The coroner’s verdict on the deaths of 19 people at a care home in West Sussex is frightening. Many of us expect either to go into a care home ourselves towards the end of our lives or to be responsible for relatives who do so. Neglect contributed to five of the deaths, the coroner found, and the home was “completely mismanaged and understaffed”.
It is a terrible case, but two points that cut against the common gloomy assumptions ought to be noted. The first is that most care homes are well run and their residents are as happy as they can be, given that they are no longer able to look after themselves. The other is that the profit motive is not necessarily the enemy. Southern Cross, the company that used to run Orchid View, and which went bust after a risky gamble on property values and creative financial engineering, was not a success. But poor management and abusive relationships between carers and cared-for exist in the public sector too, as recent NHS scandals have shown.
So the problem is one of quality control, of supervision, inspection, and acting on information from concerned relatives or whistle-blowing employees. It is a deep problem, above all, of the quality and firepower of the Care Quality Commission, which has not had the resources or the aggressive culture to ensure that standards in adult social care or the NHS are maintained. The CQC’s record has been quite simply a disgrace. After its highly visible recent failings in the NHS, an inquiry has been ordered and the familiar reassurances issued: that the regulator is being turned round, everything will be better in future, and lessons have been learned.
Reform of the CQC is difficult, not least because its remit crosses departmental boundaries. But political responsibility is clear: it lies with Jeremy Hunt, the Secretary of State for Health, and Norman Lamb, the Minister of State for Care and Support. Their sustained political attention is required, and we should hold them to account for it.