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One in five CQC staff concerned about overhaul of inspection regime

Published on: 21 Feb 2022

Hundreds of staff at the Care Quality Commission have concerns about its ‘strategic direction’ and the organisation’s ability to implement changes to its inspection regime.

Staff survey results leaked to HSJ suggest there is some unease around the regulator’s transformation programme, which was launched last year and involves a move from a “set schedule of inspections to a more flexible, targeted approach”.

Of the CQC’s official staff survey for 2021’s 2,000 respondents, 45 per cent said they felt positive about the commission’s strategic direction. Around 22 per cent suggested they did not feel positive, while 33 per cent felt neutral. This question had not been asked in previous years.

Just 27 per cent agreed that changes at the CQC “are effectively implemented”, although this score had improved slightly on the previous year.

Overall, staff sentiment had improved on multiple measures since 2019. Three out of the five “most improved questions” were about the CQC’s leadership.

In the 2019 survey just 34 per cent of staff agreed that chief executive Ian Trenholm and his executive team “provide clear direction and leadership” – a fall of 10 percentage points on the year before. This increased to 51 per cent in the latest survey.

The sentiments about strategy in the official survey were also echoed in a separate survey trade union poll of their members, where dozens of respondents said they were unhappy at the “direction of change”.

In comments submitted as part of the unions’ survey, one respondent said they felt “disconnected and disheartened with the new strategy”, with multiple people raising concerns about a “push” to carry out inspections remotely and a feeling that the change was being managed “woefully”.

Another respondent said: “I feel like CQC was very supportive initially in the pandemic, but that as lockdown continued/ended, things changed. Suddenly there was a drive for a new strategy and massive change, which was so unsettling… The strategy feels to have a general direction but little actual substance. Meanwhile workloads feel unmanageable.”

Sources from within the CQC have suggested as many as eight of the 16 deputy inspectors have applied for voluntary redundancy, with a suggestion there will be “big announcements on jobs” soon, according to notes from a staff forum shared with HSJ.

In a statement the CQC said: “We appreciate the importance of feedback and listening to our colleagues, and we are grateful for the thought they put into responding to our surveys…

“In our future regulation, on-site inspection will remain central to our approach in how we assess the quality of care being provided by services…

“We are developing a wider range of tools that we will use alongside on-site inspections to have a more ‘always on’ view of quality. We have been talking to providers and we know that they are supportive of this approach, which will help reduce the impact of evidence gathering on providers by using information collected by partner organisations.”

Leaders lobby Treasury to lift pay restrictions

The Care Quality Commission is lobbying the Treasury to be removed from civil service pay frameworks in a bid to try to increase staff salaries.

Unison members at the regulator recently balloted for strike action, after a pay freeze was announced for all except staff earning less than £24,000, who would instead receive a one-off payment of £250.

The CQC told HSJ it has developed a new set of proposals for pay and reward that will “address some of the issues that sit with our pay scheme”.

A spokesman said: “These proposals will be submitted to HM Treasury in May for approval. Until the new scheme is approved by HM Treasury we remain subject to the civil service pay remit and the pay freeze the chancellor announced as part of the Spending Review in 2020.”

According to organisation’s staff survey for 2021, 45 per cent of staff said they were happy with their overall reward package, with 35 per cent saying they are rewarded fairly compared to people doing a similar role elsewhere.

The spokesman added: “We are unclear as to why the union has pursued action against CQC alone in this matter, when this is a wider issue that applies to a broader group of organisations and is not something that CQC controls.”