CQC ratings are crumbling. Lean on health and safety instead.

In recent years, over half of care homes in the UK have been rated as ‘inadequate’ or ‘requires improvement.’^[1] Between 2019 and 2022, the number of care homes specialising in dementia who received a rating of ‘inadequate’ more than quadrupled, from 2% to 9%.^[2]

Now, the CQC’s own chief has said that CQC ratings can no longer be trusted. As a result of ‘too few inspections and reports that are years out of date’, Sir Julian Hartley has admitted that CQC ratings are no longer a reliable indicator of a home’s quality.^[3]

The picture may look bleak, but there’s now an increased need for care organisations to distinguish themselves using the metrics that are still trusted – namely health and safety, which remains a pillar of the CQC’s approach and forms the basis of one of their five key questions.

When no CQC inspection has taken place for 12 months, the organisation will still use an annual service review to determine your company’s adherence to health and safety.

Case studies: when care organisations get health and safety wrong

Care home residents are often incredibly physically and mentally vulnerable. The high-risk nature means that getting health and safety right at your organisation is therefore of the utmost importance to keep residents and staff safe.

But what happens when care companies get things wrong?

Care home fined more than half a million after a fire kills a resident

Last year, a resident of a care home in Glasgow died in a fire that broke out as a result of their e-cigarette. A faulty fire alarm zone map meant that when the fire alarm went off, the wrong zone was evacuated, with no one realising until too late that the fire was in the resident’s room. The company ended up admitting to a health and safety breach and was fined £537,000.^[4]

Olney care home deregistered after health and safety failings

Last year, a care home in Olney, Buckinghamshire, was deregistered after failing to implement safety improvements first noted by the CQC in 2023. When the CQC visited, they found three separate legal breaches, including faulty fire doors, poor record-keeping and a home that was ‘visibly dirty.’ As a result, Bay House was deregistered and officially closed shortly after.^{[5] [6]}

Care company fined and owner sentenced for fire safety failings

In early 2023, Nottingham Fire and Rescue Service (NFRS) raised concerns of inadequate fire safety measures in a care home, including an inadequate fire alarm system and poor escape routes. After failing to implement these changes, the director of the company was prosecuted. At his sentencing, the judge noted the severe risk of the inadequate fire provisions to residents’ lives, saying, “The presented risk of innocent lives was not only extreme, but unnecessary – this was a tragedy waiting to happen.” As a result, then-director Ashwin Nepal was given a nine-month suspended sentenced and the company was fined £120,000.^[7]

Health and safety refresher

How do you know whether you’re doing enough to manage health and safety at your organisation?

According to the Health and Safety Executive (HSE), there are three key elements that determine successful health and safety management:

1. Good leadership/management
2. A trained and competent workforce
3. A culture of employees feeling consulted and involved.

If you have that solid foundation, you can then evaluate whether your organisation is doing enough by answering the following questions as honestly as possible

• How does your home demonstrate its commitment to health and safety?
• Residents face real risks in a care home. What are you doing to control these risks?
• How well do you know what’s happening in the home? Are there effective checks in place?
• Have you learned from situations where things have gone wrong? How?
• Is health and safety an integral part of your day-to-day process while running your home?

The HSE says that health and safety requires a ‘sustained and systematic’ approach, and recommend the plan, do, check and act system.

• Plan: decide what needs to happen/change and how you’ll achieve it.
• Do: profile identified risks, organise activities to deliver your plan and include preventative measures, and make sure there are systems and equipment in place to do all of this safely.
• Check: monitor the work to ensure it’s being done safely and investigate the causes of accidents, incidents or near misses.
• Act: review what you’ve done and take action on the lessons learned here and from audit and inspection reports.^[7]

If you think your cover could be working harder for you, Towergate Insurance can help. Speak to a friendly specialist today at newcare@towergate.co.uk or 0330 123 5154. You can also find out more about us here.

About the author

Carolyn Baker-Mellor is a respected industry leader with over 35 years' experience- within the care insurance sector.

Carolyn currently works at Towergate as Head of Care Insurance.

Consistent with our policy when giving comment and advice on a non-specific basis, we cannot assume legal responsibility for the accuracy of any particular statement. In the case of specific problems we recommend that professional advice be sought.

Sources:

[1] More than half of care homes inspected are failing, says regulator – Disability News Service

[2] Dementia patients in England facing ‘national crisis’ in care safety | Social care | The Guardian

[3] Care home ratings can’t be trusted says CQC chief | Caring Times

[4] Care home firm breached health and safety during woman's death - BBC News

[5] Olney care home provider de-registered over safety - BBC News

[6] Bay House care home in Olney closes after inadequate rating | Bucks Free Press

[7] Care Home Owner Sentenced For Fire Safety Breaches - NFRS

[8] Health and safety in care homes HSG220