When reviewing CQC draft inspection reports, it is important to remind ourselves what amounts to evidence and what does not.
As CQC stated back in 2013 in its Inspector’s handbook:
“Any matters that are not based on factual or expert opinion are not evidence and cannot be relied on. This means that people’s assumptions, personal views, opinions, beliefs and disbeliefs are not evidence.”
Unfortunately, all too often statements are made in inspection reports that are no more than the personal views and assumptions of the inspectors, typically expressed in general and negative terms.
Examples I have come across recently include statements questioning the honesty of the provider or the motives of the provider in running the care service without any evidence to support such views.
Examples of evidence include documentary evidence, oral evidence, observation, material evidence e.g. faulty equipment, and formal witness statements. Opinion evidence is where a professional analyses factual evidence and reaches an opinion based on that analysis.
Understandably CQC does not publish documentary evidence with inspection reports e.g a person’s care plan. Instead, CQC sets out particulars in inspection reports which constitute the evidence relied upon.
The legislation says that CQC is required to send a draft report to the provider and the manager which covers the matters inspected. CQC interprets this to mean that it is only required to include its best evidence in support of its judgements, not all the evidence. If an inspection report includes a finding that the provider is in breach of regulation, the inspection report should include the evidence about the breach of the regulation.
In order for the provider to be able to challenge the facts/the evidence as part of the Factual Accuracy Process, they need to be set out sufficiently clearly for the provider to understand what is being said so as to be able to challenge them.
Unfortunately, since the introduction of the Singe Assessment Framework, inspection reports have become far less comprehensible than previously. This not only disadvantages providers in terms of making Factual Accuracy Comments but also the public.
The quality of inspection reports was noted as a concern by Sir Mike Richards in his review back in October 2014. Recommendation 14 of his review was that,
“Reports must provide a narrative that can be understood both by the provider and by the public. Suggested word lengths for different sections may be helpful, but a degree of flexibility should be allowed.”
Nothing much has changed since then other than the introduction of the hybrid approach to inspection which if anything makes matters even less clear to as far as the content of reports is concerned.
More than a year has passed since matters blew up about the workability of the Single Assessment Framework, as well as wider organisational weaknesses within CQC.
CQC now says there will be a consultation on changes to its assessment framework launched in the Autumn of this year. By the time this consultation is concluded and acted on, we will be well into 2026.
The simple fix would be to revert to the previous system, and I suspect this is what will happen, albeit it will be branded differently to try to save face.
If you need any advice relating to a draft CQC inspection report, please contact Gordons Partnership Solicitors on 01483 451900 or via neil@gordonsols.co.uk
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