The care regulator has admitted to shocked MPs that many service-users, relatives and care staff who have reported safeguarding concerns about a care home or hospital may still be waiting for a response five months later.
The Care Quality Commission’s outgoing chair and its new chief executive were giving evidence about the under-fire regulator’s work to the Commons health and social care committee yesterday (Wednesday).
The commission’s chief executive, Sir Julian Hartley, had been asked by disabled Labour MP Jen Craft if the regulator had the capacity to deal with the backlogs it faced in registering new providers and dealing with safeguarding reports.
He said that nearly a third (29 per cent) of new providers seeking to register with the Care Quality Commission (CQC) were waiting more than the 10-week target.
But he also told Craft that the backlog in dealing with “notifications and information of concern” was “another key priority”*.
He said this related to health and care providers “who notify us of major issues and incidents and changes” but also to “people [who] contact the CQC with major issues of concern”.
Craft said: “There’s a potential there for quite significant safeguarding issues around people flagging things early on.”
Sir Julian replied: “Exactly”.
He said there was currently a backlog of about 5,000 such concerns.
Craft said it felt as though “at the moment there is a potential for [the system of dealing with concerns] to go very badly wrong for individuals and for their families”.
Asked by Craft for the longest that people were waiting for CQC to respond to such concerns, Sir Julian said the “oldest case with no action” was from 19 August last year.
Asked if that was someone who had reported a concern and had not received a response from CQC, he said: “I believe so.”
Craft told him: “You can appreciate the level of shock that I think we felt on that.”
Sir Julian and Ian Dilks, the outgoing chair, also told the committee that the flawed IT system introduced by CQC towards the end of 2023 meant many assessment reports drafted by inspectors could not be published because they were “stuck” in the system and could not be accessed by staff.
Andrew George, a Liberal Democrat member of the committee, said his “shocked” colleagues’ “jaws were on the floor when we heard this”.
Sir Julian said he did not disagree and had “immediately” commissioned an “urgent” independent review by an IT expert to understand “what had gone wrong and why” when he heard what was happening.
The evidence session followed the publication last October of the final report into CQC’s effectiveness by Dr Penny Dash, which found an “urgent need” for a rapid turnaround in the way CQC operated.
It found that, over the last five years, the proportion of health and care settings that had never received a rating had risen from 13 per cent to 19 per cent, while the average age of a rating (the time since it was published) had almost doubled, from two years in 2020 to three years and 11 months in 2024.
In response to a question from the committee’s Liberal Democrat chair, Layla Moran, Sir Julian appeared to accept that, three months on from the report’s publication, the regulator could still not guarantee that the care homes, hospitals and other settings it inspects were safe.
After Moran asked if “patients and families” can be sure that “the care home their mother is in or the hospital their child is being treated in” were safe as a result of CQC’s inspections, Sir Julian said the Dash review “was very clear that poor operational performance is impacting our ability to ensure that health and social care services provide people with safe, effective, compassionate and high quality care”.
And he said there were “multiple issues that need urgent resolution”.
When asked by Moran for a “yes or no” answer on safety, he said: “We’re not delivering for people. I’m sorry I went round the houses on that.”
He said later that the regulator “had to get back to doing more assessments” and that it needed to “speed up registrations”.
Dilks, who was appointed three years ago, apologised for the failings exposed by the Dash review and said CQC had “not done what it should have been doing over a period of time, but most particularly over the last year to 18 months”.
He said: “I would love to be sitting here saying, as the outgoing chair, that this organisation is in a much better shape than everybody thought it was, and I can’t say that, for which I am personally very sorry.”
He also told the committee that he had not had regular meetings with the health and social care secretary or the relevant minister under the previous two governments, which Moran said after the meeting was “incomprehensible”.
Dilks said CQC had decided it needed to change in 2018, and had commissioned consultants two years later.
It then decided in 2021 to carry out “a much more ambitious strategy”.
But it was not until the end of 2023, when new technology was being deployed, “that the scale of the problems really became obvious”.
He said that some of the strategic decisions were “not the right decisions”, the strategy was “too ambitious”, the technology failed to “deliver”, and CQC failed to “engage well enough” at the beginning of the process with its own staff.
*Longcare Survivors: The Biography of a Care Scandal, by John Pring, editor of DNS, was published in 2011 and is available through the DNS website. It investigates the horrific abuse of adults with learning difficulties that took place at two residential homes in south Buckinghamshire in the 1980s and early 1990s, and how the repeated failings of the inspection and regulation system allowed the abuse to continue for so long.
Picture: Sir Julian Hartley (left) and Ian Dilks giving evidence
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