CQC | Update on our next phase of regulation

care quality commission

The independent regulator of health and social care in England

CQC's next phase of regulation: consultation update

Our special newsletter for providers and professionals working in adult social care

20 October 2017

Our response to the consultation

Between 12 June and 8 August 2017 the second of our consultations into the next phase of our regulation was open. In this consultation we asked for views on specific proposals on:

  • Changes to the regulation of adult social care and primary medical services, including the frequency and intensity of inspections and how CQC monitors providers and gathers intelligence.
  • Improvements to the structure of registration and CQC's definition of 'registered providers'.
  • How CQC will monitor, inspect and rate new models of care and large or complex providers.
  • An updated approach to the 'fit and proper persons' requirement.

Today we have published our response. The response document provides information on what people told us, and what we will now do. Read the full response here.


Changes to how we regulate adult social care services

We will begin to implement changes to how we regulate adult social care services.

From 1 November 2017:

  • We will regulate services using a single assessment framework for adult social care. This will strengthen our assessment by reflecting changes to the sector, the new best practice guidance, and how providers may develop their services in future. It will also simplify the process of assessment by aligning the questions we ask of different sectors and the characteristics that reflect a rating.
  • New, simplified guidance on how CQC monitors, inspects and regulates adult social care services is available on the 'Guidance for Providers' area of our website. This guidance will replace the Provider and Inspector Handbooks, and will ensure both providers and inspectors use the same guidance documents.
  • We will ask providers that are repeatedly rated as requires improvement to complete an improvement action plan to show how and by when they will improve their overall rating to good.
  • We will introduce more proportionate and targeted inspections. Every service will receive a comprehensive inspection which considers all five key questions. We will also conduct focused inspections, targeted on areas of concern, risk or improvements, informed by Insight and information collection.

Phased implementation from January 2018:

  • We will introduce an online process for collecting information from providers via a statement of quality about the five key questions and how providers are supporting continuous improvements. We will require providers to update this at least once annually, although more frequent updates can be made to record changes in quality, including improvements. This process will first be used with a small number of providers, gradually rolling out to all providers. Our aim is for full implementation by early 2018/19.
  • During the transition providers will continue to use the current system for submitting information and will gradually be invited to start using the new online process. At the same time we will continue to test and improve the questions we ask and the process we use.

From April 2018:

  • We will introduce a maximum inspection interval of 30 months for comprehensive inspections for services rated as good and outstanding. Until then, we will maintain current inspection frequencies of within 24 months, underpinned by ongoing monitoring using a broader range of information sourcesWe will continue to follow up and respond to risks and concerns through the use of focused inspections at any time. We will engage with stakeholders in advance of extending further the inspection interval for services rated as outstanding.


Changes to registration

We will make changes to registration that will allow us to hold people to account at the right level when regulating providers. We will continue to inspect at location level.

  • We will require all entities meeting our revised criteria for defining a provider to be registered with CQC. This requirement will be implemented in a phased way across different types of provider, with the first registrations of this nature in 2018/19. We will publish the schedule for these changes once detailed impact assessments have been completed. By implementing these changes we will make ownership relationships and links between providers clear to the public on our register.
  • We will implement the proposals to registration structure in a phased way through provider information collections and as providers make changes to their registration. The information will describe the provider and the services it provides. Providers will need to inform us when these details change. In some instances, they will need to apply to us and have the change agreed before changing their service provision.


Fit and proper persons requirement

  • We will make changes to the way we triage information and work with providers following a notification of concern by a third party.
  • We will clarify how we will interpret serious misconduct and serious mismanagement.
  • We will publish refreshed guidance for all providers on the fit and proper persons requirement at the end of the year.


Get involved in the #CQCnextphase conversation on Twitter

To follow conversations about the next phase consultation or to ask use questions, follow @CareQualityComm and #CQCnextphase on Twitter.

Keep up with our work with professionals and provider organisations in England by following us on Twitter @CQCProf.