Navigating the CQC Storm: A Roadmap for Health and Social Care Providers
A couple of days ago on 15th October 2024 the Care Quality Commission (CQC) shared their response to both the final report of Dr Penny Dash’s review and the first report of the independent review by Professor Sir Mike Richards.
As you will all be aware, the CQC has had a tumultuous few years. Starting with a new strategy in 2021 that aimed to be “smarter” and more responsive, the regulator has faced significant challenges in delivering on its promises. This has created uncertainty for health and social care providers, leaving many wondering how to navigate the shifting sands of CQC regulation.
At Care 4 Quality, we understand the pressures you face. We’ve been diligently tracking the CQC’s journey and are here to help you in this evolving regulatory environment.
A Bumpy Road: Understanding the CQC’s Challenges
The CQC’s recent struggles have now been brought into sharp focus with the release of two critical independent reviews. These reports paint a picture of a regulator grappling with internal challenges and struggling to effectively fulfil its role of ensuring safe and high-quality care. For providers, this has created a sense of uncertainty and frustration, raising concerns about the fairness and effectiveness of CQC inspections.
The Dash Report: Led by Dr Penny Dash, this review looked into the operational effectiveness of the CQC. It found:
significant failings within the internal workings of the CQC, which have led to a substantial loss of credibility within the health and social care sectors, a deterioration in the ability of CQC to identify poor performance and support a drive to improve quality – and a direct impact on the capacity and capability of both the social care and the healthcare sectors to deliver much-needed improvements in care.
The conclusions are summarised in 10 topics which centre around operational inefficiencies, such as backlogs in provider registrations and significant delays in re-inspecting poorly rated services and the publishing inspection reports. It also highlighted a concerning loss of sector-specific expertise within the CQC, with a shift towards a more generalist approach to inspections and a loss of CQC to provider relationships. Furthermore, the report criticised the new Single Assessment Framework (SAF) for its lack of clarity both internally and externally, inconsistent application, and inadequate focus on evaluating care outcomes. The Dash report also identified a lack of transparency in CQC processes, particularly around how ratings are calculated, further eroding trust among providers. Finally, the report suggests that the CQC could do more to support improvements in quality by for example sharing descriptions of best practice.
The Richards Report: Conducted by Professor Sir Mike Richards and commissioned by the board of the CQC to complement the Dash report, this review provided a focused analysis of the new strategy launched in 2021 and its implementation.
The report confirmed that the CQC has failed to deliver on the benefits intended as a part of the transformation programme that followed the 2021 new strategy. As well as commenting on internal staff feeling angry and demoralised and there being insufficient staffing levels, it also confirmed many of the concerns raised by the Dash report. The Richards report highlights the SAF’s complexity, lack of clarity, and inconsistent application across different sectors. The report emphasised the need for a simpler, more user-friendly framework that is tailored to the specific needs of different care settings. The report states that:
Some aspects of the SF can probably be retained, but ideological commitment to a single assessment framework cannot be justified, given the very different services that CQC inspects and regulates.
Furthermore the report comments that while the CQC has started to take steps to mitigate some of the problems identified, it needs to go much further.
https://www.cqc.org.uk/publications/review-cqcs-single-assessment-framework-and-its-implementation
CQC’s Response: A Course Correction?
To its credit, the CQC has responded to these challenges with a commitment to change. The organisation has publicly acknowledged its shortcomings and outlined a series of actions to address the issues raised in the Dash and Richards reports.
These actions include:
- New Leadership: Appointing at least 3 sector-specific Chief Inspectors to lead on regulation and bring much-needed expertise back to the organisation, working alongside the new Chief Executive, Sir Julian Hartley.
- Revised SAF: Simplifying and tailoring the SAF to make it clearer, more user-friendly, and sector-specific. This will include amending the 34 quality statements.
- Improved Technology: Stabilising and improving the troubled regulatory platform and provider portal to ensure a seamless experience for providers, particularly for those trying to register with the CQC. For assessment activity the CQC will be exploring options for delivery away from the current systems as an interim measure.
- Enhanced Engagement: Increasing communication and collaboration with providers, actively seeking feedback and co-designing improvements.
The CQC’s response signals a willingness to learn from its mistakes and embark on a path of reform. However, the real test will be in the implementation of these changes. The regulator will need to demonstrate a sustained commitment to transparency, accountability, and continuous improvement to regain the trust of providers and the public.
What Can Providers Do Now?
In this period of transition, it’s crucial for providers to stay informed and proactive. Here’s how:
- Engage with the CQC: Participate in roadshows, online engagement sessions, and other opportunities to provide feedback and contribute to the co-design of improvements.
- Embrace Continuous Improvement: Develop a culture of continuous quality and safety improvement, actively incorporating feedback from CQC assessments and inspections into your practices.
- Stay Informed: Keep up-to-date with the CQC’s evolving regulatory approach, including changes to the SAF and inspection processes.
How Care 4 Quality Can Support You
At Care 4 Quality, we’re dedicated to helping health and social care providers not just meet but exceed CQC expectations. We don’t just offer generic advice; we provide tailored support to help you navigate the complexities of CQC regulation.
Keep an eye out for our upcoming webinar reviewing the last year since the CQC’s launch of the SAF!
Here’s how we can help:
- Mock Inspections: Our expert consultants will conduct mock inspections, providing invaluable feedback and helping you identify any areas for improvement before the CQC arrives.
- Policies and Procedures: We’ll help you develop and implement robust policies and procedures that are fully compliant with CQC requirements. We’ll ensure your documentation is up-to-date, clear, and reflects best practices.
- CQC Preparation and Support: Beyond mock inspections, we’ll provide comprehensive support to help you understand the new SAF, prepare for inspections, and address any areas of concern.
- Quality Improvement Consultancy: We’ll go beyond simply helping you meet standards; we’ll help you embed a culture of continuous improvement. Our expert consultants will work with you to develop and implement robust quality improvement systems, ensuring you deliver outstanding care that exceeds expectations.
- Training and Development: We offer tailored training programs to equip your team with the knowledge and skills they need to provide high-quality care and meet CQC requirements. Our training covers key areas like CQC compliance, safeguarding, person-centred care, and leadership development.
Contact us today to learn more about how we can help you navigate the CQC journey and ensure your service is always inspection-ready.
