Research by Care Home Professional has revealed that in the last five years there has been an increasing number of health and social care providers rated as Requires Improvement and Inadequate.
Care Home Professional analysed CQC data and found the following:
- The total number of total ratings have nearly halved from 2019 (pre-pandemic) to 2020 (post-pandemic);
- There were 476 care providers rated as requires improvement in 2019, which slightly decreased to 423 in 2020 and then doubled to 852 in 2021; and
- 256 care providers were rated as Outstanding in 2019, which was also halved in 2020 to only 128.
Thus, the trend we see is a disproportionate increase in negative ratings, which can cause irreparable damage to providers including loss of funding, conditions placed on registrations to halt admissions, loss of service users, and in the most severe cases shutting down of the service.
Some theories about why this was the case include the fact that the pandemic completely changed how inspections took place. Due to Government Guidance at the time, inspecting services physically became nearly impossible. This would explain the overall decrease in the number of inspections, however it does not explain the disproportionate increase in negative ratings compared to positive.
Another theory relates to the fact that the CQC largely switched to a risk-based inspection approach, meaning they would come in and inspect in the services that need it most (i.e. where concerns have been raised about the quality and safety of care delivered). This would explain why we see more negative ratings than positive. However, it does not address the fundamental concerns of many providers and sector leaders that the CQC approach to inspections is simply not fit for purpose.
At Ridouts we often see CQC inspectors focusing heavily on, and giving what we argue is disproportionate weight and value, to evidence that supports criticisms without properly balancing this against evidence to the contrary. This can come in the form of the CQC solely and/or primarily relying on service user and stakeholder experience and opinion, viewing documentary evidence in isolation, failing to triangulate experiences and opinions with documentary evidence, and refusal to give providers a fair opportunity to offer clarity or explanation of potential concerns. This not only creates a huge tension between the CQC and service providers, but also leads to costly legal fees for providers who choose to challenge the CQC reports which tend to be disproportionately negative and misrepresentative of the service.
In a recent article I wrote (here), even staff within the CQC are losing faith in the organisation’s ability to inspect services effectively. Ultimately it seems that there needs to be a change in the CQC’s approach to inspections.