If you’re a provider who has recently been assessed by the Care Quality Commission (CQC), you may be feeling uncertain about what comes next. As specialist CQC solicitors, we understand how complex and time-sensitive this process can be. This short guide outlines what to expect, how to respond effectively following your assessment and how we can assist you.
A surge in CQC assessments
The CQC has recently announced its plans to conduct 9,000 assessments across all regulated areas by September 2026, which is approximately 500 per month. This increase comes after the CQC announced its broader strategy to deliver more regular and comprehensive inspections. The assessments will cover:
- 5,013 in adult social care;
- 887 in secondary care;
- 1,194 in primary and community care;
- 1,500 in oral health and primary dental care; and
- 726 in mental health.
With this surge in assessments, providers should prepare for upcoming inspections and be ready to respond promptly and thoroughly to their draft inspection reports.
CQC factual accuracy challenge
Before publishing the assessment report, the CQC provides the registered individuals (such as the Nominated Individual and Registered Manager) with a draft assessment report for review via the CQC portal. This offers providers a critical opportunity to challenge any factual inaccuracies contained within the report or challenge any incomplete information that may have influenced the inspector’s findings, scoring and ratings.
You can challenge the report where:
- Information is factually incorrect; or
- Evidence is incomplete or missing.
Submitting a factual accuracy challenge
A factual accuracy challenge must be submitted within 10 working days of receiving the draft assessment report. This is a strict time frame and extensions are rarely granted, only in exceptional circumstances. As such, providers are strongly advised to seek specialist legal advice as soon as they receive their draft assessment report.
The factual accuracy challenge is typically structured around three core areas:
- Typographical or numerical errors;
- Accuracy of the information that contributed to the judgment;
- Omissions or additional information that should be taken into account.
It is important to note that for a challenge to stand any prospect of being successful, each point raised within the factual accuracy challenge must be supported by clear documentary evidence that was available to inspectors at the time of the assessment visit. Evidence which was not available on the day of the assessment, but that demonstrates any action taken since the inspection to address any concerns raised, can also be submitted at this stage but it will not affect the overall judgment or scoring.
The factual accuracy challenge can be submitted using the CQC’s factual accuracy check form or the online form following the link provided.
Does a factual accuracy challenge matter?
While challenging a CQC assessment report is an important step, providers do not always submit factual accuracy comments. This may be because they do not think it will make a difference or they do not wish to aggravate matters with the CQC. This is a common misconception. If no response is submitted, the CQC may assume that the draft report is accurate and that all of the evidence base is complete. This version of the report will then be published, at which point you will not be able to challenge the accuracy and completeness of the report. The findings, scoring and ratings outlined within this report may then form the basis of future enforcement action.
A carefully prepared and well-substantiated factual accuracy challenge can:
- Correct any inaccuracies or errors contained within the report;
- Prevent enforcement action based on flawed findings; and
- Strengthen your position should further reviews be necessary.
CQC ratings review request
What are your options if your factual accuracy challenge is unsuccessful?
If a provider chooses not to challenge the draft assessment report or their factual accuracy challenge is unsuccessful, they may wish to request a review of the ratings within the final inspection report. However, the grounds for doing so are narrow: the only ground for requesting a review is that the inspector did not follow the correct process for making ratings decisions and aggregating them.
It is important to note that:
- A ratings review request must be submitted within 15 working days of publication of the report;
- A ratings review cannot be requested before publication;
- The ratings review request is limited to 500 words in total;
- There is no guarantee that a request will result in a change in the ratings;
- The ratings review could result in an increase or decrease to the ratings.
When making a ratings review request, providers must state which particular ratings they want to be reviewed, as well as specifying the grounds upon which they are requesting the review. Providers only have one opportunity to submit a ratings review request and it is therefore crucial that this is completely correctly and appropriately.
After the CQC make their decision on a ratings review request, their decision will be sent to the provider in writing. If a rating has been changed, the inspection report will be removed and replaced with a new, amended version. In some circumstances, particularly where more than one rating has changed, the CQC may remove the report entirely and undertake a full fresh inspection.
It is important to note that while these challenges are difficult, if a request is not made, providers may have to wait some time before their published ratings are reviewed or a further inspection takes place. During that time, an inaccurate rating may negatively affect their reputation; financial standing; and/or ability to secure contracts.
How can we help you?
At Stephensons, our specialist CQC lawyers regularly represent care providers nationwide during the factual accuracy and ratings review processes. In particular, we have achieved success at persuading the CQC to amend, and even remove, parts of an inspection report prior to publication, as well as withdraw entire reports from publication and re-inspect. We have also successfully challenged multiple ratings at both stages, which in some cases has changed the overall rating of a service from ‘requires improvement’ to ‘good’ and from ‘good’ to ‘outstanding’. Our experienced CQC lawyers have also successfully challenged breaches of the 2014 regulations during the factual accuracy process which has resulted in an increase in one or more ratings. You can view our CQC case studies page here for more details on some of our recent cases.
If you have received a draft assessment report or wish to challenge your ratings, we can assist you with compiling a robust and detailed response to the CQC to place you in the best possible position. For a confidential discussion with one of our specialist CQC lawyers, please call us on 0161 696 6250 or complete our online enquiry form.
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