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Care watchdog criticised over abandoned bid to replace service-user contracts

The care watchdog is facing heavy criticism after being forced to abandon a year-long attempt to find organisations to run a programme that sends expert service-users to assist on inspections of care homes, hospitals and care agencies across England.

The Experts by Experience (ExE) programme is currently run by two contractors, Choice Support and Remploy, but disabled people and other service-users who take part in the scheme have been pushing the Care Quality Commission (CQC) for years to dump Remploy because of its poor performance.

A process to find new contractors began in August 2017, with an invitation to tender released in August 2018, but CQC decided to terminate the process last November.

The existing contracts with Remploy and Choice Support were supposed to expire this June but have now had to be extended by nine months until 2020 after CQC failed to find more than two possible contractors willing to enter detailed negotiations.

Disability News Service (DNS) has been reporting on concerns about Remploy’s performance since it began work on the contracts in early 2016, with initial reports of confusion, cutbacks and a stream of resignations, and some Remploy ExEs being told to print their own ID badges.

It then emerged that Remploy had lied about the involvement of user-led organisations in its new contracts.

There were also concerns about the decision to award the contracts to an organisation mostly owned by the US company Maximus, which already had a huge chunk of Department for Work and Pensions contracts and had a lengthy record of discrimination, incompetence and alleged fraud in the US.

A group of 30 current and former ExEs have now reacted to the collapse of the tendering process by sending the commission a letter, accusing it of wasting “huge amounts of time and public funding” on a “lengthy and now abandoned procurement exercise”.

They say the last three years have been “a shambles”, and add: “The aim of the 2016 contract was to increase the number of skilled and trained Experts and ensure the experiences of people who use health and social care services were a vital and increasing part of the inspection process and rating system. That did not happen.”

The letter says the service provided by Remploy, after nearly three years of running three of the four regional ExE contracts, “continues to be poor, ineffective, chaotic, unfair, reactive and damaging to Experts, but more importantly, a disservice to people who use health and social care services”.

They say this “continues to bring the Experts by Experience programme and the whole of CQC into disrepute”, and they accuse Remploy of failing to check the references of potential ExEs, providing poor induction and training, failing to offer feedback to ExEs, and asking them to travel more than 50 miles to inspections.

These flaws are causing skilled and trained ExEs to leave the programme, they say.

They accuse CQC of failing to learn the lessons of the previous procurement exercise in 2015, which has permitted “poor performance and practice from Remploy to continue with no redress” and has allowed Remploy to continue paying ExEs £9 an hour when Choice Support pays its own ExEs £15 an hour.

Their letter also points out that CQC was forced to re-negotiate the Remploy and Choice Support contracts in 2017 after it failed to request enough ExEs to take part in inspections.

One ExE told DNS: “A lot of us have been waiting since 2016 for CQC to get rid of Remploy.

“We were expecting the new contract to start in June this year.

“Now they say they have asked the current providers to continue until 2020. That was such a blow.

“It felt like the rug being pulled from under your feet. It will be four years with a provider [Remploy] that is just dreadful.

“This is a massive waste of public money. How much must this procurement have cost over such a lengthy time? They must have had huge legal costs.

“We are stuck in limbo now. We just feel let down and abandoned.”

Chris Day, CQC’s director of engagement, said in a statement: “Unfortunately we did not reach the minimum number of required tenders to be able to proceed to the next phase of the CQC Experts by Experience procurement and had no other option but to terminate the process.

“While we understand the frustration and uncertainty faced by some around this decision it is essential that we get this right and will restart this procurement as soon as possible.

“The current contracts with Choice Support and Remploy Ltd will be extended until March 2020 to make sure there is no interruption to the programme.

“We remain absolutely committed to the Experts by Experience programme and we are grateful for the continued hard work and support from Experts by Experience, Choice Support, Remploy Ltd and their partners in helping us to ensure we continue to embed the voice of people who use services throughout our work.”

In a letter responding to the 30 ExEs, CQC’s chief executive, Ian Trenholm, said that more than 90 per cent of Experts who sent feedback forms to CQC in November and December rated both Remploy and Choice Support as either good or excellent.

A Remploy spokesperson said in a statement: “Experts by Experience is an important programme that ensures the voice of health and care service users and their families are heard during inspections.

“Remploy is proud to be delivering the programme to a high standard, consistently meeting or exceeding all contractual commitments over the past year.

“As an organisation we are committed to supporting all of our Experts by Experience (ExEs) to carry out their important work. 

“We regularly engage with ExEs to seek their feedback on the delivery of the programme.

“Feedback from more than 1,500 inspections shows that 92 per cent rated the support they received from Remploy as good or outstanding. 

“We look forward to working closely with ExEs and the CQC as we continue delivery of the current contract until March 2020.”

Choice Support declined to comment.

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