to root out evidence of abuse and poor standards, after publishing a series of reports into services run by the company at the centre of a major care scandal.

The Care Quality Commission (CQC) today published reports into standards at 23 services for people with learning difficulties run by the care provider Castlebeck.

The reports were ordered after a BBC Panorama investigation uncovered serious allegations of abuse at Winterbourne View, a private “hospital” near Bristol for people with learning difficulties, which was run by Castlebeck.

Of the 23 Castlebeck services reviewed, CQC found “serious concerns” with four of them, while a further seven failed to “fully comply with essential standards of quality and safety”.

The watchdog said it was taking enforcement action against the four services – Arden Vale in Meriden, Solihull; Cedar Vale in Nottingham; Croxton Lodge in Melton Mowbray; and Rose Villa, on the edge of Bristol – but for legal reasons could not yet say what that action was.

Among the concerns unearthed at Arden Vale, a private hospital, CQC found people with learning difficulties were “not always adequately safeguarded from physical and emotional harm”; at Cedar Vale, another hospital, CQC concluded that patients “may not be protected from abuse” and “were not always protected from harm”; and at Croxton Lodge, another hospital, CQC said people living there were “not safeguarded against potential abuse” and were “not safe”.

Castlebeck had already suspended four members of staff from the fourth service, Rose Villa, a home for nine adults with learning difficulties situated less than 10 miles from Winterbourne View.

CQC gave Rose Villa a “good”, or two-star, rating after an inspection last year. But this week’s report lists a string of concerns, including evidence of a failure to protect some people against the risk of abuse, and decisions that restricted the liberty of residents.

Two of the other three services have also been inspected by CQC in the last 18 months.

CQC inspected Croxton Lodge this March, and concluded then that it was protecting people from abuse, in contrast with its new report.

Cedar Vale was last inspected in January 2010, when the CQC praised the staff’s “good progress” and “commitment”, following previous concerns over care standards.

Arden Vale, the fourth of the services, was last inspected in October 2007, when the Healthcare Commission – the CQC’s predecessor as healthcare regulator – reported that a string of standards were either “almost met” or “not met”.

Since 2007 – despite those concerns – the two regulators had decided it was not necessary to inspect Arden Vale, until the latest series of reviews.

The new CQC reports also identify company-wide concerns with Castlebeck, such as problems with training, inadequate staffing levels, and a failure to notify the authorities about safeguarding incidents.

When asked whether the new reports again demonstrated its previous inspection failures, a CQC spokesman said the “primary responsibility for safety rests with providers and the staff who work for them”, while commissioners – such as local authorities – also have a part to play by “not rewarding poor practice”.

He said CQC’s role was “mitigating the likelihood of people being harmed” and “dealing with failure… within a legal framework that sets out acceptable standards of care and gives us enforcement powers to take action when we need to”.

He added: “What we cannot do is guarantee people’s safety in each and every interaction they have with care – nobody can do that.”

A Department of Health (DH) spokeswoman said that both DH and CQC were “committed to learning lessons from Winterbourne and driving up standards across social care, acting quickly where there are signs of poor care”.

She said: “This isn’t just about the regulator: commissioners and providers need to work better too.

“The owners of Castlebeck in particular must take a hard look at these reports and take tough action now to ensure they do what they should have been doing all along – protecting the vulnerable people who had been placed in their care.”

The 23 new reports were published just days after CQC defended the failure of its inspectors to uncover evidence of serious abuse at Winterbourne View before the BBC investigation, as it published its damning report into the alleged abuse at the hospital.

Care services minister Paul Burstow said the new set of CQC reports was “deeply disturbing and indicates levels of care that are unacceptable” at Castlebeck.

He said he had appointed Imelda Redmond, chief executive of Carers UK, to work with the government on how to improve the quality of social care.

Castlebeck admitted that some of its services had “not met the high standards we would expect to achieve” and that it was “committed to addressing all of these shortcomings as a matter of urgency”.

28 July 2011

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