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The CQC's next phase of regulation - an update on the changes

View profile for Laura Hannah
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The Care Quality Commission demands improvements to detox clinics

Adult social care providers should now be aware of the new assessment framework that was introduced by the Care Quality Commission (CQC) in November 2017, following a year of consultations. The CQC published its second consultation response in October 2017 and this outlines further changes in relation to how the CQC will monitor; inspect; rate and take action to improve adult social care services.

Changes to the CQC’s monitoring of adult social care services

The CQC have proposed an online process for collecting information from providers. This will be via a statement of quality about the five key questions and how providers are supporting continuous improvement, and will be in addition to the CQC’s ongoing monitoring and collection of information from other sources. There is likely to be further consultation on how and when this will take place, as well as further consideration of how this information will be developed and shared. The CQC have also proposed the implementation of ‘CQC Insight’ which is a tool that presents all of the information collected about providers. The CQC state within the second consultation that this could help inspectors understand the context to a provider’s performance.

CQC inspections and ratings

The timescales between comprehensive inspections are to be increased for providers who have previously been rated as ‘Good’ or ‘Outstanding’ from 24 months to 30 months from April 2018. Focused inspections will also be undertaken to target any areas of risk or concern and to monitor improvement. All focused inspections will focus on the well-led key question and in addition, the overall rating of a service acquired from their most recent comprehensive inspection will be able to change, by aggregating the ratings obtained from these focused inspections with the remaining key question ratings from the previous comprehensive inspection. This is a key difference from the previous framework which dealt with ratings from different inspections separately.

Taking enforcement action against a care provider

For those providers who are repeatedly rated as ‘Requires Improvement’, the CQC now plan to request an improvement action plan, which will be required to demonstrate how and when their overall rating will improve. If a third overall rating of ‘Requires Improvement’ is issued, enforcement action will be considered. Emphasis will also be placed on engaging with the leadership of providers with multiple locations where more than half of those services are rated ‘Requires Improvement’ or ‘Inadequate’, or if the CQC find significant concerns in a smaller proportion.

The CQC are also currently looking at plans to publish more details about the enforcement action taken against a provider in inspection reports. At present, the CQC are not able to publish such information until the period in which the provider can make representations or an appeal has passed and the outcome given. It is reported that the CQC’s approach to this change is to facilitate more transparency with the public by earlier publication of this information.

What does this mean for providers?

The success and effect of these changes is unlikely to be clear for some time. However, what providers should be doing now is making sure that they are familiar with their new framework and the incoming changes so that they can ensure that they are compliant and fully prepared for their next inspection.

There is no doubt that there is likely to be further modifications to the new framework as the CQC assess the success of these changes over the coming months and years. It is therefore extremely important that providers seek specialist assistance where required and make detailed and supported challenges to any findings or decisions that are not accurate or consistent with the CQC’s strategy and new framework.

If you are a registered provider or manager and you need advice or representation in relation to a CQC inspection; enforcement action; or an appeal to the first-tier tribunal, we have a dedicated team of specialist lawyers who are on hand to assist you. Call us now on 01616 966 229.