Lucy Bowker, Solicitor in Gordons Partnership Health and Social Care department, is featured in the October issue of Caring UK, discussing the CQC’s new approach to regulation.

Introduction

CQC are evolving their approach to regulation. They say that they will focus on risk and every month they will review all data held about all services including feedback and complaints. The data will be stored on a monitoring app for inspectors which providers will not have access to. How providers will be able to address concerns without seeing the evidence base is yet to be seen.  A standardised public statement will be issued if CQC are content. If no statement is published for your service, you can expect either monitoring calls and emails or perhaps an inspection.

Re-rating

It is important to stress that CQC will not be able to re-rate a service without physically inspecting. This is something that CQC would very much like to be able to do.  In order to do so, CQC say they need to consult on the issue however no timeframe has been given for when this will take place.

As it stands, when Inspectors visit services, they are applying a focused methodology which allows them to change the ratings. If, however, they are responding to something they consider to be high risk, then they will need to come in quickly without the time to plan a focused inspection, so it is likely to be a targeted inspection which does not lead to a change in ratings.  Providers will not be seeing the routine full inspections that we were accustomed to.

Furthermore, with the focus being on risk, it seems that those services looking to go from Good to Outstanding or even from Requires Improvement to Good are likely to have to wait some time before seeing any changes to ratings. CQC have acknowledged that current ratings are not necessarily reflective of services, and they suggest that if a rating is causing business difficulties it is worth highlighting this to your inspector.

New Performance Assessment Framework

A flexible new assessment framework has been promised, although a publication date has not been forthcoming. It is anticipated that it will be ready at some point in 2022. We have been assured that the five key questions will remain the same but there will be a simplified set of KLOEs and characteristics.

What to expect from an inspection?

CQC have warned that inspections may feel different. When they do visit, the focus will be on observations and conversations. Documents are likely to be requested before or after the physical inspection. The inspector is likely to know what they are looking for evidence of and they will be trying to fill gaps. It will be harder to demonstrate your achievements. CQC suggest using the Provider Information Returns (which will be due on the registration anniversary of a service) as means to demonstrate any improvement.

Conclusion

It is clear that there is no sudden change of direction for CQC following their new strategy. The risk-based approach which has emerged in recent times is here to stay. It will be much harder for services to demonstrate improvements. For many services outdated ratings are here to stay at least for now.

You can find the full Caring UK October issue here.

About the Author

Lucy is a regulatory lawyer acting for health and social care providers within the firm’s Health and Social Care Department. Clients include care homes for adults, children’s homes, domiciliary care agencies and independent hospitals.

Lucy Bowker - Gordons employee

Lucy Bowker
Solicitor