Ever since the implementation of CQC’s ‘New start’ in the wake of the Mid Staffs Inquiry, providers have got used to dealing with a tougher regulator. Initially, this was in the form of the new, more robust, inspection regime and published Quality Ratings, which can impact considerably on service user choice and the purchasing decisions of commissioners and health insurers.
As the first cycle of inspections has been completed, CQC has been increasingly ‘baring its teeth’ in terms of enforcement, with action to address 'Inadequate' services. This is done through the Special Measures regime and prosecutions of regulatory breaches, with unlimited maximum fines becoming more commonplace.
In addition, the changing health and social care landscape, together with more partnership working, new models of care delivery and increasing use of technology, heightens the need for clarity around how services should be registered and who is to be held accountable.
I am writing to express my heartfelt gratitude for the assistance you have given the Hospital over recent weeks. From the outset, you have been extremely responsive and professional and it goes without saying that your efforts were not without success. I am naturally delighted with the outcome and it was with absolute pleasure that I delivered the news of our achievement to our staff
Against this backdrop, our in-depth knowledge of the CQC regulatory regime can assist providers to structure services appropriately, ensure compliance with the Fundamental Standards, and challenge inspection findings and enforcement action where appropriate.
We also advise on regulation of educational and children's social care services by Ofsted and health and social care services in Wales by CSSIW and HIW.
Our clients include providers of healthcare (both independent sector and NHS), primary care, adult social care (ranging from large corporates to single location operators), and retirement living. We support these clients with our extensive knowledge of the regulatory regime having previously acted for CQC, and predecessor national regulators since 2002, including as their recognised legal advisor in the Mid Staffs Inquiry.
Examples of our work include:
- Advising on regulatory implications of corporate and commercial joint venturing structures in healthcare and retirement village providers
- Advising clients on applications for registration with the Care Quality Commission
- Policies and procedures, training and advice on compliance issues such as:
- Fit and Proper Person checks and investigations
- Duty of Candour in response to patient safety incidents
- Mental Capacity Act and Deprivation of Liberty Safeguards
- The use of CCTV monitoring in care homes
- Supporting clients in their preparation for CQC inspections, including Board workshops and conducting mock inspections and interviews with senior managers
- Challenging CQC inspection reports through the factual accuracy process, Quality Rating Reviews, and independent reviews
- Supporting clients in Quality Summits
- Making representations against CQC enforcement notices.
- Representation in regulatory prosecutions
- Challenges to CQC decisions in the First-tier Tribunal
- Judicial review challenges against CQC.
Colchester Hospitals University NHS Foundation Trust
We advised Colchester Hospitals University NHS Foundation Trust on responding to co-ordinated enforcement action taken by CQC and Monitor following adverse inspection findings in relation to irregularities cancer waiting time data. This involved considered representations in response to proposed enforcement action and advising the Trust on the handling of a subsequent independent investigation including issues relating to data protection and defamation risks.
Retirement Village Structuring
We advised a retirement village operator on the regulatory implications for the structuring of service delivery vehicles in a retirement village
Mock CQC inspections
We conducted mock CQC inspections for a care home provider of 8 care homes for service users with Learning Disability and physical disability to assist their readiness for CQC inspection
Illegal Drug Use
We advised an adult social care provider on its policy in response to the therapeutic use of cannabis by service users in residential care facilities
Review of CQC Inspection report – care home
We carried out a successful independent review for a care home provider leading to upgrading of a care home inspection report from 3 'Requires improvement' and two 'Good' ratings and breaches of two regulations to five 'Good' ratings and no breaches of the Regulations.
Review of CQC Inspection report – independent hospitals
We carried out a successful independent review for an independent hospital provider leading to upgrading from an overall rating of 'Requires improvement' to 'Good'
Review of CQC Inspection report
We carried out successful independent reviews for two independent mental health hospitals leading to upgrading from overall ratings of 'Requires improvement' to 'Good'
We brought a successful First-tier Tribunal appeal of a CQC decision to remove the location of a care home
Representations against care home closure
We made successful representations to overturn a CQC proposal to remove the location of a care home for service users with Learning Disability,
Representations against domiciliary care agency closure
We made successful representations to overturn a CQC proposal to cancel the registration of a domiciliary care agency
St Anne's Community Trust
We represented St Anne's Community in the first CQC Health and Safety prosecution under the 'Fundamental Standards'
Southern Health NHS Foundation Trust
We represent Southern Health NHS Foundation Trust in the first ever prosecution of an NHS Trust by CQC – a case relating to the failure to comply with the regulatory requirements regarding safe premises.
Representations against Fixed Penalty Notice
We made successful representations to overturn a CQC fixed penalty notice for failure to have a registered manager in place at a care home
We advised a client on procedural challenges regarding a CQC prosecution being out of time and contrary to its Enforcement Policy