The Honourable David Gifford Leathes Prior, Tory-Toff and chair of the CQC is back at work. Following his hip-op (private) he's legged it back and is already putting his foot in it.

The Telegraph's NHS Talthybius, Laura Donnely, writes; the boss of the flat-earthers told her, "The elderly and vulnerable were failed by... (the CQC)... set up to protect them, because it feared legal threats from owners of care homes..."

In a nut-shell Prior claims the CQC 'failed' because it accepted legal advice to duck taking care homes to court in case they lost. "There have been... cases where... inspectors have felt there was a very strong case and would like to have taken action but were advised to back off by... legal advice."

Regular readers will recall the care home I wrote about last spring. 'Not a place for a pig' I think I said. The CQC knew it. Under each of their inspection headings this was a basket case. Anyone with half a grain of gumption would have turned the key in the door.

Insiders at the CQC confided; they couldn't do that because if they closed the home there was no spare capacity in the system and nowhere to decant-yer-granny. Added to which they didn't have an 'A-Team' of super managers poised to parachute-in and run the place properly.  

They confessed their powers were clunky and pursuit through the courts, glacial. They acknowledged, they were powerless. As far as I know, the residents are still sitting in the same puddles of urine they were last April.

It has since emerged, in total, more than 750 care homes have been found to be failing on one or subsequent measures for at least 12 months. At a rough guess I would make that, probably, 18,750 vulnerable people living in precarious circumstances that the CQC have done nothing about for a year.  

All on the watch of the present hierarchy.  Oh dear!  Given it is their task to make sure our care homes are safe, where does that leave us?  Already their new NED Robert Francis has accused them of institutional complacency for turning a blind eye to Trust failings.  It looks like he is more right than he thought!  Would it be fair to say, if a hospital Trust failed 18,000 patients the CQC would call them a failing organisation?

CQC powers have been strengthened in the Care Bill/Act but enforcement will still be a grind through the courts and the standard and threshold for evidence, for a successful prosecution, has not changed.

And, the flat-earthers are still in a muddle. Torn between process, laws, common-sense and emotion. The Mighty-Midget, chief-granny-home inspector Andrea Sutcliffe said; "Really it is about 'the mum test': think about somebody that you love and care for - would you be happy for them to use this service? That is the question that I want my inspectors to ask". Well it's an excellent question but I doubt the 'Mum' test will cut the mustard in the high court.

Prior predicts about 100 care providers a year would be likely to go into special measures under the (new) regime, giving them a fixed time to make improvements or close. 

The significance of this will not have passed you by. You do the maths; a conveyor-belt of 2,500 frail elderly people living in unsafe circumstances that the CQC, in all honesty can do little to alleviate other than to run to the High-Court. Assuming, in half the cases they do and apply ex-parte, on the grounds of urgency, and let's assume they obtain a temporary closure order, pending a full hearing, what happens then?

First, their legal bill will explode. Next, if the home closes where do frail elderly people get shunted to? Where will they call home? What about relatives who might have lasting power of attorney and object to a move. Who will take over and run 50 homes. You might be looking for 1,500 new staff.

We know Deming is right about inspection; "Cease dependence on inspection to achieve quality. Eliminate the need for massive inspection by building quality into the product in the first place." We know Prior cannot change the immutable laws of management.

We can see from his Telegraph confessions; Prior knows he can change very little. CQC processes, procedures, measures and methods are powerless to prevent 2,500 people a year pulling a red chord and wondering why no one answers.