Hospital failure regime extended to care homes

A system of special measures designed to improve failing hospitals in England is to be extended to care homes, the government is expected to announce.

The process was introduced by the Care Quality Commission (CQC) a year ago at 11 failing trusts.

Most have since made progress – although only five have been or are being taken out of special measures.

A similar scheme will be introduced for care homes and home care agencies next year, ministers will say.

That will cover 25,000 services and could lead to the closure of those that fail to improve.

The system is not expected to start until April as the ratings regime it is based on will only be rolled out in the social care system from the autumn.

The ratings, based on a system first used in schools, give health and care services a rating of outstanding, good, requires improvement or inadequate.


Nadra Ahmed, chairman of the National Care Association, told the BBC that anything that safeguarded vulnerable people “has got to be good”.

But she said she did have concerns about how the new measures would be implemented and the financial pressures on care homes put into special measures.

She said care homes in special measures may no longer get residents placed in their care by the local authority, and as a result would lose additional funding and could face closure, in a way that does not happen to a hospital.

“I wonder whether a home in special measures will be able to continue to function,” she said.

And Judy Downey, who is the chairwomen of the Relatives and Residents’ Association, said it was not clear how the system would change.

“The CQC have always had the power to close a home on an emergency basis, they can give warnings to improve, they can impose fines. I really don’t see what this adds,” she said.


But in the future the failure regime may also be rolled out to GP surgeries.

It started last year in the hospital sector with those rated inadequate being placed in special measures.

The first 11 trusts placed in special measures came after a government-commissioned review of high-risk hospitals following the public inquiry into the Stafford Hospital scandal.

Since then another six hospital trusts have been placed in special measures after critical inspections.

Steps taken include closer scrutiny by regulators, management changes, buddying schemes with successful trusts and an improvement director being parachuted in to oversee any changes that need to be made.

Ministers will hail the process a success – even though not all of the 11 original trusts identified as failing have improved enough to leave special measures.

Health Secretary Jeremy Hunt will say the Stafford Hospital scandal was a “wake-up call” for the NHS.

“Thanks to a sharp focus on admitting problems rather than burying heads in the sand, some of these hospitals have tackled their deep-rooted failings for the first time and are on the road to recovery.”

But the CQC’s chief inspector of hospitals, Prof Sir Mike Richards, said: “We have achieved a great deal in the last twelve months.”

Rob Webster, chief executive of the NHS Confederation, which represents hospital trusts, said: “Changing the culture in an organisation – and the outcomes it delivers – is never easy.

“The staff and the leadership teams at each of these organisations should be proud of the progress they have made over the past 12 months in improving patient care.”