As we continue to emerge from lockdown measures and deal with local measures and the short and long term economic impact of Covid-19, local authorities will need to re-assess how services will be delivered for years to come.
The report, dated 13 October 2017, looked at most of the CQC's regulatory activities, but focused on how well the regulator was performing regarding its core functions of registration, monitoring, inspecting and rating, as well as responding to concerns, and taking enforcement action.
It also reflects that the number of completed enforcement actions increased over 2015-16 and 2016-17, whilst interestingly, the number of providers entering special measures remained steady.
In short, the report concludes that since NAO’s inspections in 2011 and 2015 the CQC has improved in its effectiveness, but there remain issues that the regulator still needs to address.
Regarding Registration, the NAO reported that the CQC aimed to inspect 100% of all newly registered locations of adult social care (in 2017/18) within specified time limits based on the date of registration. These are as follows:
|Registered||First Inspection Target|
|If registered between 1 October 2014 and 30 September 2015||Within 2 years (max)|
|If registered between 1 October 2015 and 31 March 2016||Within 18 months (max)|
|On or after 1 April 2016||Within 12 months (max)|
In the first quarter of the reporting period, 94% of adult social care providers received a first inspection on target, and so the CQC is already a little behind its target.
The CQC has undertaken 21,176 inspections of adult social care providers in the first quarter of 2017-18, and the outcome is as follows:
It is heartening to see that this clearly shows that the majority of health and social care providers provide good care (despite reports to the contrary in the press). It is also interesting that the same number of providers are noted to be ‘inadequate’ as are found to be ‘outstanding’. We know that providers have complained for some time that “outstanding” ratings appear to be unachievable in some geographical areas and if a provider does achieve “outstanding” ratings they are extremely difficult to maintain, with providers sliding towards “good”.
The NAO found evidence that between 2016-17 and the first quarter of 2017-18 there were 5,750 re-inspections and most providers improved their rating, which indicates that the CQC has encouraged real improvement in the sector. For adult social care 51% improved, 43% remained unchanged, and 7% worsened. However, it should be noted that those that declined include services that had previously achieved an ‘outstanding’ rating.
One of the main points of interest for adult social care providers will be that the audit has revealed concerns raised by providers around CQC’s inconsistency in making regulatory judgements. The NAO received examples of individual inspectors being subjective or inconsistent. Stakeholders questioned the consistency and profile of ratings within and across sectors. This will come as no surprise to our clients who often find that they received different ratings for the same Key Lines of Enquiry when there was a generic approach. To address this, the CQC is implementing specific measures such as training for inspectors. Each inspection directorate is to have its own quality assurance process for the review of reports and findings and a “quality framework supported by a quality sampling process” is to be implemented. It is not entirely clear what this means in practice, but we hope that it will mean more consistency in approach.
The report makes a number of recommendations to the CQC related to these issues. For example, they have asked CQC to assess how inspection staff engage with other local stakeholders, to review the activities it currently uses to test and demonstrate inspection approaches and judgements, and set out how the CQC will obtain assurance that its inspection staff are taking appropriate decisions about regulatory action in response to intelligence.
We hope that this will not mean that professional judgement will not be engaged but that there will be a more slavish approach to investigations and reliance on checklists.
We know that the CQC plans to change the frequency of inspections for adult social care providers; the proposed frequency changes are:
|Outstanding||3 years (max) by 2019-20|
|Good||2.5 years (max) by 2019-20|
|Requires improvement||1 year (max)|
The NAO report also highlights that the CQC needs to address the persistent issues with the timeliness of some of its regulatory activities. It has warned that the CQC’s aim to base more of its activities on intelligence and risk-based information will introduce significant challenges. It is vital that the CQC’s digital technology and systems are up to the job and that it is efficient in its collation and sharing of information whilst at the same time, maintaining a level of flexibility.
In addressing these concerns and adopting the proposed strategies we think that there will be increased pressure placed on adult social care providers in the short term. It is inevitable that if the regulator is criticised for not hitting targets, this will cascade down to providers. We are seeing an increase in the issue of penalty notices with the invitation of acceptance of “fines”. There has also been an increase in requests for large amounts of information to be provided in a format imposed by the CQC. However, responding to submissions about these demands is taking an inordinate amount of time leading to periods of uncertainty for providers.
If the strategies proposed can be implemented and a more consistent approach to investigations and ratings is adopted, adult social care providers should see an improvement in the way they are regulated in the long term. However, with a decrease in its budget and the number of identified shortcomings, it will be interesting to see if the CQC can implement all of its proposed actions and catch up with the remaining work.
The Government first announced plans for a shared ownership right to buy in October 2019. At the time the sector raised concerns about the impact the plans would have on housing associations ability to borrow. An election and a pandemic later the Government announced, during the CIH Housing Festival last week, the return of the right to shared ownership as part of its Affordable Homes Programme (AHP).
Two final pieces of the possession jigsaw have been published on 15 September 2020. Mr Justice Knowles’ working group on possession proceedings has issued its guidance on the “overall arrangements” for possession proceedings.
One change proposed by the Building Safety Bill is the introduction of a duty holder regime, which will see statutory responsibility for the safety of higher risk buildings placed on key individuals
Throughout this pandemic, the Competition and Markets Authority (CMA) has been publishing various “Statements on Coronavirus” (Statements) which provide guidance on consumer rights during this time.
A recent increase in COVID-19 cases in the UK means new measures are being put in place in an effort to reduce the risk of a second wave. Whilst the impact of COVID-19 continues to be felt, it is important to remain focused on the sector’s road to recovery.
Sometimes half an hour at a conference gives you the reality that has been staring you in the face all along. That was my experience watching “Change is on the Horizon”
Following our recent e-briefing on Possession Notices, Helen Tucker and Emilie Pownall from our housing litigation team discuss the impact of the changes on social landlords.
Not only has the possession stay been extended until 20 September, the notice periods to be given to tenants has been extended in certain circumstances with some important exceptions.
The Court has confirmed that a party cannot withhold its consent in order to re-write the original bargain.
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