Care Quality Commission Updates

Last week two significant and interrelated reports concerning the Care Quality Commission were published.

The first is Sir Mike Richards’ review of the CQC’s Single Assessment Framework (SAF) and its implementation.

The second is Dr. Penny Dash’s comprehensive review of the operational effectiveness of the CQC.

Both reports have been met with responses from the CQC

Let's look at the Key Findings, Recommendations and how you can have your say on the future of the Single Assessment Framework

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Key Findings and Recommendations

The findings and recommendations from both reports are closely aligned and are unlikely to surprise care providers.

Here are the main points from each review:

Dr. Penny Dash’s Review

Dr. Dash’s review includes seven key recommendations aimed at improving the CQC’s operational performance:

1. Operational Performance: Rapidly enhance operational performance, fix the provider portal and regulatory platform, improve the use of performance data within the CQC, and enhance the quality and timeliness of reports.
2. Organisational Expertise: Rebuild expertise within the organisation and relationships with providers to restore credibility.
3. Single Assessment Framework (SAF): Review the SAF and its implementation to ensure it is fit for purpose, with clear descriptors and a greater focus on effectiveness, outcomes, innovative care models, and resource use. This specifically references Sir Mike Richards’ work.
4. Transparency in Ratings: Clarify how ratings are calculated and make the results more transparent.
5. Local Authority Assessments: Continue to evolve and improve local authority assessments.
6. ICS Assessments: Formally pause Integrated Care System (ICS) assessments.
7. Sponsorship Arrangements: Strengthen sponsorship arrangements to facilitate the CQC’s provision of accountable, efficient, and effective services to the public.

Dr. Dash will also conduct two further reviews focusing on patient safety and quality.

Sir Mike Richards’ Review

Sir Mike Richards has made several recommendations under various themes:

• Structure: Revert to the previous organisational structure with separate sector-based inspection directorates led by Chief Inspectors, and reintegrate Regulatory Leadership with inspection.
• Assessment Framework: Abandon the Single Assessment Framework in its current form, retaining the five key questions, “I” statements, and quality statements with some modifications. Develop Key Lines of Inquiry (KLOEs) relevant to the selected quality statements.
• Data and Insight: Utilize NHS data more effectively in the CQC’s regulatory work.
• Staffing: Conduct an urgent review of staffing, reinstate the role of Deputy Chief Inspector, increase the number of inspection team staff, and review pay bands.
• Prioritisation of Inspections: Resume narrative reports and prioritize reducing delays in registration and re-inspecting services previously rated as requiring improvement.

CPA Review of the Single Assessment Framework

The Care Provider Alliance (CPA), chaired by Vic Rayner OBE , is conducting a review of the SAF to complement Sir Mike Richards’ work.

This review will explore the practical application, effectiveness, and provider experiences of the new approach. It aims to gather feedback on desired changes from providers.

The first stage focuses on providers’ experiences with the SAF, either in preparation or during an inspection. Managers and compliance leads in regulated care services are encouraged to participate in an online survey here. Feedback from this survey will inform the second stage, which will delve deeper into what providers want from the CQC in the future.

For organisational-level feedback from care providers with multiple services, please email [email protected] to join a focus group discussion and share broader perspectives.

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