One of the unfortunate outcomes of the COVID-19 pandemic is that many care homes and nursing homes may end up having to close due to the additional financial pressures this pandemic has placed on already struggling social care services.
In recent years, it has been reported that the demand for social care is expected to continue to rise quite significantly. However, with rising costs and more rigorous regulatory requirements, we have also seen an increase in care home closures. In December 2019, The Telegraph reported that there had been more than 600 care homes in England opened in 2019, however, there were over 900 closures, according to data commissioned by The Telegraph from the Care Quality Commission. The Telegraph also reported that this equated to an overall loss of 23,452 beds.
As the demand for care home placements and homecare will no doubt continue to rise in the coming years, we may (and hope to) see an increase in applications for registration with the CQC from new and existing providers wanting to register new care homes; nursing homes; and domiciliary care agencies to cater for this demand.
However, obtaining registration with the CQC is not always a straightforward, easy task. The CQC have been taking a more stringent approach to registrations in the last few years and this is reflected in the increase in refusals of registration. In the CQC’s annual report for 2018/19, it confirmed that the CQC had issued 564 registration Notices of Proposal in 2018/2019, which was an increase of 119 (26.7%) from 2017/18.
The CQC’s power to refuse an application for registration
It is not uncommon for applications for registration to be rejected by the CQC as ‘incomplete’ during their initial checks and before it is passed on to a registration inspector for assessment. This is not a refusal of the registration application, but simply a notification that the application needs to be amended and resubmitted before it can proceed. Applications are usually returned due to minor errors with the completion of the relevant forms, such as missing or incomplete information in relation to the provider’s details; the regulated activities applied for; or the location details, for example. It may also be rejected if the provider application and associated manager application have inconsistent details.
Following an assessment of the registration application, the CQC has the power to refuse the registration under Section 12 of the Health and Social Care Act 2008 if it is satisfied that the “the requirements of regulations under section 20, and the requirements of any other enactment which appears to the CC to be relevant, are not being and will continue to not be complied with (so far as applicable) in relation to the carrying on of the regulated activity”.
The most common reason for refusing a prospective provider’s application for registration with the CQC is that the CQC are not satisfied that a number of the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 will be complied with. This may be because the CQC has identified concerns over a provider’s proposed policies and procedures; staffing arrangements; or medicines management, for example. The CQC may also not be satisfied that the proposed manager is a ‘fit and proper person’ to manage the regulated activities.
Before refusing the application, the CQC must issue an applicant with a notice of proposal to refuse their application for registration in respect of the proposed regulated activities, which will detail their reasons for the proposed refusal. An applicant will be given a period of 28 days to make written representations against this proposal.
This is a provider’s opportunity to respond to the CQC’s concerns and provide any additional evidence or information in support of their application. It is important that a provider reviews each reason carefully and takes a careful and measured approach; this is only a proposal at this stage and there is still time to persuade the CQC to grant the registration.
Where a provider disputes the reasons provided, it is important that robust submissions are made to challenge those reasons with supporting documentation, and with reference to any applicable legislation; guidance; or case law. If any of the reasons provided are accepted, providers should consider how they can rectify or address those concerns in a timely manner and provide assurances to the CQC about their future compliance, particularly before any final decision on the registration is made.
After assessing any representations and evidence submitted, the CQC will determine whether to proceed with their refusal of the registration. If the CQC decides to adopt their proposal, the CQC will subsequently issue the applicant with a notice of decision confirming their proposal to refuse the application. The applicant has a right of appeal against this decision to the first-tier tribunal (care standards chamber) and the appeal has to be made in writing within 28 days. These appeals can take a number of months to conclude and in order to stand any prospect of success, providers need to ensure that they are able to support their challenge with clear, documentary evidence.
Our CQC lawyers can help you
You can view some of our recent case studies in this area here: CQC case studies
If you have received a notice of proposal or notice of decision from the CQC to refuse your registration as a service provider or manager, we have a specialist team of CQC lawyers who would be happy to help you. You can call our CQC lawyers now for advice on your registration on 0161 696 6250.
Recent blogs and articles
Read some of our other recent blogs and articles in relation to CQC registration here:
- How and when to register a regulated activity with the CQC – NRC (August 2019)
- Personal care - the requirement to register and when it goes wrong – Stephensons’ Blog (July 2019)
- Successfully completing the CQC registration process – NRC (February 2019)
- Wider issues around registration for CQC regulated bodies – The Carer (August 2018)
- CQC takes tougher line on manager registrations – CHM Online (July 2018)