CQC inspections


Successfully challenging a CQC inspection report or rating


While a daunting prospect, CQC ratings can be successfully challenged by providers if they do so in a reasonable, proportionate, and evidence-based way, as Laura Hannah, partner in the regulatory department at law firm Stephensons, explains


Challenging a CQC inspection report or rating is important but it is often a step avoided by health and social care providers. Many providers tell us that they are worried about challenging the CQC as they want to maintain a good relationship with their inspector and fear that a challenge will ‘rock the boat’, while other providers do not think a challenge will make a difference. We can tell you from experience that this is not the correct approach. While it is always good to maintain a


positive relationship with your inspector, providers should not be anxious about challenging their inspection reports or ratings where they have solid grounds to do so and can back up any challenge with robust documentary evidence. Inspectors expect to be challenged and it is vital for ensuring quality monitoring of their practices and processes and to ensure that they are held to account where they do not accurately and fairly follow these – this is why these routes to challenge inspection reports and ratings exist. However, in order to be successful in any challenge, providers need to ensure that their challenges are reasonable and proportionate and are set out clearly to avoid any misunderstandings. Challenges cannot be rushed or lack an evidential basis. This year, we have assisted numerous health and social care providers in challenging the factual accuracy of their draft inspection reports and the ratings in their published inspection reports. In


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some cases, these challenges have led to significant changes in a report, including the removal of alleged breaches of regulations, as well as entire rating changes.


Preparing for your inspection Providers will be aware that the CQC will soon be introducing its new assessment framework and intends to gradually start carrying out assessments of providers in the new way later this year. It is therefore vital that providers familiarise themselves with this new framework, specifically the quality statements (known as ‘we statements’), prior to their next inspection. Providers should ensure that they understand what is expected of them in each key question (safe, effective, caring, responsive, and well-led) and that their policies and procedures, quality monitoring systems, and records are up-to-date and are being followed appropriately. Some providers may find it beneficial


Providers need to ensure that their challenges are reasonable and proportionate


to develop a compliance action plan which clearly sets out each ‘we statement’ under each key question and how the provider can evidence each one. This can be given to the inspector during an inspection and can prove useful to providers when answering the inspector’s questions. It also allows providers to identify any areas where they may be falling short and plan any necessary action prior to their inspection. Documentary evidence is key to any inspection – if a provider is unable to demonstrate compliance, an inspector is unlikely to be satisfied that they are complying with their legal requirements. During an inspection process, providers should also consider the steps that could be taken to strengthen their position and improve their chances of receiving an accurate inspection report first time round. We find that some providers wish to challenge inaccurate findings within a draft inspection report based on evidence or information not considered by an inspector during the inspection. It is vital that providers do not assume that an inspector will only ask to review a particular document or ask a certain question if they need to – providers should always volunteer relevant documentation or information pertaining to an area being inspected, and


www.thecarehomeenvironment.com February 2024


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