The Care Quality Commission (CQC) is the independent regulator for care within England. This includes the care provided by the local authorities, independent providers, the NHS and voluntary organisations in registered settings. The CQC register most but not all types of care.
The CQC regulates:
- Providers of healthcare services to people of all ages, including hospitals, ambulance services, clinics, community services, mental health services and other registered locations, including dental and GP practices.
- Providers of social care services for adults in care homes (where nursing or personal care is provided), in the community and in people's own homes.
- Providers of services for people whose rights are restricted under the Mental Health Act.
- Providers of health and care services for children or young people
The CQC register health and adult social care services across England and focus on inspections, to check whether or not standards are being met. Their inspections take place regularly and can be unannounced or notified dependent on service. Changes to the CQC’s strategy from 2021 see them taking a more proactive approach, with a greater use of data and ongoing monitoring alongside periodic inspections.
Further change began in mid-late 2022, with the introduction of CQC New Inspection Framework which you should certainly familarise yourself with if you are, or aspire to be a provider of care services in England.
What does CQC mean for the care profession?
1. Residential adult social care services
As mentioned, inspections will usually be unannounced. In a few instances, where there are very good reasons, they may let the provider know they are coming. For example, they may contact small homes to check that people are home before setting off to inspect.
2. Community adult social care services
CQC inspections of domiciliary care agencies and Shared Lives schemes will usually be announced 48 hours in advance. This is so they can be sure the manager or a senior person in charge is available on the day of the visit.
They may also give 48 hours’ notice to supported living schemes and extra care housing, but this will vary depending on the way the service is organised – in particular, in relation to the location of the registered manager and people using the service.
3. Hospice services
Hospice inspections for inpatient hospices will usually be unannounced. In a few instances, where there are very good reasons, they may let the provider know they’re coming. The CQC usually announce inspections of community-based hospice services and day hospices 48 hours in advance. This is so that they can be sure the manager or a senior person in charge is available on the day we plan to visit.
Core functions of the CQC
It is not just inspections that the CQC’s work looks at. The key parts of their main regulatory work are:
CQC Registration
Providers that want to provide care that is regulated under the Health and Social Care Act 2008 must apply to be registered with CQC. As part of the application process, they have to provide evidence that shows they will be able to provide care that meets the government standards. To find out more about CQC registration download this free guide to registering with the CQC.
CQC Inspecting and monitoring
As spoken about earlier, once the CQC have approved a provider’s registration application, they monitor the provider to check that the care they are providing at each of their locations meets government standards. By ‘government standards’ this mean the regulations made under the Health and Social Care Act 2008.
Enforcement
If the CQC find that a service isn’t meeting the standards required, they can take action. This is called ‘Enforcement’. There are a range of enforcement actions, that are exercised in proportionate ways, such as:
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- Issuing a warning notice requiring improvements within a short period of time.
- Restricting the type of care that the service can offer.
- Stopping admissions into the care service.
- Issuing fixed penalty notices.
- Suspending or cancelling the service’s registration.
- Prosecution.
Publication
The CQC publish results publicly for their regulatory work, to help the public make informed decisions on what service provider to choose. They do this by:
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- Publishing inspection reports on our website.
- Publishing summaries of our inspection findings on our website, through a care directory of every service we regulate.
- Issuing local media releases when we have taken enforcement action against a service because they are non-compliant with one or more of the regulations.
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The regulations and this guidance are an essential component of CQC's approach, as set out in their strategy Raising Standards, putting people first. The diagram of their operating model summarises how they register, monitor, inspect and award ratings to providers, take enforcement action and provide an independent voice on the quality of care.
As well as their inspecting and rating of health and care services, CQC also publish research, advice and guidance and market reports.
Understanding The CQC - Your Next Steps
If you are looking to start a new care service and are trying to understand how to register, read this 'how to' article on CQC registration.
As the CQC is currently undergoing fundamental changes to how it inspects and regulates care services, you should also read this article to get the fundamentals on the new CQC Single Assessment Framework and for a deeper dive, download the free guide via the link below.