The Care Quality Commission (CQC) has published its first issue of a new quarterly report based on the results of unannounced inspections of over 14,000 locations, which reveals patterns of compliance in England's health and social care services.
The Market Report looks at how well the sectors now regulated by the CQC are meeting the required standards of care, and showed the majority of providers to be meeting the Essential Standards of Quality and Safety, with 77% in NHS services and 82% in independent healthcare in compliance.
However, the inspection data highlighted common patterns of poorer performance across the different health and social care sectors. Areas of concern included the management of medicines, with 17% of all locations inspected failing to meet this essential standard; staffing issues, with 11% of locations failing to meet one or both of the two standards related to staffing; and record keeping, with 15% of locations failing in this standard.
CQC inspectors said they had seen a worrying number of cases where risks associated with medicines were not properly managed in the locations they visited. The risks included inadequate information being provided for people taking the drugs, for those caring for them or for staff administering the medicines. Social care environments, in particular, were experiencing an increased demand in this area due to the growing complexity of drug treatments and a rise in co-morbidity.
In one case, Barchester Healthcare Homes Ltd was formally warned by the regulator that it was failing to comply with Regulation 13 of the Health and Social Care Act when inspectors found in one of its nursing homes in north London that people were missing doses, poor records meant no one could tell whether some medicines had been given, and the system for ordering medicines to be ineffective. In one month, prescribed medicines ran out so people missed drugs, including pain relief, for up to five days. One person should have taken an anti-coagulant every day but the medicines chart showed this had not been administered for more than two weeks; staff said they had been waiting for advice from the GP or hospital.
The inspectors also found that, across the sectors, the wrong numbers of staff, a lack of support for staff to do their job, the non-availability of temporary staff and vacancies being left open for a number of months all compromised an organisation’s ability to comply with essential standards and affected the quality of care given, as well as staff training and supervision.
Other common areas of non-compliance were records being incomplete or not up to date, not kept securely or confidentially or not stating that risks to people had been identified and were being managed.