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New CQC inspection regime announced – a “wake up call” for private care providers?

The Government has announced that a wider 'Ofsted' style inspection regime will be applied to all privately owned care homes and home-care services from October 2014.

Ofsted style inspections have, we are told, been successfully applied to NHS hospitals and are now going to be rolled out to the private sector. The Care Quality Commission (CQC) is expected to be granted new powers to put homes into ‘special measures’ where failings in care are found, and the ability to shut down homes that fail to make improvements.

What’s changing?

We understand that a new CQC inspection ratings regime will be applied to all privately owned care homes and managed home-care services from October. The new regime will give enhanced regulatory powers to the CQC to inspect, recommend and oversee the implementation of improvement measures, police enforcement of standards and shut down the services of private health care providers where standards are not met.

Although the CQC, in some cases in association with the Police, have relatively sharp teeth already when it comes to dealing with underperforming service providers, these changes will result in a significant increase in the regulators’ powers. The Government believes that the implementation of this new regime will drive up standards.

What does this mean?

The aim will be to inspect a targeted proportion of the estimated 25,000 services in the UK from October under the new regime and identify those demonstrating fundamental breaches of care and/or major failings in leadership, service user safety, standards of care and engagement (amongst other things). Those services providing inadequate care will be placed in special measures by the CQC. It is likely that the first service providers with identified failings will be placed in special measures from April 2015.

With reference to the new regime, following an inspection your service could be rated as outstanding, good, requiring improvement or inadequate. If your service is inadequate and placed in special measures and then fails to improve by meeting the required standards within a specific time, it is likely to be shut down and/or possibly contracted out to a competing service provider.

Whereas NHS hospitals put into special measures could rely on help from other trusts and organisations funded by the taxpayer, private service providers are unlikely to receive anywhere near that level of external support, if any. We also suspect that private providers will be given a lot less time to turn around failing homes and services.

Clearly there will be an impact on staff if your service is placed into special measures and is then subject to improvement measures, or even subsequently shut down or contracted out. There are likely to be significant ER issues arising from this new inspection regime such as disciplinary, safeguarding and whistle blowing issues, an increased number of protected conversations with targeted individuals, enhanced and additional training requirements, redundancy situations, TUPE issues and resulting employment claims.

What do we need to be doing?

There is no doubt that the government wants the CQC to get ‘tough’ with the private sector following recent scandals. Private health care providers have a short amount of time before October to prepare for this new inspection regime and the possible implications of being judged inadequate and placed into special measures.

  1. Conducting your own internal inspections, structured in accordance with current practice guidelines, to identify any potential exposure before it’s found by the CQC
  2. Where exposure is identified in the form of safeguarding issues, or other staff conduct/disciplinary issues, seek to deal with these properly and effectively
  3. Review current safeguarding, disciplinary / grievance and whistle blowing polices etc. with a view to including references to the CQCs new powers and potential implications
  4. Consider what implications there could be if your service – or the service of a local rival provider – is shut down, and review your redundancy and TUPE practices

There could be opportunities flowing from these regulatory changes, as well as challenges, for those private providers able to adapt and capitalise.

For further information on these changes and to discuss how our employment and regulatory experts can assist you, please get in touch.

Please note that this briefing is designed to be informative, not advisory and represents our understanding of English law and practice as at the date indicated. We would always recommend that you should seek specific guidance on any particular legal issue.

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