The unacceptable treatment of residents at the Winterbourne View Care Home in Bristol, exposed by the BBC’s Panorama programme, has raised two major issues for those involved in contracting for care services.
Firstly, it appears that there were few or no measurable Key Performance Indicators in place to ensure that acceptable levels of care were being delivered to the residents, which would lead one to conclude that there were no proper Contract Management processes in place.
Whether the service was tendered for, commissioned or just grant-funded, the responsibility of care still remains firmly with the public bodies placing vulnerable people into residential care, which is why they are regulated by the Care Quality Commission (CQC). CQC regulation should safeguard residents, even when other processes fail.
The chance of such levels of abuse happening in a care home where proper escalation procedures had been implemented to allow the residents (end-users) to raise problems immediately they occurred, aligned to proper Supplier and Service Level Management processes, would have been greatly reduced as such processes would have identified problems far earlier than occurred at Winterbourne View.
Good Contract Management involves building a good working relationship between customer and provider and managing proactively throughout the life of the contract to anticipate future needs. By properly managing service delivery, contracting authorities have the ability to measure the level of service quality being delivered and where issues are identified, to seek rectification of any breaches.
Had such processes been in place at Winterbourne View, this would have allowed the quality of service to be assessed regularly, even in areas where it is hard to quantify, and would ideally have sounded alarm bells long before they rang in this case.
Unfortunately, this is unlikely to be an isolated incident and one fears that more examples will arise in the future, which leads us to the second major issue that this exposé has revealed.
The CQC licences providers of care services in England and many NHS and local government bodies stipulate that providers must be licensed by CQC. However, as this case appears to highlight, those public organisations may have little justification in accepting such a licence as proof of suitable quality.
The public sector cannot contract out its responsibilities for delivering services to the public. Placing such emphasis on what is, at best, currently a questionable qualification criterion, could lead to questions about whether proper verification had taken place when contracting for care services.
If it was challenged, could any public body justify the acceptance of a CQC licence, following the BBC’s exposé, as a key reason to contract with an organisation?
In my opinion, the most logical process for any public body, at the current time, would be to undertake a mix of site visits and resident interviews (where feasible), to support their acceptance of CQC licences and therefore show that due diligence had been undertaken.
Failure to do so could ultimately lead to an expensive legal challenge.
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