Challenging CQC inspection reports

Factual accuracy challenge - CQC

Before a CQC inspection report is published, providers are given the opportunity to challenge the accuracy and completeness of the evidence on which the inspector’s ratings and judgments are based. The factual accuracy challenge is separated into three sections:

• Typographical or numerical errors

• Accuracy of the evidence

• Additional or omitted information that should be considered

Providers are usually given around 10 working days from the date they receive the draft report by email to submit any challenge. Extensions to this period are no longer granted unless there are exceptional circumstances and these are outlined to the CQC in writing. It is therefore vital that providers seek specialist advice as soon as they receive their draft report.

The CQC have recently introduced a new factual accuracy check form, which must be downloaded from the CQC’s website and used for any challenge. There is now a limit of 975 characters for each point made and each point must be made on a separate row within the form. Previously, the form would be sent to providers with their draft inspection report and there would be no word limit.

At this stage, it is vital that providers make detailed and supported challenges to any findings within the draft report that are not accurate or consistent with the CQC’s assessment framework and guidance. However, it is important to note that, for a challenge to stand any prospect of being successful, it must be supported by clear documentary evidence, which was available to the inspectors on the day of the inspection. Where evidence is relied on, providers should ensure that they direct the CQC to the specific page or part of the document which supports the point made.

Evidence which was not available on the day of the inspection, but that demonstrates any action taken since the inspection to address any concerns raised, can also be submitted at this stage. Whilst the CQC can amend the report to reflect this new information, it will not usually form part of the CQC’s decision in relation to their final judgements or ratings, except in exceptional circumstances.

It is sometimes the case that providers do not submit factual accuracy comments even where they are not satisfied with the accuracy or completeness of a draft report. This may be because they do not think it will make a difference or in some cases, they do not wish to aggravate matters with their inspector. This is entirely the wrong course of action; providers should always make clear, robust challenges against draft reports, whatever the circumstances may be. If no challenge is made to a draft report and it is subsequently published, there is a presumption that the contents of the published report is entirely accurate. There is also no record that a provider has challenged any of the findings within the inspection report, which is often used as the basis for a decision by the CQC to pursue enforcement action. It is also much more difficult for providers to dispute the need for enforcement action on the basis of unchallenged inspection findings.

Ratings review request - CQC

If a provider is not happy with the outcome of the factual accuracy process, there is subsequently an option to request a review of the ratings. The only ground for requesting a review is that the inspector did not follow the process for making ratings decisions and aggregating them.

A ratings review request must be submitted to the CQC using the appropriate online web form within 15 working days of publication of the report; it cannot be made before publication.

It is important for providers to be aware that the CQC recently limited a provider’s ability to challenge ratings by capping any challenge to just 500 words. This means that the factual accuracy process is even more important as the CQC will reconsider any factual accuracy challenge made when considering a ratings review.

When making a ratings review request, providers must state which particular ratings they want to be reviewed, as well as the grounds upon which they are requesting the review. Providers only have one opportunity to submit a ratings review request and it is therefore vital that this is completed correctly, any subsequent request in respect of the same inspection report will not be considered by the CQC. It is also important to note that a review of ratings cannot only result in an increase in ratings, but also a decrease too.

After the CQC make their decision on a ratings review request, their decision will be sent to a provider in writing. If a rating has been changed, the published inspection report will be removed from publication and replaced with the new, amended version. In some circumstances, where more than one rating has changed and it has resulted in significant changes to the report, the CQC may decide to remove the report entirely and undertake a completely fresh inspection.

Whilst success with these challenges is sometimes difficult, if a request is not made, the CQC will not look to consider the published ratings and they will remain unchanged. In the most serious of cases, where a negative rating escalates to enforcement action, clear challenges to the factual accuracy of a draft report and the published ratings can provide helpful evidence in any appeal against such enforcement action.

Get in touch

If you wish to challenge your inspection 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 0203 816 9274 or complete our online enquiry form and a member of the team will contact you directly.