Official care homes rating system set to return after Nuffield review finds people have been 'left in the dark'

An official care homes rating system looks set to return after a review by the Nuffield Trust found people have been “left in the dark” over the quality of care homes, hospitals and GP practices.

The care regulator, the Care Quality Commission (CQC), stopped issuing its own star ratings in 2010.

Dr Jennifer Dixon, Nuffield Trust chief executive who led the review, found as a result: “There is a major gap in the information available to the public on the quality of care of their local hospitals, GP practices, care homes and other providers, people are left in the dark.”

Since the CQC stopped running its ratings system, a number of companies have sprung up which issue ratings to care homes.

Consequently Dr Dixon said: “The information that does exist is spread across a number of sources, which may reduce its impact and use by the public.”

She believes “one aggregate, comprehensive rating of providers may provide more clarity and simplicity for the public, especially if it came from one 'official' trusted source”.

Responses to the review revealed more people are in favour of introducing ratings in social care and possibly general practice, than in hospitals which tend to be more complex in the range of services they provide.

“It is here where the analogy with Ofsted’s ratings of schools particularly breaks down: hospitals are large, with many departments and different activities, seeing large numbers of different people every day, carrying out complex activities many 24/7, and in which people are sick and can die,” added Dr Dixon.

The review which was commissioned by the Secretary of State for Health, Jeremy Hunt, recommends that ratings are combined with other approaches, such as robust surveillance, inspection and special investigations. It also suggests that the body that would be ideal to carry out the ratings would be the Care Quality Commission and for the design and presentation of the rating to be sector-led with groups representing the public and users of care meaningfully involved.

Des Kelly, executive director of the National Care Forum, has been calling for the return of an official ratings system in order to reassure the public and as a driver of accountability.

He said: “We fully support the conclusions of the report of The Nuffield Trust that there is considerable benefit from developing one comprehensive system operated by a trusted source such as the Care Quality Commission.

“We are particularly pleased to note that the Nuffield report recommends to the Secretary of State an independent and comprehensive assessment of quality for social care services. He added: “We welcome the proposal that the development of a quality ratings system should be sector-led and aligned with existing frameworks for assessing quality and we look forward to engaging in the process.”

ECCA (English Community Care Association) also backed the findings in the report.

Professor Martin Green, chief executive of ECCA, said: “Nuffield rightly reflects that there is a real desire for quality ratings in social care. We regret the speed with which the former star ratings system for social care was discarded and the gap in knowledge that this has left for people seeking care services.”

He added: “We need to stop the current proliferation of different quality assurance systems across the various health and social care commissioners which cannot provide a consistent and independent view of quality in care services. A national and independent approach to the assessment of quality, over and above essential standards, is necessary and can be used by state commissioners and individuals and their families alike. We hope the Government will respond with a strong vision for the future on care quality.”

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