CQC’s care agency COVID deaths secrecy ‘puts commercial interests before disabled people’

The care regulator has been accused of prioritising the financial interests of home care agencies over the safety of disabled people, after refusing to release information that would show which of them have reported deaths of service-users linked to coronavirus.

The Care Quality Commission (CQC) has told a campaigner that releasing details of which care-providers have experienced COVID-19-related deaths could put their businesses at risk.

CQC was responding to a freedom of information (foi) request from Dr Minh Alexander, a former consultant psychiatrist and NHS whistleblower.

A previous foi response to Alexander revealed that, between 10 April and 20 August, domiciliary care providers in England notified CQC of 892 deaths of service-users that were confirmed or suspected to have resulted from COVID-19.

These deaths were reported by 474 different care-providers, with 166 of them reporting more than one death.

Other than hospices that provide community services, the highest number for a single service was eight deaths.

But when Alexander asked in a follow-up foi request for details of which service-providers had reported coronavirus deaths, CQC refused to provide the information.

One CQC explanation was that just because an agency had reported a death, did not mean that service-provider was unsafe.

Another reason for the refusal was that agencies only need to notify CQC of deaths that may have occurred as a result of, or during, the provision of care by their staff, and there is “still some inconsistency in approach meaning that some domiciliary care providers notify CQC of deaths when this is not required under the regulation”.

CQC told Alexander that releasing the information “risks creating confusion as to the prevalence, spread or impact of the virus”.

And it said that “worried families” could “seek to transfer loved ones from services which have notified CQC of deaths to others which have not and which are therefore – mistakenly – perceived to be safer”.

CQC said that this “may result in significant impact upon providers who are already facing serious financial pressures” and “may act as a disincentive for providers to properly notify CQC that deaths are suspected to be COVID-19 related”.

CQC concluded: “Given the exceptional circumstances, CQC is therefore not currently releasing location-level data about death notifications by care services received during 2020.

“We are keeping this position under regular review and we do intend to publish more data when the level of risk is lower, so that the pandemic response by the government, providers and CQC can be subjected to proper, public scrutiny.”

But Alexander said she was concerned that CQC was asking the public to trust it when it had already been guilty of “an unforgivable lack of protection and accountability”.

She said: “It seems very arrogant that the regulator, which lamentably did not start requesting COVID-19 deaths data from care providers until well into the pandemic, now says, to paraphrase: ‘You’ll just have to trust us to know what’s best for now, and ask us questions when it’s all over.’

“The key issue is that we are facing winter pressures and a second wave, and there is no assurance that CQC and the government have learnt all the lessons of the first wave.”

Mark Harrison, of the Reclaiming Our Futures Alliance, an alliance of disabled people and disabled people’s organisations in England, said: “They are putting the commercial interests of private home care providers ahead of openness and transparency and the interests of disabled people of all ages.

“The other thing is that we don’t trust the CQC.

“They have demonstrated through their lack of credible inspection that they are not to be trusted.

“The care home scandals of Winterbourne View and Whorlton Hall have been broken by television companies and not by the CQC.”

He added: “CQC, at the beginning of the COVID pandemic in March, suspended inspections of the assessment and treatment units [and other services] when they should have been stepping them up.

“They put the interests of CQC and their staff before the residents, so at a time when doctors and nurses and bus drivers were putting their lives on the line, CQC went AWOL.

“They are not fit for purpose.”

Professor Peter Beresford, co-chair of the service-user and disabled people’s network Shaping Our Lives, said: “At best, the CQC response is patronising and out-of-date.

“The whole point of setting up regulatory bodies like CQC was to ensure safety, transparency and effective accountability to service-users and loved ones.

“Taking this decision flies in the face of this, especially during a pandemic where service-users have been disproportionately exposed to risk and death and official information has often been inadequate and unreliable.

“This looks like the latest wrong move from an organisation beset by failure and disaster.”

Alexander said she had started submitting freedom of information requests to CQC on home care-providers because she felt it was an area that had received less media coverage and attention than care homes.

The Guardian ran a story in August which criticised CQC for failing to release similar details about COVID-related deaths in care homes, which it said were “being kept secret by regulators in part to protect providers’ commercial interests before a possible second coronavirus surge”.

Meanwhile, the Department of Health and Social Care this morning (Thursday) announced a six-month extension of its Adult Social Care Infection Control Fund, which had been due to run out this month.

The extra £546 million can be used by local authorities to help social care providers pay staff their full wages when they are self-isolating, and to enable staff to work in only one care home, cutting the risk of spreading COVID-19.

Although the fund is focused on supporting care homes, councils can use 25 per cent of their grant on other COVID-19 infection control measures, including payments to domiciliary care providers or “wider workforce measures”.

These wider measures could include financial support to buy personal protective equipment or measures to “boost the resilience and supply” of the adult social care workforce in their area to “support effective infection control”.

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