Following Pannone Corporate’s Freedom of Information Act request to the Care Quality Commission (CQC), regulatory associate partner, Bill Dunkerley, looks in more detail at what the statistics tell us and asks: what next for the CQC? Read more here:

What next for the CQC

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Safeguarding concerns in the UK care sector are falling from the highs seen during the coronavirus pandemic, new figures show.

From January to May this year, more than 9,000 safeguarding alerts and concerns have been raised in the sector. This compares to a total of 21,886 in 2021, with figures hitting 23,116 last year.

The figures obtained through a Freedom of Information (FOI) request to the Care Quality Commission (CQC) – conducted by law firm Pannone Corporate – also show that inspections in the UK’s care sector are on track to fall, continuing the downward trend seen since 2019.

Announced inspections fell from a peak figure of 6,684 in 2019 to just 1,458 in January to May 2023. Unannounced inspection also appear to be decreasing. According to the FOI figures, 2,223 unannounced inspections were carried out in the first five months of 2023. In 2016, this reached a high of 19,586.

The significant reduction has been attributed not only to the pandemic, with the CQC temporarily ceasing all physical inspections from 16 March 2020, but also to the evolving regulatory model being adopted by the Commission.

Bill Dunkerley, regulatory lawyer and associate partner at law firm, Pannone Corporate, commented: “The seismic impact of the pandemic on the care sector is widely documented and this can be seen in the figures released by the CQC around safeguarding concerns and inspections.

“What’s also clear is that the CQC is not static in its approach and the standards which it expects providers to achieve continue to evolve. This is evident in the introduction ‘Single Assessment Framework’, as well as the initial evidence-gathering phase being simplified into six new categories, to streamline the information collated. The feedback received will allow the CQC to make individual assessments more bespoke to individual providers, for example in respect of their delivery model or population group.”

The FOI research also shows that since March 2021, the CQC has received nearly 37,000 whistleblowing enquiries, with more than 6,000 being received in the first five months of 2023. The number of complaints raised during the same 26-month period topped 135,000. However, with only 25,017 made between January to May 2023, it’s unlikely the figure will exceed the 62,591 seen in total in 2022.

Dunkerley said: “The trend across the board is a general decline in headline figures, with complaints, whistleblowing, and safeguarding concerns all likely to be lower in 2023 based on the current statistics.

“As the CQC continues to roll out its new regulatory model, and Inspectors find their feet with the new data-driven approach, it will be interesting to see how the figures develop over the coming months and years. It may be the case that the CQC’s new approach results in a permanent reduction to the frequency of inspections, but equally may also result in an increase in the use of its more dynamic powers, such as notices, which can have an immediate and profound impact on a provider’s continuing operations.”

Dunkerley added: “Whilst the CQC has modified the form of its regulatory function, and amended its assessment criteria over the years, its fundamental roles have remained consistent: ensuring the safety and quality of care of service users; and maintenance of appropriate standards of behaviour by providers.

“These are the same core objectives held by providers, and so long as they continue to put these demonstrable tenets at the centre of their business, then they are likely to be well-placed to respond to any future changes in the CQC’s operations and regulatory model.”

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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.”

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