What Have we Learnt about CQC Failings this Autumn?
Author: Alistair Slack
Key Contact: Jenny Wilde
The interim report by Dr Penny Dash, published in July, gave the sector an early glimpse of the forthcoming condemnation directed at the CQC (Care Quality Commission). Now in early November, we have access to the full text, as well as a supplementary report on the single assessment framework by Professor Sir Mike Richards, and a formal response from the CQC itself. We highlight the key takeaways of these appraisals, as well as their likely impact on the sector.
The Dash report
In her damning, Cabinet Office-commissioned review into the operational effectiveness of the CQC, Dr Dash spotlights 10 conclusions outlining areas relating to the functioning of the regulatory body, none of which will come as a surprise to service providers and users. These range from a lack of consistency in how care is assessed, to more structural failings such as the need to improve the sponsorship relationship between CQC and DHSC.
With the social care sector frequently making headlines in recent years, the direct tone of the report suggests that government departments are finally acknowledging the persistent concerns of service providers. This is just the first step service providers are owed, emphasising the need for the CQC to respond and take decisive action.
At the end of the report, Dr, Dash presents seven recommendations:
- Rapidly improve operational performance, fix the provider portal and regulatory platform, improve use of performance data within CQC, and improve the quality and timeliness of reports;
- Rebuild expertise within the organisation and relationships with providers;
- Review the SAF and how it is implemented to ensure it is fit for purpose, with clear descriptors, and a far greater focus on effectiveness;
- Clarify how ratings are calculated and make the results more transparent;
- Continue to evolve local authority assessments;
- Formally pause ICS assessments; and
- Strengthen sponsorship arrangements.
The Richards report
Commissioned by the board of the CQC, the report produced by Professor Sir Mike Richards goes in further in its scathing criticism, demonstrating that the leading initiatives that brought about the transformation programme back in 2021 have failed to deliver the benefits intended. Professor Richards’ rhetoric goes as far as to propose a fundamental reset akin to that in 2012/13, with a reversion to the previous organisational structure. Further key takeaways include:
- Re-establishing sector-based inspection directorates led by Chief Inspectors;
- Simplifying the Assessment Framework (SAF) to be sector-specific, removing evidence categories and scoring at the evidence category level;
- Retaining the five key questions and quality statements but abandoning the use of all evidence categories, which complicate the SAF; and
- Key Lines of Enquiries should be developed to provide better guidance when assessing the quality statements.
The CQC response
The CQC has stated that it has accepted the recommendations of both reports and “is taking rapid action in response”. Further, it claims to have committed to:
- Appointing at least three chief inspectors to lead on regulation;
- Simplifying the SAF and making it relevant to each sector;
- Fixing its systems and the provider portal; and
- Improving the registration experience.
The speed with which Sir Julian Hartley and the CQC can rebuild trust with service providers remains to be seen, but these recent publications are an encouraging sign that the challenges facing providers are now being prioritised. We hope the transparency these reports bring will compel the CQC to maintain an open dialogue approach as they address their deep-seated issues.
For advice on how the CQC’s proposed responses to criticism in the Dash and Richards reports may affect your service, contact our Health & Social Care team.
