The Mental Health Foundation (MHF) has called for regulator the Care Quality Commission (CQC) to place greater emphasis on mental health and learning disability services.

This call came as the Department of Health (DH) published a performance and capability review of the CQC, which set out a series of recommendations on how the regulator can improve. While praising the CQC for the “considerable achievements” it has made since it was established in 2009, the DH review also criticised the regulator, saying it could have done more to manage risks during the early years of its operation. The review also acknowledged that the role of the CQC has not been as clear as it needs to be to health and care providers, patients and the public. But the review recognised that over the past 9 months, the CQC has made significant improvements, increasing inspection staffing and focusing more on its core duties to register and inspect healthcare providers.

Recommendations made in the review included:

  • • Strengthening the CQC board with additional members
  • • Building an evidence base for its regulatory model to demonstrate and ensure confidence in its effectiveness
  • • Inspectors having greater access to individuals with professional experience, such as doctors, nurses or social care experts
  • • More consistency in how inspections are carried out
  • • Ensuring there are enough inspectors to meet future demand.

Simon Lawton-Smith, head of policy at the MHF, also wants more emphasis on mental health and learning disability considerations: “The CQC was set a difficult and complex task and it is not surprising that it has sometimes failed to meet the demands on it. It has done some good work, for instance we welcomed the decision to produce an annual report on the use of the Mental Health Act. But concerns still remain, notably that there are not enough visits and inspections of mental health and learning disability services, and there are too few Second Opinion Appointed Doctors (SOADs) to operate the Mental Health Act effectively. “We must make sure that we never again allow the appalling practice that was found at Winterbourne View, where staff have admitted to physically and verbally abusing patients. The CQC must do more to ensure that the safeguards for people detained under the Mental Health Act and supported under the Mental Capacity Act are fully complied with by local services. “In particular we strongly endorse the recommendations around safeguarding and risk. Even within the strongest governance framework, it is ultimately the front-line staff, their training and culture that requires the greatest scrutiny and focus.”