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Health and Social Care Bill

My Lords, I know that my noble friend feels passionately about inspections. I have listened to and considered his concerns very carefully. We fully appreciate that those who live in care homes are particularly vulnerable. The Care Quality Commission will have a vital role of ensuring that those who receive social care are safe. The noble Baroness, Lady Barker, gave a very good account of what the CQC needs to be aiming for. She is absolutely right. As we have previously discussed, there is no intention to reduce the total amount of inspection activity. Indeed, we want to create a regulator that focuses its attention where it is needed most to get the greatest benefits in terms of safety and quality for patients and service users. At the same time, the commission needs to allow—as the noble Baroness, Lady Howarth, said—good providers to get on and deliver their services. This is in the interests of everyone, but particularly service users. In response to some of the concerns, I shall quote Paul Snell, chief inspector of the CSCI. He recently said: "““Now we’ve taken a much tougher approach. We don’t tell people we’re coming, we turn up unannounced, and we’re focusing our attention on the poorest of services. And we’re seeing some real improvement in relation to poor services””." The programme referred to by several noble Lords did not reflect the whole story, as some people have said. As my noble friend admitted, most care homes are excellent. Therefore, while I do not believe that it will be necessary in most circumstances, Clause 57 gives the Secretary of State the power to set the frequency of inspection in regulations, should that be required in particular circumstances. Several noble Lords referred to LINks. I agree with the noble Baroness, Lady Meacher, that they have a great role to play. As noble Lords may recall, we discussed LINks on the first day on Report last week, and have introduced an amendment that makes—if noble Lords will excuse me—the link between LINks and the CQC, and highlights the need for them to work together and for LINks to send reports to the CQC. I have no doubt that LINks will play an important role in ensuring that the CQC takes users’ and the public’s voices seriously. They also have access and can arrive unannounced where appropriate. I regret that I am unable to accept these amendments. We currently intend to leave these decisions to the discretion of the commission, and provision already exists to set specific frequencies if required. I hope that I have been able to reassure my noble friend that the Bill will allow the new commission to take action where it is needed, and that it gives the commission powers to encourage services to improve and focus attention on the poor services that fail to meet those requirements. I therefore ask my noble friend to withdraw these amendments.