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CQC finds four out of five hospitals unsafe

Four out of five hospitals inspected by regulators are not safe, according to the annual State of Care report from the Care Quality Commission (CQC).

The report looks at the first year of the new style inspections, which gives all hospitals, care homes and GP surgeries Ofsted-style ratings.

The CQC said “the public is being failed” by the numerous hospitals, care homes, and GP surgeries unable to meet basic standards, and it vowed to call time on an “unacceptable lottery” in care.

Patient safety was the biggest concern as inspections of 82 hospitals found 65 were inadequate or required improvement, when it came to safety. Out of 38 NHS acute trusts inspected only nine were rated ‘good’, while five trusts were ‘inadequate’ and 24 ‘require improvement’.

The report says: “Safety was the biggest concern: four out of every five safety ratings were inadequate or requires improvement… far too many hospitals were inadequate on safety and the majority required improvement to be considered safe.”

Some of the biggest problems were found in Accident & Emergency departments, with shortages of consultants and nurses. It also revealed that many patients were left to wait on trolleys in corridors.

The report also mentions that in maternity shortages of midwives and doctors were “frequent”.

In mental health and community care the report found widespread staffing shortages, unavailability of beds and unsuitable environments such as poorly maintained buildings and failures to meet requirements for same-sex accommodation.

Widespread problems have been found in care homes, with the worst care in nursing homes, which look after those with dementia and other health problems. At Werrington Lodge, an 80-bed-home in in Peterborough, run by Barchester Healthcare, inspectors found that an immaculate reception area but residential areas reeked of urine. Some residents were lying in wet beds, and staff were not responding to people calling out for help.

The report says there is much excellent care but “the variation in the quality and safety of care in England is too wide and is unacceptable”.

CQC’s chief executive David Behan said: “The findings from our inspections over the last year clearly show there is too much variation in quality and safety between services and within services. People need to have confidence that they will get good care. Our role is to identify what works well and why, and what doesn’t work, and use this information to drive improvement and close the gap.

“While we will celebrate good and outstanding care where we find it, we are calling time on unacceptable inadequate care. When our inspections identify poor care, they must lead to improvement by providers, who should learn from the good and outstanding care we champion through our new ratings.

“We acknowledge the rising pressure on care services. Financial pressures are real but not unexpected, and yet we continue to see many examples of good and outstanding care even in financially challenged organisations. Understanding the quality of care is complex – it is about how people experience services, it is about the outcomes of the services and about how safe they are.”

Health secretary Jeremy Hunt added that the report highlights examples of excellent care but it also exposes unacceptable levels of variation — “exactly why we gave the CQC independence and why we're confronting underperformance in the NHS as never before”.

“The report also confirms that the NHS has seen a period of ‘hard realities and rapid change’ following the scandal at Mid Staffs,” he said. “We need to keep building on this to ensure greater cultural change, more transparency and a relentless focus on safety to drive up standards of care across the country.”

Responding to the report Dr Katherine Rake, chief executive of Healthwatch England, added that the variability in care across the country is simply unacceptable.

“We wholeheartedly support the CQC’s challenge to sub-standard parts of the system to improve and ensure everyone has access to high quality, safe and dignified support,” she said.

Caroline Abrahams, charity director at Age UK, said the some of the report amounted to evidence of neglect. “Let’s not mince words about what some of the findings show,” she said. “Leaving someone in soiled beds or clothing for a long time or failing to ensure that an older person is able to eat or drink is neglect and should be treated as such.

“Providing care for older people must not be about completing tasks in whatever is the quickest or cheapest way. Decent care is about looking after a fellow human being in the way that we would like to be cared for when we are older.”

Rob Webster, chief executive of the NHS Confederation, added: “We know you cannot inspect quality into services. Quality and value is the primary responsibility of boards, NHS leaders, staff and teams. Inspection by external teams, including individuals with expertise gained as both professionals and patients, is a valuable contributor to managing and improving NHS performance and a good source of reflection and insight.

“From our Decisions of Value report we know the importance of having the right relationships, behaviours and environment to deliver better value of care in the NHS and we welcome the emphasis CQC has placed on the value of strong leadership.”

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