CQC Inspections and Conflicts of Interest

Over the last three years, Gordons Partnership Solicitors has advised several providers on conflicts of interest on the part of CQC inspectors.

One CQC inspector turned up for an inspection and proceeded to tell the owner all about their care consultancy service in the area and how she was on good terms with all the local commissioners. We pushed back and eventually a new inspector was appointed with the service gaining an overall Good rating on re-inspection, in contrast to the conflicted inspector who had awarded an initial overall Inadequate rating.

On another case, it transpired that the inspector had applied for two jobs the previous year with the provider they were now inspecting. Evidently, the inspector had not got either of the jobs yet did not think it a problem to turn up and inspect one of the provider’s services. We wrote to CQC three times and eventually, the inspection was abandoned. A new team came out and rated the service in question overall Good, whereas the conflicted inspector had awarded overall Requires Improvement.

CQC has its own internal guidance on identifying conflicts of interest called Declaration of Interest and Resolution of Conflicts Policy. The current version is dated April 2015 and is available on the CQC website. The Policy states:

“All members of staff recognise and disclose activities that might give rise to conflicts of interest or the perception of conflicts and ensure that any such conflicts are seen to be properly managed or avoided. This ensures we can protect the credibility of CQC’s work and of the individuals who work for us.”

Significantly, the Policy states:

“Individuals will not ordinarily be allowed to inspect or register a service they have been previously engaged with or commissioned for a period of five years.”

We have come across situations where CQC inspectors have turned up to inspect services that they had been engaged with in a different capacity within the past five years. For example, in one case the inspector had been an advocate for a resident in the care home.

There are also situations where inspectors are close friends with people working in a care service they are inspecting. The CQC Policy states:

“Where staff are in a close friendship, personal or family relationship or financial relationship, there may be a potential for conflict of interest or breach of confidentiality. Therefore, where such a personal relationship exists or develops the individuals should declare their relationship in confidence to their line managers.

CQC staff are expected to demonstrate high standards of professional conduct and impartiality and it may be necessary to arrange their work so as to avoid the possibility of favouritism, adverse treatment and to protect the interests of all individuals.”

Providers and managers need to be alert to possible conflicts of interest involving inspectors. Of course, you may not know the inspector has a consultancy position advising other organisations in your area or is a close friend of someone working in your service. All you can do is be as vigilant as possible given the real and dramatic impact a conflict can have on an inspection in terms of ratings, as the above examples confirm.

More broadly, even if you do not know if there is a conflict of interest, where there is the appearance of bias on the part of an inspector this needs to be taken up with CQC given the potential impact on the integrity of the inspection. This can include negative or inappropriate statements about the provider or conduct that is not respectful towards staff such as acting in an authoritarian or intimidating manner. Such conduct, which thankfully is rare, is completely unacceptable and should be taken up with CQC without delay.

About the Author

Neil Grant
Partner and Health and Social Care Lawyer

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