CQC criticised: “A regulator which gets it wrong is worse than no regulator at all”

The House of Commons Joint Committee on Human Rights published its second report earlier this month. The report is critical of the Care Quality Commission (“CQC”) and highly critical of the current state of health and social care services for children with learning difficulties and autism.

The report proposes a number of recommendations to improve what it sees as shortfalls in the CQC’s inspection process, which it hopes will be adopted by the ongoing Whorlton Hall enquiry.

If adopted, the recommendations could significantly change CQC’s inspection practises and how the CQC determines ratings. The recommendations include:

  • Making inspections more “fleet of foot”. In other words, having more unannounced inspections at nights and on weekends;
  • Preventing the CQC giving an overall “good” rating where one key line of enquiry falls below that rating;
  • The use of covert surveillance to better inform inspection judgments;
  • Recognising all patient’s (and families’) concerns about treatment as constituting evidence and acted upon; and
  • Legislative change to enable the CQC to act more swiftly

Whether these are adopted remain to be seen and there is unlikely to be any immediate significant reform. However, the consensus seems to be that reform is needed.

In the long term, providers can assume that it will be a matter of when and to what degree – not if – things change for CQC inspections. There are likely to be further developments, consultations and publications, and providers are encouraged to keep abreast of developments.

In the short term, providers may see a subtle shift in CQC activity where this does not require changes to the law or existing policy, such as more out-of-hours inspections.

Providers would be sensible to remind all staff about the CQC inspection process and that standards should be maintained at all times of day and night. Staff should be encouraged to take (and keep) a record of what was discussed with the inspector, whenever it takes place, particularly if key members of management are not present.