The CQC has last week published Guidance for providers on meeting the regulations on how all registered health and adult social care providers across the country can meet the requirements of the Health and Social Care Act (Regulated Activities) Regulations 2014 (the 2014 Regulations) and the CQC (Registration) Regulations 2009.

All providers registered with the CQC are required under the 2014 Regulations to ‘have regard’ to this guidance, which will replace in its entirety the CQC’s previous publication Guidance about Compliance: essential standards of quality and safetyand the 28 outcomes set out therein. The CQC must also take this new guidance into account when taking regulatory decisions.

The publication of the new guidance is timely, as the new fundamental standards (set out within the 2014 Regulations) will come into force from April 2015. It is therefore important for all health and adult social care providers to familiarise themselves with the guidance, and what is expected from them under the new regime, before that date.

The guidance is accompanied by a new enforcement policy published by the CQC that sets out the principles and approach that the CQC will follow when using its enforcement powers.  This enforcement policy will apply from 1 April 2015, but it will also guide any enforcement action started before that date which has not completed by 1 April. The policy sets out a structured decision process to help the CQC decide:

  • which cases should result in enforcement action;
  • which enforcement powers should be used; and
  • which approach the CQC should take when using their powers.

The CQC has also published a helpful decision tree that describes the different stages that it will follow when considering enforcement.

Draft versions of these documents were published by the CQC for consultation last July 2014. The CQC has taken into account comments made during that consultation process and made a number of refinements to these documents before publication last week.  Changes made by the CQC include new definitions/more detailed definitions for key aspects of the guidance and to explain the enforcement thresholds (serious, multiple and persistent).  However, the CQC has kept the overall new approach to enforcement, with the expected greater use of prosecution powers to encourage providers to improve.

Commenting on the new publications, David Behan, chief executive of the CQC, has stated:

‘We now inspect services against the five key questions that matter most to people who use them – are they safe, caring, effective, responsive to people’s needs and well-led. This helps our inspection teams to identify good care.

When our inspection teams identify poor care, this guidance will help us to determine whether there is a breach in the new regulations and if so, what action to take. In some cases, this will mean we will use our powers to prosecute. We hope this helps providers in their preparations for April and to make sure that their services do not fall below acceptable levels of quality.

More will follow next month, including guidance on how care homes, general practices, dental surgeries, private hospitals and other services can meet the ‘duty of candour’ and ‘fit and proper person’ requirements for directors. These will oblige providers to be open and honest when things go wrong and hold directors to account when care fails people. The requirements have been in place for NHS trusts since last November.’

Changes relating to CQC regulatory requirements are coming thick and fast. These new publications are therefore welcomed to assist providers in understanding the new fundamental standards and what is expected of them. However, it is expected that more changes are afoot, not just the further guidance that David Behan mentions in his statement - such as the new requirement on service providers to publish their performance assessments by the CQC which is due to be implemented on 1 April 2015.