CQC’s update to Registering the right support guidance: more work to be done

As we have recently reported, the CQC are engaged in a project of reviewing and updating their guidance for providers of health and care services to people with learning disabilities and autism.

The previous guidance, entitled Registering the Right Support (RTRS) was issued by the CQC under its statutory powers to issue formal guidance to providers. Whilst it is “guidance” and not the law, providers of these services are required to consider and, in all but exceptional cases, apply it to meet their regulatory requirements.

Many have found the existing guidance unhelpful in practice and have found CQC’s approach to the guidance concerning. It has been the subject of a significant number of disputes and has caused registrations to be delayed significantly. It is noteworthy, that a number of RTRS cases have made it to the Care Standard Tribunal in recent years.

We were particularly disappointed to see that the proposed guidance, entitled Right Support, Right Care, Right Culture does little more than add a few pages of further commentary, with some accompanying case studies. It does not go to the heart of any of the real and practical issues that providers have faced when they, or the CQC, have tried to follow the previous guidance. In our view, it makes CQC’s position even less clear and puts transparency and consistent decision making at risk.

The CQC reports that they received over 150 responses on the portal – one of which was from Ridouts – and in light of those responses, acknowledges that further work needs to be done before the guidance is finalised. They state:

 “it is clear there is more work for us to do to give more clarity in the guidance around the size of services we will register, the link to NICE guidance and how  demonstrations of personalised care and outcomes impact our registration decisions. Because of this we will be taking some more time to engage and make further revisions to the guidance.”

The CQC have therefore at least acknowledged that more work needs to be done. Whether they will seek to contain this work to the limited areas identified remains to be seen. We hope they will go further to ensure that the guidance is clear, and workable, once and for all.  Either way, providers can expect further announcements from the CQC, and probably further draft guidance, to follow.

Providers are encouraged to get involved in the CQC’s project, and to respond to any calls for comments or views. The next round of engagement may be the last opportunity for providers to have a say and help frame the guidance before it is finalised.

Guidance to promote and support quality, person-centred and outcome focused care for people with learning disabilities and autism is clearly important. At the same time it is critical that the final guidance is clear, and works in practice for the CQC and providers alike, unlike RTRS.

If they have not already done so, providers are advised to sign up to the CQC citizen lab portal and, when signing up, opt in to e-mail updates. Otherwise, CQC “projects” may pass them by and they might lose the opportunity to have a say before the guidance is finalised and comes into force.