FINANCE & LEGAL THE INSPECTION GAP
Bill Dunkerley, Associate Partner at Pannone Corporate, examines the effectiveness of the CQC’s regulatory role and whether its new framework has translated into the more dynamic oversight providers were led to expect.
The Care Quality Commission (CQC) remains ‘sedentary’ in its approach, despite a new regulatory regime promising a more ‘dynamic’ assessment of its services.
The latest figures show that physical inspections have dropped from a peak of almost 23,000 in 2016, to less than 4,500 inspections conducted so far in 2025. Current figures remain lower than pre-lockdown levels (17,671 in 2019 and 7,711 in 2020), with regulatory action also falling.
According to data obtained by law firm Pannone Corporate under the Freedom of Information Act, the total number of regulatory actions taken by the Commission has decreased year-on-year and recently sat at around half of pre-lockdown levels.
Despite an obvious drop-off in the number of regulatory actions taken in 2020, figures have remained consistently low ever since, between 3,000-5,000 per year compared with upwards of 15,000 each year in the period following the CQC’s receipt of enhanced powers in 2015. The use of Warning Notices has also dropped year-on-year since 2022, currently sitting at 98.
The Care Quality Commission’s new regulatory model has been in place for some time but, despite the fanfare, it could be said to have had something of an inauspicious start.
How the introduction of a single assessment framework differs, in practice, from the previous assessment models, is questionable. Likewise, whilst in its promotional material the CQC was hopeful that its new approach would enable it to be more dynamic in its assessment of services, and permit more contemporaneous data collection to take place, the extent to which it has achieved these objectives remains to be seen.”
Far from becoming a more proactive, dynamic and responsive agency, the CQC remains relatively sedentary in its approach. That being said, there are perhaps early indicators that this
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consolidation of activity is perhaps the forerunner to a renewed and re-focussed CQC, which is not afraid to utilise the full range of statutory powers at its disposal.
The figures show that the number of times registrations have been cancelled, fixed penalties issued and conditions imposed have remained fairly consistent since the CQC obtained its additional powers in 2015.
The data obtained by Pannone also reveals that there are currently 101 open criminal investigations concerning specific incidents or unregistered providers, and the number of prosecutions brought does appear to be slowly on the increase, with 10 prosecutions being concluded in 2024, and seven so far during 2025. The majority of prosecutions, by far, are brought under Regulation 12 – failure to provide safe care and treatment.
The average fine following prosecution by the CQC is just shy of £102,000, with average prosecution costs being in the region of £12,500. This represents a slight decrease from previous years.
As made clear in the latest State of Care report, the CQC has stated its intention of, “taking action to protect people from poor care”. This mindset is perhaps indicative of a more bullish approach by the Commission, as it becomes accustomed to its new operating model and starts to subject to increasing scrutiny those providers who are not meeting the required standards.
However, to be an effective regulator going forwards, and one with real teeth, the CQC has to combine its new inspection and assessment framework with meaningful regulatory activity. Whilst the CQC’s recently stated aim is to protect people requiring of care, to be effective it must fully embrace the powers at its disposal. The latest figures are perhaps indicative of that mindset, but only time will tell whether this trend and pattern of behaviour continues.
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