Inspections in the UK’s care sector have fallen dramatically in the last seven years, as the Care Quality Commission (CQC) continues to evolve its regulatory model, accelerated by the coronavirus pandemic.
From 2015 to this year, the number of inspections undertaken by the CQC has dropped by around 97 per cent – from a peak of almost 23,000 to just over 8,000 to date in 2022. Understandably, there was a significant reduction across all types of inspections during 2020 as a result of the pandemic, with the CQC temporarily ceasing all physical inspections from 16 March.
The figures obtained through a Freedom of Information (FOI) request to the CQC – conducted by Pannone Corporate – also shows that announced inspections fell from a peak figure 6,684 in 2019 to 3,593, with unannounced inspections also decreasing, from 19,586 in 2016 to 4,663 to date in 2022.
Bill Dunkerley, regulatory lawyer and associate partner at law firm, Pannone Corporate, commented: “It’s very clear that the coronavirus pandemic had a profound effect on the CQC’s ability to carry out inspections within the care sector, despite a number of inspections taking place by means of its Emergency Support Framework.
“However, what is clear from the figures is that inspections have been progressively declining over a number of years, from their peak in 2016. The reason for this decline is unclear, given that inspections are the primary way the CQC monitors compliance. Anecdotally, there may have been an initial backlog from when the new legislation came into force, with the CQC reviewing every application for re-registration.
“As the Commission continues to capture information and rate providers in accordance with the new standards, there is less need for unannounced inspections, with Inspectors proceeding instead by way of ongoing monitoring and announced follow-up visits in response to specific concerns received. This reflects the CQC’s revised – and evolving – regulatory model, which emphasises targeted inspections in response to specific concerns received. Moving forward, this risk-based approach is likely to continue as part of the Commission’s move towards a ‘single inspection framework’ and programme of rolling multi-point assessments.”
The research also shows that between 11 November 2021 and 15 March 2022, when vaccination was a condition of deployment, the CQC received 13,339 concern, safeguarding and whistle-blowing enquiries. By contrast, the total number of concern enquiries received by the CQC in 2019 as a whole was just over 43,000.
Dunkerley said: “During a short period of time, the number of concern enquiries remained at a high level. However, the annual figures are broadly consistent over a number of years which indicates perhaps that the presence of COVID-19 had little impact on the number of complaints generated.
“What is evident from the CQC figures is that in terms of enforcement, notices remain by far the single most commonly used regulatory action by the Commission, accounting for more than half of its enforcement activity.”
The FOI request shows that more than 69,000 requirement notices have been issued since 2015 (3,099 in 2022 to date), with over 7,000 warning notices during the same period (152 during 2022 to date).
Dunkerley added: “The changing landscape and evolving position of the CQC cannot detract from the fact that the Commission is still eager to impose conditions, cancel registrations and vary conditions of care providers. With the number of legal reviews standing at 132, it’s imperative that service providers review their procedures, systems and address risk areas in anticipation of inspection or intervention. The most effective management, however, is to avoid the initial set of circumstances that bring about regulatory intervention or investigation.”