05/12/05 - Inspectors under fire

The NCA were shocked at the numbers of homeowners and managers who felt bullied or intimidated by the inspection process following on from this was a reluctance to complain in case of retaliation.

These issues were highlighted during 16 seminars held during April, May and July 2005 to consult with practitioners in the Social Care Sector about what would improve inspection for the benefit of service users.

Below are some of the Key points made by Owners & Managers

The managers and owners felt that on too many occasions the personal views of the inspectors informed the inspection process and the report. Managers were voluble in their concerns that inspectors thought that it was appropriate to comment on the decor of a care home for instance, not because it was not of a satisfactory standard but because the inspector did not like it.

Managers and owners were extremely concerned at the pressure that was put on staff both by the inspection process itself but also by the inspectors. Many members of staff had complained to their Managers of feeling intimidated

Focus on paperwork rather than care outcomes.

It is essential that regulation be changed to ensure that inspection concentrates on what is important rather than what can be easily measured, inspection is for the benefit of service users and not for inspectors.

Requirements for CRB and POVA checks

There were a number of concerns here, the primary one being that the law forced the care sector to be reliant on a third party to comply with legislation and that third party (CRB) frequently failed to complete checks within an acceptable length of time. This forced providers into an unacceptable dilemma.

POVA first is improving but still there are from time to time unacceptable delays in receiving a response.

Inspectors often required CRB checks to be carried out on newly arrived members of staff from abroad.

There should be clear guidance on such matters as in most cases this is just a waste of money.

Amending Reports

The refusal of inspectors to change things on reports even when factually incorrect led to a lack of faith from providers in the whole system.

Managers were at a loss to understand why inspectors refused to change things in reports, which are clearly incorrect.

Reports should reflect the positive as well as the negative.

Failure to do this has a depressing impact on the morale of management and staff. This concentration on the negative was perceived to be a reflection of the attitude of some local offices i.e. Inspection is to identify failure rather than where appropriate to celebrate good practice.

If criticising something then advice on what would be an improvement should be freely given.

The refusal of so many inspections to offer constructive advice when they have identified something that they believe can be improved is incomprehensible and unacceptable.

Inspectors inspecting in specialist areas where they have no expertise or experience.

There was genuine resentment from managers from all categories of care at being inspected by people who have no knowledge of the client group being inspected.

Are Inspectors trained?

There was a genuine belief that uniform training of inspectors would lead to a more consistent approach to inspection.

Too many Standards which can only be measured by

The inspection of paperwork

The owners and managers attending the seminar genuinely wanted the quality of their care provision to be inspected rather than their paperwork

It was felt that the focus of inspection through the current national minimum standards is on paperwork.

Paperwork is of course necessary but the ability to observe and monitor the care being provided is a skilled task, because care can never be exactly determined, should not be a reason for failing to inspect care.

Paperwork does not inspect care it provides underpinning information. Contact with service users and their advocates or family is essential.

Feedback from Inspection

Often the reports bear little relation to the feed back at the end of inspection.

In every way there must be consistency in the inspection process.

Notes relating to the feedback at the end of inspection should be signed.

Any serious matters must be recorded in the feedback notes.

It is unacceptable for an inspection report to bear little resemblance to the issues raised at the feedback.

2 Scoring Methodology

The current scoring method is not perceived to be a useful tool as it is dependent on the view of individual inspectors.

The scoring method was not welcomed by providers, it was inconsistent and providers felt that it was a subjective rather than an objective method.

Any scoring method should simply be:

Standard Met
or
Standard Not Met

Specialist Standards

There need to be standards for all specialisms e.g. dementia care, brain injury etc. There was a strong belief that as well as core standards, there also needed to be standards for each individual specialism.

Provider Feedback

There was universal resentment and anger amongst managers that provider's comments are no longer to be included with the inspection report. If the inspection were just carried out against the regulations then there would be no objection, but when the majority of the report relates to the subjective view of one inspector about meeting the National Minimum Standards, then the providers felt that they had the right for their response to be included.

If a provider or manager raises a question at the inspection, even the most general of questions such as what is the process if the home is sold, this appears in the report.

Owners and mangers should be able to ask questions and discuss any relevant matter without them becoming part of a public document.

Inspection should only measure regulation.

National Minimum Standards should be part of a separate evaluation

Source : NCA