Re-building a trusted approach to our regulation

CQC has set out how it will drive the improvements needed to re-build trust in our regulation.

This involves making immediate changes to support our response to the recommendations in the interim report from Dr Penny Dash and to improve our ways of working ahead of the publication of the final report. These changes will help us to deliver:

• a clear and transparent programme of assessment and ratings
• quicker and more effective registration and assessments of providers
• simpler and clearer reports.

Summary of immediate changes

• We are recruiting a new Chief Executive, and we will appoint 3 Chief Inspectors to strengthen our leadership across the health and care sectors that we regulate.
• Working with Professor Sir Mike Richards and Professor Vic Rayner, the Chair of the Care Provider Alliance, we are reviewing longer-term improvements to our single assessment framework and how we use it. Their work is being informed by discussions with colleagues, providers and stakeholders, as well as insight and feedback from people who use services and the public. Findings from the first part of Sir Mike’s review will be shared in the coming weeks, followed by further work reporting later in the year.
• A current pilot project is looking at a better way of managing our relationship with providers. This pilot has started with NHS trusts and will expand to involve groups of providers in each sector. These pilots will run until early next year, when we will decide how to apply the most effective approach.
• Another pilot project is looking at how our operations managers can manage teams in specific sectors.

Internal improvements to how we work, along with recruiting more staff, will support us to increase the number of monthly assessments. Some actions include:

• Making changes to single assessment framework. We will be scoring at quality statement and rating at key question level. Assessments will still evaluate evidence categories to reach a quality statement score but we will not score evidence categories. We will apply professional judgement to ensure it is a complete picture and the quality statement scoring is correct. This will allow us to assess and inspect more services while ensuring our ratings are robust. This will also allow us to produce better reports that are clearer about our judgements and ratings.
• Changing how we use our technology. This is to improve how we carry out assessments, and the processes for factual accuracy checks, producing reports, and registration. We will also make improvements to the provider portal, and will give a further update on this in the coming weeks.

These new approaches will be evaluated to ensure we fulfil our core purpose. This will be through independent evaluation and working with providers and the public if new approaches are rolled out more widely.

We are progressing our work to assess local authorities on their duties under the Care Act 2014, implementing ongoing improvements to our approach as we go. We will continue to engage to ensure that we are hearing the voice of health and care providers and feedback from the local government sector.

Discussions with the Department of Health and Social Care are ongoing regarding when we will commence our assessments of integrated care systems (ICSs), in line with our statutory duty. We will also need to consider any recommendations in the final report from Dr Penny Dash that relate to this work. This means that our ICS assessments are currently paused.

There are key changes that we think will rapidly improve how we can work with providers and support a clearer view of the quality of care. We would like to co-design our approach, by engaging online and face-to-face, focusing initially on:

• Designing with you what a rating of good looks like.
• Developing a clear and accessible regulatory handbook.

We will announce more details soon of what is happening and when. This will include further information on the frequency of assessments and when we expect to carry out more assessments.

We will select providers to participate in the pilots and inform them before assessments begin.

Working with you

It is vital that we have feedback from providers, the public and wider stakeholders about your experiences as we make these changes.

As well as our Regulatory Approach Advisory Group, we are planning a series of roadshows for providers to enable them to connect with local CQC teams, learn more about specific aspects of our assessment approach and take part in activities to co-design the improvements we’re making. We will share more information on these soon.

In the meantime, we will continue to engage with providers, the public and wider stakeholders through our established channels, online engagement sessions and our online participation platform. 

You can find out about the opportunities to engage in our bulletins. If you don’t already receive an email bulletin, sign up on our website.