Government has been forced to act after the release of the interim report which has highlighted numerous failings at the CQC. The regulator has been instructed to take immediate action to restore the confidence of health and care providers and the public.
The report was conducted independently, with Dr Penny Dash taking the lead, from May 2024. In the subsequent two months, Dr Dash spoke to roughly 200 senior managers, caregivers and clinicians across the health and social sectors. Over 50 senior manager and national professional advisors at the CQC were also spoken to throughout this time.
Dr Dash’s report has found that:
- Of all the locations the CQC has the power to inspect, it is estimated that one in five have never been inspected.
- Some organisations had not been re-inspected for several years – with the oldest rating for a social care provider dated back to 2015.
- There was a lack of experience among some inspectors – including a care home inspector who had never met a person living with dementia.
The report has also identified significant failings within the CQC that are actively hampering its ability to effectively judge the quality of health and care services. In addition, the report has found inspection levels were still below pre-COVID levels, clinical expertise among investigators and consistency in assessments were lacking and problems with the CQC’s IT system. Furthermore, the report has revealed that many social care providers have been waiting too long for their registration and rating to be updated after the inspection.
In the aftermath of the report’s publication, Wes Streeting, Secretary of State for Health and Social Care, said, ‘I have been stunned by the extent of the failings of the institution that is supposed to identify and act on failings. It’s clear to me CQC is not fit for purpose. […] We cannot wait to act on these findings, so I have ordered the publication of this interim report so action can begin immediately to improve regulation and ensure transparency for patients.’
The Secretary of State promptly announced four immediate steps to be taken by Government and the CQC:
- Re-appointment of Professor Sir Mike Richards, by the CQC, to review CQC assessment frameworks.
- Improving transparency in terms of how the CQC determines its ratings for providers.
- Increased Government oversight of the CQC, with regular updates to the department on progress.
- Requesting Dr Dash to review the effectiveness of all patient safety organisations.
Dr Dash said, ‘The contents of my interim report underscore the urgent need for comprehensive reform within CQC. […] By addressing these failings together, we can enhance the regulator’s ability to inspect and rate the safety and quality of health and social care services across England. Our ultimate goal is to build a robust, effective regulator that can support a sustainable and high-performing NHS and social care system which the general public deserves.’
Helen Wildbore, Director of Care Rights UK, said, ‘We are pleased to see the new Government acting so swiftly on the failures at CQC. […] We have been calling on the CQC for many years to act to protect people relying on care services, telling them how their lack of action is leaving people’s lives and dignity at risk. We hope now they will be forced into action. For the people we support, in the most vulnerable of situations, this cannot come soon enough. They desperately need the regulator to do their job.’
CQC’s response must be proportionate to the scale of its failure, which with personal experience of six inspections I can summarise as historic and existential. The failings to be addressed include poor organisational culture, unsuccessfully managing inspections and consistent outcomes, HR processes with inspectors ranging from engaged to incompetent, plus an ineffective complaints process. The single assessment framework (SAF) is the product of people who I believe do not clearly grasp the practical realities of delivering care. In my opinion, there appears to be no meaningful baseline data and no comprehension that binary data highlights issues but not causes. The sense data is the all-important – what the eyes see, the nose smells, the ears hear and the brain processes during an inspection. Strategically, the regulator should review its interactions with safeguarding, local environmental and health protections teams and leverage them intelligently, not overburdening them through effectively duplicating workloads. It must also cease being a market shaper, given that 2017’s Registering the right support hampered innovation, creativity and investment in new services for the most complex individuals, thwarting Government policy to shutdown Assessment and Treatment Units, where over 2,000 individuals remain confined. Seven years on, the SAF’s implementation, in my view, is the product of a regulator that pays lip service through consultation but continues along a predetermined and unfettered path. The regulator needs to create teams familiar with specific areas of care, including autism and learning disabilities. In addition, regulation’s focus needs to change from being biased against finding ‘good’ whilst favouring ‘bad’. It also needs to be proportionate about the impact of poor commissioning and underfunded placements, attributing failure between all parties, not just the home manager. Adopting a proven ‘just culture’ approach, an area of expertise that we have drawn on, is key. The CQC should suspend the SAF, reverting to its pre-pandemic approach. It should also announce the inclusion of providers and other professionals to develop new, fit for purpose regulation. Lastly, it should be mindful that if these were the failings of a provider, the shareholders or trustees would exit its board. X: @HFHC_LTD Email: [email protected] Paul de Savary, Executive Chairman, Home From Home Care
The CQC has been called out, and honestly, it’s about time. The interim report highlights major issues, including endless registration delays and a worrying lack of sector expertise. As someone who spends their working life supporting care providers with registrations, quality and compliance matters, I’ve seen firsthand how these inefficiencies create unnecessary challenges for care providers and impact the quality of care. The CQC is meant to be the backbone of health and social care regulation, but right now, it’s bogged down by bureaucracy and losing sight of what really matters – ensuring quality care for those who need it most. The time for half-measures is over. The SAF needs an overhaul. As it stands, it’s more about ticking boxes than measuring real outcomes. We need a system that focuses on the bigger picture – how care affects people’s lives, not just whether it meets a checklist. Let’s not forget data. The CQC has access to a wealth of information but isn’t using it to its full potential. In today’s world, data is one of the most powerful tools we have. If the CQC doesn’t adopt modern analytics to gain real-time insights and target inspections where they’re needed most, it risks falling further behind. Care is evolving rapidly, and regulation needs to keep up. The biggest issue, though, is trust. Care providers have lost confidence in the CQC. To rebuild that trust, the CQC needs inspectors with real, hands-on experience in the sector. They should know what it’s like on the ground to make fair, insightful assessments. This is no longer just about inspections; it’s about helping providers improve and thrive. Transparency and clear communication are also crucial. Providers need straightforward feedback on how to improve. The current system leaves too much in the dark. The CQC has a golden opportunity to reset. By focusing on outcomes and acting now, it can restore its credibility and become a real force for quality improvement. It’s time to seize that moment. Linkedin: Kata Care Email: [email protected] Fae Mell, Managing Director, Kata Care Solutions Ltd