It is always helpful for providers to keep an eye out for reports of recent CQC enforcement action in order to help identify trends and to learn from other providers. Looking back over this year’s CQC press releases there have been some substantial fines and some key areas for providers to be alert to.

Failure to keep people safe

Not surprisingly, keeping people safe has been the key focus of CQC’s enforcement action with some hefty fines being imposed on both managers and providers. It is likely that these safety issues will be in the forefront of the minds of inspectors.

One of the largest fines was imposed by the courts in June 2022, when a care home provider was fined £1,500,000. They were also ordered to pay the victim surcharge of £170 and £27,000 in costs to CQC. In this case, an individual was admitted to the setting after being discharged from hospital. The speech and language therapist at the hospital had advised that he was at risk of choking and needed a special diet. A team leader at the setting did not identify a choking risk. A nurse reviewed the care plans and amended them to say that the resident eats a normal diet and drinks normal fluids. Shortly afterwards the resident died and the cause of death was choking on his food.

It highlights the importance of supporting residents to eat and drink safely, maintaining accurate care records and working with external healthcare professionals, incorporating advice into care plans and risk assessments.

In July 2022, a care provider was fined £100,000 after a resident sustained minor injuries to their head, hands and legs having exited from a first floor window. There were window restrictors in place but these did not comply with the recognised safety standards and could be manually overridden. In addition to the fine, the provider was ordered to pay costs to CQC and a victim surcharge. It is a reminder to make sure that all window restrictors are in place and are suitable.

A residential care home provider was fined £30,000 and the individual manager was fined £1,200, (plus costs and a victim surcharge) following an incident whereby a resident fell out of their wheelchair and sustained injuries including a fracture and significant bruising but no medical assistance was requested and no notification was made. It turned out that no lap belt had been in place at the time of the incident and the family had to call an ambulance upon their next visit.

Duty of Candour  

The Duty of Candour under Regulation 12 of the Health and Social Care Act is extremely important for providers and CQC do prosecute when they feel it is necessary. A care home was recently convicted and fined £11,371 as it failed to inform and apologise to the appropriate person following the death of a resident living in one of their care homes. The resident had died after falling from an upper extension roof while trying to leave the care centre. At the time of the hearing the family had not received verbal or written confirmation of the event or an apology.

Failure to protect someone from sexual assault

A care home provider was recently fined £128,000 and ordered to pay a £120 victim surcharge and £10,645 costs to CQC. In addition, the manager was ordered to pay £1,000 and £15,067 costs and a victim surcharge of £100. The manager was aware that one of the residents was on the sex offenders register, yet this resident sexually assaulted another resident with advanced dementia who lacked capacity. Suitable systems and processes must be in place to keep people safe.

Conclusion

These examples of CQC’s enforcement activity demonstrate that CQC are not afraid to flex their muscles and push for hefty fines when incidents occur that breach the regulations. It is a reminder that it it not just ratings that providers need to be alert to. It is crucial to periodically keep an eye on trends in CQC enforcement and take on board areas for learning to ensure the safe delivery of care to your clients at all times.

Solicitors Health and Social Care

Please feel free to contact us for an initial chat about any regulatory issues you may have with CQC.

About the Author

Lucy Bowker
Health and Social Care Lawyer