A hindrance or a help? The contribution of inspection to the quality of care in homes for older people

Abstract

In England, care homes for older people have been subject to four different regulatory bodies within the last six years (see Table 1). The government has announced further change with the creation of a new regulator of adult health and social care in 2009 (CSCI, 2007). The current regulatory body, the Commission for Social Care Inspection (CSCI) will merge with the Healthcare Commission and the Mental Health Act Commission to create the Care Quality Commission. The Department of Health (DOH) is currently reviewing the future regulation of health and adult social care in England (DOH, 2005; DOH, 2006a) and the way that CSCI carries out the regulation and inspection of a range of social care agencies including care homes for older people. Substantial reforms of the regulatory system of regulation and inspection were embodied in the Care Standards Act (CSA) 2000 that was part of the wider Government agenda to modernize health and social care services. The Act established new regulatory bodies for care services and workers and along with the regulations and mandatory National Minimum Standards (NMS) created a framework to ensure greater consistency of quality and to better protect vulnerable children and adults (Engelman and Spencer, 2003). The impact of these changes for both inspectors and providers of care services has been significant. Regulators have had to adjust and adopt new ways of working whilst carrying out their statutory responsibilities. Care providers have had to respond to the revised changes in standards and requirements of registration. This article examines inspection as a mechanism for improving the quality of care standards. It reports on a study conducted in 2004 that sought the views of managers of care homes for older people about the NMS and the inspection process at that time. The role of inspectors will be considered in light of the findings and published literature.