Watchdog’s use of service-user inspection scheme has fallen sharply since 2015

The care watchdog is only managing to send service-users to assist on just over half of its inspections of residential homes, care agencies and day centres in England, new figures have revealed.

The Care Quality Commission (CQC) has repeatedly insisted that it views the Experts by Experience (ExE) programme as a vital part of its inspections of both social care and health services.

But figures obtained by Disability News Service (DNS) under the Freedom of Information Act (FoIA) show that, in the latest quarter, just 57 per cent of social care inspections involved an ExE.

That figure is 15 percentage points lower than it was in the third quarter of 2014-15.

The previous year, in October 2013, CQC had said it wanted to make greater use of the ExE programme.

Instead, the proportion of inspections using ExEs fell during 2014-15 and through to early 2016, during the chaotic CQC process that saw the former government-owned firm Remploy taking over three of four regional contracts to run the ExE programme at the start of 2016. 

In the final quarter of 2015-16, just 23 per cent of social care inspections included an ExE.

That has slowly risen in the last two years, but it is still far lower (57 per cent) than it was in the third quarter of 2014-15 (72 per cent).

Claire Bolderson, a former ExE, now campaigns for improvements to the way Remploy runs its part of the programme and to the pay ExEs receive.

She said: “The whole idea was to put more money into the programme to substantially increase numbers, with the aim of increasing ExE involvement in inspections.

“This has obviously failed.”

Figures published by the Choice Support consortium, which won the other regional contract – across central England – appear to show that a significant cause of the ExE problems is the way that Remploy has managed its contracts.

Choice Support says its ExEs took part in 2,118 social care inspections in 2016-17 (38 per cent of the total), which – because there were 5,621 that year across the four regions – means there were just 3,503 across the three Remploy regions.

Choice Support also says it employs more than 320 ExEs in its one region, compared to what are believed to be about 500 employed by Remploy across its three regions, about half the number per region compared with Choice Support.

Although the Choice Support region is the largest of the four, it only accounts for 32 per cent of all inspections, with more than two-thirds taking place in Remploy areas.

The latest figures have added to concerns about CQC’s inspection record.

In November, DNS reported on figures – also released by the commission following an FoIA request – that showed how the number of inspectors working for the watchdog had fallen sharply over the previous year, with the number of adult social care inspectors falling from 850 to 787.

Remploy, the disability employment business formerly owned by the government but now mostly owned by the scandal-hit US company Maximus, has attracted heavy criticism for its delivery of the three regional ExE contracts.

It was hit almost immediately by accusations of incompetence when it took on the contracts in February 2016, with claims of resignations, confusion and cutbacks.

Internal reports secured by DNS, again through an FoIA request, show CQC was forced to write “formally” to Remploy three times over its concerns about its performance on the ExE contracts.

And last October, DNS revealed that Remploy was failing to make the most basic background checks on its new ExE recruits.

Bolderson said: “They’re still not back up to the levels of 2014-15 and that’s with massive intervention from the CQC’s engagement team, who have had to focus a great deal of resources on trying to bring Remploy up to scratch, mostly by passing on concerns and complaints that we bring to their attention.”

She is critical of CQC for “handing this enormous contract to a company with no experience at all of running this kind of programme”, “no existing infrastructure to support the work”, and substandard training and recruitment programmes.

CQC is currently retendering all four ExE contracts.

A CQC spokeswoman said the failure to return to 2014-15 levels of ExE engagement “reflects the changing approach to our inspections – with fewer planned inspections and a lot more that are responsive and urgent – which by their very nature will not always be possible to include an Expert by Experience”.

She said this had “resulted in fewer requests for Experts by Experience support across all four regions”.

But when asked how many fewer planned inspections there had been, she then claimed that “all inspections are planned”, although she failed to provide any figures to back up her claim that more inspections were now “responsive and urgent”.

She declined to say whether 57 per cent was now its target, or whether CQC was still trying to increase the proportion of inspections involving an ExE.

The CQC spokeswoman said that because Choice Support had previously been involved in the ExE programme before the new contracts were awarded in late 2015 it “had already built relationships with inspection teams”, which helped explain its higher number of ExEs and inspections.

She said it was “never the aim” to have an ExE attending all CQC inspections because “it would not be practical” because of “factors such as the size, urgency and risk of a service”.

But she added: “Both Remploy and CQC have acknowledged that there were challenges in the implementation of the EXE contract in 2016 and we have worked together and with our Experts by Experience to address these issues in a systematic and co-ordinated way.”