Care Quality Commission registration was ghastly

Going through the process for Julia's House was horrific and at times agonising, says Martin Edwards

Martin Edwards
Martin Edwards

When the BBC's Panorama programme exposed abuse at the Winterbourne View hospital in Bristol, I was not at all surprised that the government regulator, the Care Quality Commission, had failed to intervene.

When Julia's House sought to register our children's residential hospice care with the CQC in the same region, it was clear that paperwork, rather than any true measure of quality, was paramount.

Before we could offer overnight care services, we had to write nearly 1,000 pages of policies - which were pored over in excruciating detail by the assessors before they were deemed to achieve, in the CQC's favourite Orwellian word, "compliance".

The CQC declined meetings with us to resolve issues and rejected a medications policy written by a senior nurse and doctor with a combined total of more than 50 years' clinical experience.

One day, our director of care told me we were required to write a policy on policy-making. I laughed at her gallows humour, but my laugh choked as I realised she wasn't joking. For two long years, paperwork and legal arguments went back and forth.

During this time, before they could use the new service, some of the children died. I sometimes wondered if the assessors thought they were on a TV show called Britain's Got Bureaucrats, aiming to celebrate the worst excesses of officialdom. It also irked me that our not-for-profit organisation had to pay to be assessed to provide a free, voluntary service.

But it was the eventual assessment visit that was truly horrific. As it happened, our lead nurse had not been trained in SAS-style resistance to interrogation, and after 30 minutes of inquisition she was wobbling precariously. But this was just the beginning.

For eight agonising hours the assessors inched their way through our paperwork and procedures. Tellingly, even though there was a daycare session in the building at the time, the assessors ignored it.

They failed to say hello to any children and even ignored them when they sat next to them at lunch; it was heartbreaking. In the same vein, the CQC's tick-box culture simply could not compute the numerous awards that Julia's House had won for our standards.

We achieved registration in the end, but only after helpful pressure from several MPs, one of whom described our experience as a "ghastly two-year bureaucratic nightmare".

The CQC says it has since changed its emphasis from auditing processes to assessing outcomes for patients. The Winterbourne View debacle suggests there is still a long way to go.

When our registration certificate finally arrived, I literally kissed the ground. Then a colleague handed me a fortune cookie that she had been saving. It said: "What the world needs is more love and less paperwork."

Martin Edwards, is chief executive of the children's hospice Julia's House

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