Norman LambDirectors in charge of care homes and hospitals that allow neglect and abuse to take place could be held personally and criminally accountable for failures in care, under proposals unveiled by the Government.

Other proposals include introduction of a compulsory ‘fit and proper’ person test for directors, addressing the loophole in the system where providers responsible for failures in care can escape prosecution and making it easier for the Care Quality Commission (CQC) to prosecute providers and directors where there are clear failures to meet basic standards of care.

The consultation forms part of the work to begin rebuilding trust in the health and care system, after scandals including Winterbourne View and Mid-Staffs.

Under the new proposals, organisations and their directors that fail to meet the new fundamental standards of care could face immediate action from the regulator including prosecution. CQC’s powers to prosecute for criminal neglect would be strengthened.

Currently, providers can escape prosecution, even in the worst cases of care failures and abuse. The CQC can only prosecute in cases where it has previously issued a warning notice to the provider and the provider has failed to comply with that.

With the introduction of fundamental standards following the Francis Inquiry, the government wants to make it easier for the CQC to prosecute providers where there are clear failures to meet basic standards of care, without the need to issue a warning notice first.

Rebuilding confidence in health and care

Norman Lamb, Care and Support Minister said: “Scandals like Winterbourne View and Mid-Staffs have damaged confidence in our health and care system. Part of our commitment to rebuilding that trust comes from making sure that people at all levels are held to account for failings when they occur.

“Whilst there must be a sharper focus on corporate accountability, more needs to be done to ensure those responsible for leading a care organisation are up to the job. I hope that providers and people who use services and their families will respond to this consultation as we look to take these proposals forward.”

CQC chief executive, David Behan, said: “Those who run health and care service are accountable for the quality and safety of the care they provide. People have a right to expect that care homes and hospitals meet basic standards of care. The power to prosecute, along with a ‘fit and proper’ person test for directors, gives people who use services greater assurance that poor care will be challenged and that they will receive safe and effective care.”

In a joint statement, Jan Tregelles and Vivien Cooper, chief executives of Mencap and the Challenging Behaviour Foundation respectively, said: “Since the appalling abuse of people with a learning disability at Winterbourne View was exposed, we have called for much tougher corporate accountability of care providers who fail people with a learning disability and their families. People with a learning disability still face abuse and neglect in care and hospital settings, and we welcome these proposals as an important step in creating accountability from the boardroom to the frontline.

“But we also want to see the delivery of new powers in the Care Bill currently going through parliament, which will stop providers being able to withhold information from Serious Case Reviews that look into why services have failed. Castlebeck, [which] ran Winterbourne View, withheld information about what took place and none of their board was ever held to account. This lack of openness and accountability is simply unacceptable and must change.”