Social care: Recent changes to the CQC's regulation of adult residential care (care homes)
The Care Quality Commission has changed how it regulates adult residential care (i.e. care homes), replacing blanket annual inspections of all adult care services with the reintroduction of a “risk-based approach” meaning that poorly-rated services are inspected more frequently (together with some random inspections) under a new inspection framework underpinned by "Fundamental Standards".
There have been fundamental changes made to the Care Quality Commission’s (CQC) inspection regime for adult residential care (i.e. care homes) in the past couple of years:
- in June 2013, the CQC issued a consultation ("A new start") which proposed a new approach to inspection across all sectors, which proposed risk-based inspections (rather than annual inspections), specialist inspectors and new quality ratings. These were seen as being very similar to an earlier inspection regime;
- the approach was confirmed in October 2013, subject to some changes that were raised during the consultation;
- following on from the new overarching framework, in April 2014 the CQC issued draft "Provider Handbooks" for consultation, which provided detail on the inspection regime for specific sectors including residential care homes;
- the new "Provider Handbook" for residential care came into effect from 9 October 2014;
- in April 2015, the CQC introduced a special measures regime for failing services;
- also in April 2015 new "fundamental standards" set out in regulations replaced the “essential standards”, following the review of the Mid Staffordshire NHS Foundation Trust scandal – a new "Provider Handbook" was issued for residential care settings;
- it was originally intended that all adult care services were be inspected under the new framework by March 2016, but on 22 October 2015 the CQC’s chief executive announced further slippage in the timetable to the end of December 2016;
- looking ahead, the CQC is planning to launch a consultation on its new strategy in January 2016; as a first step, on 28 October 2015 it issued a discussion paper entitled "Building on Strong Foundations" in which the CQC is asking “for your views on how regulation can develop ahead of the next stage of consultation on our new strategy in January 2016”;
- in April 2015, the CQC also became responsible for monitoring the financial health of certain care and support providers, especially larger providers.
Community Care magazine has commented that the adoption of the previous risk-based approach (in place of annual inspections of all providers in place since 2012) meant that the CQC's regulation of care homes was going "back to the future".