Inconsistencies in the Care Quality Commission (CQC)’s inspection regime could be impacting the performance of  care homes.

Analysis of CQC data has found that one in five care homes in England is underperforming, with nearly 3,000 of the 14,975 properties have ratings of Inadequate or Requires Improvement.

Greater Manchester’s Trafford has 37 out of 86 services with either of the two ratings, meaning it has the highest percentage (43%) in the country.

Portsmouth, Tameside, Barnsley, Isle of Wight, Bradford, Barking and Salford all have more than a third of providers rated less than Good, according to the analysis by the BBC.

West Berkshire, however, was found to have the highest rate of Good care homes, with just one of 62 providers deemed Inadequate or Requires Improvement.

Nadra Ahmed, National Care Association chief executive, told the BBC that regional variations in underperforming care homes reflected ‘inconsistencies’ in the CQC’s inspection regime, as well as staffing problems.

‘What we find with people who have different homes in different parts of the country is that, while they have the same ethos, inspectors can differ in their ratings,’ she said.

Bhavna Keane-Rao, director of care consultancy BKR, told CM: ‘There needs to be a way of making the CQC inspection regime more consistent.

‘There’s obviously a link between lack of funding and the care homes up north facing challenges, but the variation also has a lot to do with the inconsistencies of inspectors operating in a subjective system.

‘The role of the regulator and its methodology has changed significantly. It used to be more advisory, then it became more about enforcement and now they are returning to working with providers,’ she said.

In April, the CQC’s chief inspector of adult social care Andrea Sutcliffe told MPs she was concerned about the ability of organisations to sustain good ratings or make improvements in the face of cost pressures and growing service demand.

Responding to the latest figures, she said: ‘The CQC takes very seriously the importance of consistency in deciding upon the ratings for services and reaching the judgments we make. Every report is quality assured and decisions about enforcement action are subject to considerable scrutiny.

‘These measures are designed to minimise inconsistency and ensure the public and providers can have confidence in the rating judgments we make.

‘If issues are raised with us we will always consider them and share any learning with the team,’ she added.

Professor Martin Green, Care England chief executive, dismissed the BBC analysis. He said: ‘The number of services described as Inadequate is small, and the Inadequate rating is an indicator of poor services.

‘Requires Improvement is a different category, and can include minor breaches of administration, and in most cases, the care is judged as good.

‘I am disappointed that a public service broadcaster such as the BBC, is through sloppy reporting, creating a false view of the quality of care.’