CQC Inspection Reports – the retreat from objective into subjective truth
In society in general, there has been an increasing retreat from objective truth into subjective truth.
We have noticed this trend with Care Quality Commission inspection reports. For example, CQC will quote care staff in a draft inspection report alleging that staffing levels are insufficient or there has been a lack of training or the manager is not supportive. Often the statements can be highly personal in their criticism of the service’s manager and thus highly damaging to that person’s reputation. They can also affect the morale of the service overall.
The identities of the care staff who have made negative statements are never disclosed by CQC as part of the inspection process as they are deemed confidential. Therefore, it makes it difficult for the provider and manager to respond. Of course, the criticism may be justified, with action needing to be taken to address any shortcomings. However, we come across cases where a group of staff in a service may not like the manager, often when their performance has been called out by that manager. When interviewed by a CQC inspector, it is not surprising they give a less than flattering account of the manager and the service.
When we have submitted objective evidence to rebut allegations about insufficient staffing levels or training or support, CQC has responded by saying that they are obliged to publish the “lived experience” of the staff. However, that cannot be right. CQC is an investigative body with the responsibility of deciding whether standards in care services are meeting legal requirements. It should be regulating on the basis of objective, robust evidence, not the perception or feelings of staff members.
A few years ago, CQC published an excellent document called the “Judgement Framework” which stated that inspectors had to triangulate or corroborate general anecdotal statements before publishing them, otherwise they would be merely unsubstantiated hearsay. However, now CQC says everyone is entitled to a “voice”, meaning they must publish statements even when there is objective evidence to challenge them.
Of course, statements from staff, as well as residents in care, need to be taken very seriously but they should not be treated as the truth without being tested first, particularly when those same statements are likely to be used to rate a care service and support findings of breach of statutory requirements, and can damage the reputation of a manager, sometimes irretrievably.
Thankfully the courts still arrive at decisions on the basis of the facts and the evidence. That is why I tell clients to get their case across to CQC for the record, even if CQC ignores the facts and evidence. It includes challenging CQC if its response to a provider’s factual accuracy comments is inadequate. It is about creating an evidence trail so that if CQC does take enforcement action it can be shown the provider has objected previously to CQC’s “findings” on the basis of objective, not subjective, evidence.
About the Author
Partner & Health and Social Care Solicitor
D.D: 01483 366069
Tel: 01483 451900
Email: neil@gordonsols.co.uk