Here at Ridouts we spend a large part of our time acting for Clients who have suffered at the hands of an inefficient CQC.
We are regularly approached by Clients who have been issued with draft inspection reports that are riddled with errors, judgments with no basis in fact or are simply built around an inspector’s own subjective view of a service. We unpick the prose and try to work through the Provider’s evidence to get to the truth and submit robust factual accuracy comments. In these cases it is our job, on behalf of the Provider, to highlight to the CQC where they have got it wrong. The results of that work can vary, depending on whom at the CQC reviews the submissions but largely, where solid evidence has been provided, the CQC will be reasonable and amend the draft inspection report.
Often we marvel at the unpredictable quality of inspection reports. CQC are a national regulator and are responsible for providing vulnerable service users and their families with accurate details about health and social care services. Despite this enormous responsibility, we have seen countless instances where the draft reports are flawed, misleading and have to potential to do serious damage to a Provider’s commercial relationships, as well as its reputation. This is usually as a result of an inspector/ author who has failed to properly consider evidence or who has a personal agenda against the service.
It would appear that now, after years of highlighting to the CQC that the consistency and reliability of reports is a serious issue, the regulator is taking action. In recent weeks the CQC have been openly recruiting for the brand new position of “Report Writing Coaches”. The job description states that the purpose of the role is:
“To improve the quality of inspection and registration reports and reduce the burden of report writing on inspectors and managers in the adult social care directorate……
To role model CQC’s values and behaviours……
The outcome will be inspectors write better reports in a shorter time – in terms of inspector days”.
Whilst it is reassuring to see the CQC taking affirmative action, many Providers will be frustrated that the concerns they have been expressing for years are only now being acknowledged and addressed.
The job description states that the Report Writing Coach will be responsible for “giving prompt, structured feedback to the writer in a form that enables them to improve the quality of the report” and “providing coaching and training that is tailored to the needs of the individual report writer”. The big question is: “WHY HAS THIS TAKEN SO LONG!?” Providers may also ask themselves what was in place before the creation of this role.
The subjectivity of inspectors has been a longstanding issue. Couple this with the fact that the inspectors themselves review and make decisions on factual accuracy comments and Providers have a perfect storm. We have challenged CQC regularly on the reliability and fairness of the factual accuracy comments process. How can it be right that the inspector whose work you are calling inaccurate and flawed is the person that decides whether or not those concerns are rejected or accepted? To accept factual accuracy comments acknowledges a weakness in process and drafting. There is a significant risk that inspectors will ignore a Provider’s comments in order to preserve their own professional reputation. CQC’s response to this concern is that the Provider’s factual accuracy response is reviewed by an “independent” inspection manager before being returned to the Provider BUT in reality, how independent is that manager? Surely they also have a degree of an agenda, specifically, wanting to support their colleague and direct charge. Surely the success of an inspector also reflects upon them as their manager. For an inspection manager to pick holes in a draft inspection report and accept a Provider’s view that the inspection may not be up to scratch is a bold move and not one we have seen regularly demonstrated by this pool of managers. There is no impartial system for Providers to rely upon and instead, they have to hope that the inspector is a reasonable person who will consider their comments with impartiality and fairness…..easier said than done!
The introduction of the Report Writing Coaches may seem like a minor thing to most but to us we see it as acknowledgement from the CQC that, historically, inspection reports have not been fit for purpose. We would agree with that view. Our only hope is that the work put in by these new CQC staff members will not only result in more balanced, clearer and better quality reports but also that report authors will be reminded of the importance of only making statements that can be supported by evidence. Time will tell.
We will continue to support clients with responses to draft inspection reports and empower them to challenge CQC when the report is not truly reflective of their service. Inspection reports are a vital tool for both Providers and members of the public and the CQC ought to be reminded that it owes it to these groups to make sure that the documents they produce are quality controlled and fairly assessed when deficiencies are found.