The level of inspections of care homes in England fell "significantly" following the introduction of a new watchdog, which has so far failed to deliver value for money, according to a new report.
The Care Quality Commission (CQC) came under fire earlier this year for failing to follow up a whistle-blower's warnings of alleged abuse of vulnerable patients at the Winterbourne View care home in Gloucestershire.
The report from the National Audit Office (NAO) said that the CQC had cut back on inspection and compliance checks after its establishment in 2009 in order to concentrate its efforts on meeting timetables for registering care providers.
As a result, the Commission completed only 47% of its target number of compliance reviews of standards of care between October 2010 and April 2011.
The NAO said it was unclear how much of the blame the Department of Health should take for the CQC's under-performance. The new commission had a "difficult task" in establishing itself on a £164 million budget, which was 6% lower than those of the three bodies it replaced even though it had more responsibilities, said the NAO.
And Government recruitment restrictions led to 14% of staff positions - almost half of them registration assessor and compliance inspector posts - lying vacant, meaning the commission did not even spend all the money available to it.
Auditor General Amyas Morse said that the CQC has had "an uphill struggle to carry out its work effectively and has experienced serious difficulties". But he added: "It is welcome that it is now taking action to improve its performance."
CQC chief executive Cynthia Bower said that the new commission was faced with the challenge of setting up an entirely new regulatory system and registering over 40,000 provider locations against tight deadlines, but was now "firmly on the right track" with more than 700 inspectors on the ground speaking to patients and staff and observing care.
Michelle Mitchell, charity director of Age UK, said: "This report is deeply concerning and clearly shows that the CQC has been under resourced at a time when its workload has increased. The CQC has responsibility for ensuring safe and good quality services for people who need care, so it's crucial that they are fully resourced to inspect and regulate the care system."
A Department of Health spokeswoman said: "We are currently carrying out a review of the CQC's performance and capability to ensure that it is doing the best it can to protect patients. The findings of the review will be made public in the New Year. In the meantime, we will consider, with CQC, the recommendations made by the NAO."
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