How the CQC intends to shake up regulation for adult social care

Under plans released just before the 2016 Christmas break, the Care Quality Commission set out its broad plans to revise the way that it performs its obligations from April 2017.

The approach towards taking regulatory action where providers fall beneath the requirements set out in the Fundamental Standards remains. There will be an increased focus on how providers demonstrate good leadership and good standards of safety.

CQC is looking at what it should do from a regulatory perspective when a provider fails to improve their rating above ‘requires improvement’ or ‘good’ and is effectively coasting without change. This finding has been drawn from the annual State of Care Report which found just shy of 50 per cent of adult social care providers failed to improve their ratings on re-inspection.

This trend has cross-sector significance and CQC has announced in this consultation its intention to act to encourage perceived coasters to improve. CQC will publish another consultation document in the spring which will flesh out the detail of its intentions but providers should take note in advance.

There appears to be clear impetus to focus on holding to account senior management within larger operators for the roles they play in individual locations. The importance of good leadership within an organisation above the level of the individual location will be recognised as part of inspections and within changes yet to be announced within the registration process.

CQC seeks to capture the ‘guiding mind’ of an organisation within the registration process, a task which it feels the current registration process fails to account for. This approach may see the registration form for new providers require more detail in relation to company structure and responsibilities; we await the spring 2017 consultation for further detail.

CQC plans on reducing the 11 separate handbooks and assessment frameworks to two: one for healthcare and one for adult social care. At first reading this looks to be a common sense way of giving providers the clarity to go to one source easily to ensure their compliance with regulatory standards.

The new proposed assessment frameworks, published as appendices to the consultation, will prove more difficult to interpret than the older versions as they are catch-all frameworks with caveats drawn out to reflect those areas which do not apply to particular providers. This will make it harder for providers to easily digest the content.

CQC has also stated that it may seek to provide ratings for adult social care organisations as a whole-something which is not currently done, the detail of which will hopefully become apparent in the consultation to be announced later this year.

The five key questions remain with proposed revisions to key lines of inquiry (KLOEs) and ratings characteristics. The desire is to draw a more direct correlation between the questions asked at inspection with the characteristics which define each rating level. CQC states that the changes it seeks to make should make responding to requests a simpler and more straightforward process and will draw upon lessons learned over the past three years inspecting. We await to hear of these lessons in due course.

The consultation reveals in broad terms how CQC intends to carry out its regulatory functions post-July 2017. It remains to be seen how CQC will react following the completion of its inspections of all providers in the early part of 2017; we may find a regulator who feels empowered to taking more regulatory action on the back of its baseline of inspections. Providers should watch out for the spring consultation for the detail behind the concepts put forward in this consultation for adult social care.

Nythan Smith is a trainee solicitor at Ridouts. This article was first published in February’s edition of Caring Times.