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Page last updated at 09:44 GMT, Friday, 6 June 2008 10:44 UK
Care inspections 'raise concerns'
Elderly (generic)
The CSCI inspects and reports on care services and councils

An investigation into the watchdog that regulates care homes for the elderly has uncovered concerns that inspections are not being carried out often enough.

A questionnaire of staff from the Commission for Social Care Inspection (CSCI) also raised worries that residents are at greater risk.

The questionnaire was organised by BBC Radio 4's Today programme.

A CSCI spokesman said that the organisation was taking more action against poor providers than before.

The spokesman added that the watchdog, which oversees 18,500 care homes in England, believed that services were improving.

To be honest, I would not leave my dog in 90% of our care homes
Anonymous respondent

An anonymous questionnaire was distributed to more than half of CSCI's employees via unions Unison, the Royal College of Nursing and Prospect.

In all, 30% were returned and more than 200 inspectors took part.

Some replies did not pull any punches.

"To be honest, I would not leave my dog in 90% of our care homes," one inspector wrote.

Another respondent said: "I do feel CSCI is trying to get it right in terms of making the best use of available resources but given the reduced budgets and political agenda, it seems inevitable the system of inspections will become more arbitrary and less responsive to the needs of those who live in care homes."

'Less protected'

The BBC sent out the questionnaire after receiving concerns from a small number of inspectors. One contact told reporter Jon Manel:

"Homes aren't inspected as frequently as they were before. We rely a lot on information given to us by the providers of a service to say how good that service is. When we actually go out to visit the homes they are completely different to what the proprietors have actually told us in their feedback to us."

The contact added that at one time, all homes would be inspected a minimum of twice a year.

"That's now changed and we'll be inspecting homes anything from what could be a weekly or monthly process for very poor homes right up to a maximum of one inspection in three years.

"Services can change - even excellent services have been seen to go down to poor in the last year."

Care homes now also carry out self-assessments.

Complaints raised by families about homes are no longer looked into by the watchdog. Instead, the complaint is passed to the care home owner or the local authority which funds the individual.

The CSCI says the new system helps the organisation focus on improving the performance of below-standard homes.

Elderly (generic)
The questionnaire suggested inspectors were not doing enough inspecting

'Huge pressure'

The BBC was also told that an inspector had been forced by a CSCI manager to change the outcome of an inspection.

The contact said: "For me the issue was the care is poor and if it is poor, we need to say it is.

"However the pressure I was under was huge and so against my own judgement, I made the rating adequate."

The contact said that a poor-performing home required a lot of extra work. The contact said:

"As soon as a poor home comes on the radar, then an inspector's time and a manager's time is focused on that home.

"Managers don't want that but inspectors do because that's what we're there for."

Another questionnaire respondent said care homes were now effectively policing themselves.

"All people using care services regulated by CSCI are in effect less protected than previously because we are inspecting them less on the basis care services will police themselves."

The home was poor throughout and needed enforcement action to be taken but the regulation manager did not want this to happen - too many poor homes this year
Anonymous inspector

'Improving services'

A CSCI spokesperson said that the organisation had consulted widely and received widespread support for the way it was carrying out inspections.

"Our new way of inspecting allows us to be much tougher with poorer providers than before.

"The evidence is clear. Services are improving. And we are taking more action against the poorest providers than ever before.

"Our new quality ratings for all providers will also give them a further incentive to improve. With better information people are likely to choose the best services, which will thrive.

"The poorest services will face closure by us unless they improve."




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