The following comment on the government inspection of care homes seems worth putting up as a posting, too. I asked the author for a glossary of terms for those who are not familiar with all the organisations he refers to. They are at the end.
The government regulations are amazingly bad, cost a fortune to both care home owners and the public sector, and achieve nothing.
There are several problems.
(1) They are applied quite staggeringly inconsistently. Some hammer people for minor or invented infractions, some just ignore them. This tends to (IME) bias towards those run by the Public Sector. largely because the inspections are done by the former colleagues of the people in the public sector ; back scratching stuff.
It’s a bit like Fire Regulations. With LEA schools the line has always been basically getting them up to scratch would cost an absolute fortune, so they are effectively exempted. Private Schools do not have this luxury. This seems to apply in NCSC/CSCI/CHAI as well.
(2) The Inspectors are laughably ignorant about the actual work, literally, I once had to leave the room because I had a fit of the giggles. It is tickbox mentality run riot. Because they have no clue, they focus on minutiae like how big the windows are, because they have no qualifications or experience to evaluate what is actually happening.
The comments in (1) still apply ; the application of tickboxes is variable to say the least. They write what they want.
(3) The standards have to be measured. This forces towards things which are quantifiable. Quality of Care, Happiness of Patients etc is not quantifiable. Forms and Records are. So they require more and more forms and records, which makes less time available for the job of actually caring. Inspection is usually about 70-80% looking at records and forms, and has been done without viewing any practice at all. This is like OFSTED inspecting a school without ever seeing a classroom or child.
(4) They can say and do what they like. The complaints route is all to them and their above levels, and they will ignore the ombudsman, basically. There is a tribunal, but the burden of proof is on the complainant, not on CSCI. A variation on OFSTED is you always get the same inspector, so if you make a complaint the same person will come back effectively wanting revenge. So no-one complains, though I know no-one who thinks any of them are competent.
(5) Like any quango, the main aim is to increase its reach, budget, areas of control. Much effort goes into this. There is a laughable punch up going on where I live between SSD & CSCI, which involves them refusing to invite each other to meetings etc. (for the benefit of the children, doubtless). This is because both want the power and money that comes with “child protection”
(6) Because they don’t have to pay for anything, the requirements extend endlessly as a back covering exercise. It is always in their interest to demand more staff, more targets, more forms, more systems. This increases costs, which most users cannot afford and SSDs will not pay. So care home owners sell up and quit, or they focus purely on meeting the targets. You get the impression that as long as the forms are okay they don’t care about what is actually happening.
The worst cost increase is staffing. They are demanding minimum levels of staff training, which is fine, except someone has to pay for it at some time. Care Homes are run to some extent on cheap employees to do mundane jobs. Having everyone at NVQ3 (another rule ignored for public care homes and schools) racks up employment costs spectacularly, let alone training costs. At the same time, they want more staff (except for Local Authority provision).
(7) As a carry-on from (1), LAs are dodging the targets by redefining care homes as “rented accommodation with 24-hour support”. This way most of the regulations don’t apply. So they dodge them (something Private orgs aren’t allowed to do), even though the practice is identical. To be fair, there’s nothing actually wrong with the homes, they just don’t tick the boxes.
(8) It repeatedly reorganises at great expense. Originally it was done by SSD. Then they all went to work for NCSC (late 2002). Two weeks after NCSC started, they were told they would be converted to CSCI and CHAI (early 2004). Now they are going to be OFSTED and CHAI. Imagine the money wasted !
IME : In my experience
LEA : Local Education Authority ; run public sector schools, pretty
badly. It’s worse than you can possibly imagine.
SSD : Local Authority Social Services Departments ; roughly
divided into “Children & Families” and “Adult” divisions, though they
are trying to combine this back and add control over education. Yet
another bureaucratic turf war. Also responsible for Child Protection,
but are squabbling with CSCI over this at the moment. Both sides want
DfES : Department for Education and Science. *Also* squabbling for power with NCSC/CSCI/CHAI, over who has control of Residential Mainstream and Special Schooling.
NCSC : National Care Standards Commission, monitoring Residential
Accommodation, Hospitals, Fostering, OAP Care, Residential Schools,
Sheltered Housing and all sorts of other similar stuff. Typical Blairism Monitoring and Targets organisation. Basically a “OFSTED for Care Provision”.
Later (announced 2 weeks after opening !) split into :-
CHAI : Commission for Healthcare Improvement
CSCI : Commission for Social Care Improvement
Which does the same thing. Not quite sure where the split is. I think
CHAI does Hospitals, CSCI does the rest but wouldn’t swear to it. I
*think* that CSCI are going to be subsumed into OFSTED, this is one of
Gordo’s red tape reductions. I’d bet my life savings the same people
will be doing the same jobs …. it’s a joke.
Incidentally, as far as I can tell despite all these switches the same
people (literally) do the same jobs in the same way, they just change
the name and bring out masses of new initiatives and reprint all the
OFSTED : Office for Standards in Education. Quango for schools
NVQ : National Vocational Qualification.