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54-764: The Care Quality Commission ( CQC ) is an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom . It was established in 2009 to regulate and inspect health and social care providers in England. It was formed from three predecessor organisations: The CQC's stated role is to make sure that hospitals, care homes, dental and general practices and other care services in England provide people with safe, effective and high-quality care, and to encourage those providers to improve. It carries out this role through checks during

108-490: A good or outstanding CQC rating was associated with a better quality of life for residents. High staff wages were linked with better CQC ratings, and short-staffed homes were linked with worse CQC ratings. Michelle Fenwick, the director of Heritage Healthcare Franchising, complained in December 2019 that the fees charged to home care providers, which are proposed to be based on the number of clients supported, were unfair and

162-633: A male carer and mistreated by four others. The standard of care at the nursing home had been rated "excellent." The victim was an 81-year-old woman with Alzheimer's disease and severe arthritis . Although the commission's primary function is to enforce national standards including safeguarding the vulnerable and "enabling them to live free from harm, abuse and neglect" the CQC responded by stating that they "should not be criticised for failing to protect people from harm" and could not be expected to spot abuse "which often takes place behind closed doors." Whorlton Hall

216-493: A meeting where deletion of a critical report was allegedly discussed. Bower and Jefferson immediately denied being involved in a cover-up. The Guardian newspaper reported on 19 June 2013 that Tim Farron MP had written to the Metropolitan Police asking them to investigate the alleged cover-up. Following an investigation, CQC found that Jefferson had not been party to any alleged 'delete' instruction. Jefferson

270-504: A result of an improved risk management and a stronger learning culture." They also said the research was based on a limited sample of inspections which took place over five years ago. In August 2019 the Avon and Wiltshire Mental Health Partnership NHS Trust was fined £80,000 as a result of a prosecution brought to court by the CQC. This followed the fall of a patient from a hospital roof which led to serious injury. The service had been warned of

324-543: A small secretariat from the parent department, and any expenditure is paid for by that department. These bodies usually deliver a particular public service and are overseen by a board rather than ministers. Appointments are made by ministers following the Code of Practice of the Commissioner for Public Appointments . They employ their own staff and allocate their own budgets. These bodies have jurisdiction over an area of

378-648: Is a private hospital in County Durham which had previously been owned by the same company as Winterbourne View. An undercover investigation by the BBC Panorama programme found evidence that vulnerable clients with autism or learning difficulties were physically and verbally abused by staff. Patients were also physically restrained. The current owners of the service, Cygnet have stated that all patients have now been transferred to other hospitals. The service had been visited at least 100 times by official agencies in

432-609: Is responsible for their costs and has to note all expenses. NDPB differ from executive agencies as they are not created to carry out ministerial orders or policy, instead they are more or less self-determining and enjoy greater independence. They are also not directly part of government like a non-ministerial government department being at a remove from both ministers and any elected assembly or parliament. Typically an NDPB would be established under statute and be accountable to Parliament rather than to His Majesty's Government . This arrangement allows more financial independence since

486-653: The Healthcare Commission and the Commission for Social Care Inspection . The Mental Health Act Commission had monitoring functions with regard to the operation of the Mental Health Act 1983 . The commission was established as a single, integrated regulator for England's health and adult social care services by the Health and Social Care Act 2008 to replace these three bodies. The commission

540-616: The law . They are coordinated by His Majesty's Courts and Tribunals Service , an executive agency of the Ministry of Justice , and supervised by the Administrative Justice and Tribunals Council , itself an NDPB sponsored by the Ministry of Justice. These bodies were formerly known as "boards of visitors" and are responsible for the state of prisons, their administration, and the treatment of prisoners. The Home Office

594-475: The 1200 homes inspected were rated as outstanding. In September 2016 the CQC said that 40% of nursing homes in the country were rated as "requiring improvement" or "inadequate". It is a legal requirement for homes to clearly display their CQC ratings on their websites, but a July 2017 survey carried out by Which? found that 27% of care homes surveyed either completely failed to display them or placed them where they were very difficult to find. As of September 2018,

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648-480: The 34 homes closed during Cynthia Bower 's tenure after failing their inspection later reopened with a new name or under new ownership, but with similar problems. The campaigning charity Compassion in Care told the magazine that if a home changed name or ownership it was then listed by the CQC as "new services" and "uninspected", and there was no link to reports on the same establishment under different ownership, even if

702-458: The CQC continued to respond to concerns raised by staff. In October 2020 the Department of Health asked the CQC to investigate the use of Do Not Resuscitate (DNACPR) decisions early in the COVID-19 pandemic, when blanket DNACPR decisions were applied to all care home residents without considering individual circumstances. In March 2024, it was announced that psychotherapist Sue Evans, who was

756-570: The CQC inspectors but also the NHS staff who are diverted from other activities." They suggested a less resource-intensive approach should be adopted. A spokesman from the CQC responded: "To use rates of reported falls and pressure ulcers in isolation to determine CQC's impact is a crude measure and presents an overly simplistic view that is not borne out in the quality and safety improvements we have seen through our hospital inspections. It also fails to recognise that increased reporting of such incidents may be

810-497: The CQC rated almost 3,000 out of 14,975 care homes in England as inadequate or needing improvement. The care home Horncastle House was closed by CQC in September 2018 as an urgent enforcement action to protect residents. In November 2018 the CQC had rated 1% of adult social care providers as inadequate, 17% as requiring improvement, 79% as good and 3% as outstanding in that year. A 2021 review of 20 care homes in England found that

864-449: The CQC said that an urgent review was carried out when the issue was discovered and it was found that "none of these referrals contained information about immediate risk of severe harm to people". Sutcliffe apologised for the error and said an independent investigation "will assist us in ensuring we improve our systems to avoid something like this happening again". In October 2018 CQC's Chief Executive Ian Trenholm stated that he wanted to make

918-455: The Health and Social Care Act 2008 does not distinguish between types of health or social care service, in practice, the CQC has different regulatory approaches for: Cross-sector inspections In November 2009 Barbara Young , then the CQC chair, resigned from the commission when a report detailing poor standards at Basildon and Thurrock University Hospitals NHS Foundation Trust was leaked to

972-482: The Journal of Health Services Research and Policy studied rates of falls which led to harm and pressure ulcers in more than 150 hospitals following CQC inspections. Rates of improvements in these criteria slowed after the inspections. Lead researcher Ana Cristina Castro stated that the inspection regime "creates a significant pressure on staff before and during the inspection period, and also significant costs, not just of

1026-555: The Labour government in office from 1997 to 2010, though the political controversy associated with NDPBs in the mid-1990s for the most part died away. In 2010 the UK's Conservative-Liberal coalition published a review of NDPBs recommending closure or merger of nearly two hundred bodies, and the transfer of others to the private sector. This process was colloquially termed the "bonfire of the quangos". NDPBs are classified under code S.13112 of

1080-481: The Public Accounts Committee reported that although the regulator had "improved significantly" there was "no room for complacency" in the organisation which had "persistent weaknesses and looming challenges". Whilst there had been improvements in the timeliness of hospital inspection reports since 2015, only 25% of reports on hospitals where less than 3 services were inspected were published within

1134-594: The UK Government. This total included 198 executive NDPBs, 410 advisory bodies, 33 tribunals, 21 public corporations, the Bank of England , 2 public broadcasting authorities and 23 NHS bodies. However, the classification is conservative and does not include bodies that are the responsibility of devolved government , various lower tier boards (including a considerable number within the NHS), and also other boards operating in

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1188-498: The backlog. In October 2014 Field announced that the commission was going to begin inspecting health systems across whole geographical areas from 2015, including social care and NHS 111 . There are suggestions that it could inspect clinical commissioning groups . Behan admitted in March 2015 that the commission would not be able to inspect all acute trusts before the end of 2015 as it had intended. In February 2015, it reported that it

1242-457: The commission issued an apology after admitting that up to 500 Disclosure and Barring Service (DBS) certificates submitted by applicants to become registered managers and providers had been lost during a planned office refurbishment; a locked filing cabinet had been incorrectly marked up to be taken away and destroyed. In the period of August 2016 to January 2017 the CQC sent questionnaires to inpatients of NHS hospitals who had been service users in

1296-638: The creation of a "public appointments commissioner" to make sure that appropriate standards were met in the appointment of members of NDPBs. The Government accepted the recommendation, and the Office of the Commissioner for Public Appointments was established in November 1995. While in opposition, the Labour Party promised to reduce the number and power of NDPBs. The use of NDPBs continued under

1350-747: The first to raise concerns about Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust when she worked there in 2005, along with a parent of a fifteen-year-old, were challenging the CQC in the High Court over its decision to license the Gender Plus Hormone Clinic, accusing the CQC of breaching its statutory duties under the Health and Social Care Act 2008 . The CQC regulates providers of "health or social care in, or in relation to, England", where: Health and Social Care Act 2008 , section 9 While

1404-419: The four types of NDPB (executive, advisory, tribunal, and independent monitoring boards) but excludes public corporations and public broadcasters ( BBC , Channel 4 , and S4C ). The UK Government classifies bodies into four main types. The Scottish Government also has a fifth category: NHS bodies . These bodies consist of boards which advise ministers on particular policy areas. They are often supported by

1458-490: The government is obliged to provide funding to meet statutory obligations. NDPBs are sometimes referred to as quangos . However, this term originally referred to quasi-NGOs bodies that are, at least ostensibly, non-government organisations , but nonetheless perform governmental functions. The backronym "quasi-autonomous national government organization" is used in this usage which is normally pejorative. In March 2009 there were nearly 800 public bodies that were sponsored by

1512-491: The information held by the organisation more widely available to the public and that he also intended to make CQC an easier organisation to do business with and a better place to work. A chief digital officer was to be appointed as part of this process. In January 2019 it was announced that Mark Sutton would take on the role of chief digital officer from April 2019. In April 2019 a study by the University of York published in

1566-543: The media. The report found that "hundreds of people had died needlessly due to appalling standards of care." One month earlier the commission had rated the quality of care at the hospital as "good." In August 2012, chief executive David Behan commissioned a report by management consultants Grant Thornton . The report examined the CQC's response to complaints about baby and maternal deaths and injuries at Furness General Hospital in Barrow-in-Furness, Cumbria and

1620-469: The month of July 2016. 77,850 surveys were sent out. In October 2016, a briefing paper issued by the organisation stated that no directorate was meeting objectives for producing reports on time. Of services which had been inspected over half had not improved their rating when re-inspected, with 45% staying at the same rating and 10% having a lower rating. Following the cyber attacks on NHS systems in May 2017 it

1674-569: The new owners were linked to the previous owners, and there was no follow-up inspection if problems had been identified. They had found 152 homes re-registered as new, when they had only changed owner or name. The commission had identified safety concerns in more than 40% of the homes it had inspected, and 10% were rated as inadequate. In April 2016, it was reported that 44% of care homes in the South East inspected over an 18-month period were rated as inadequate or requiring improvement. Only 0.9% of

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1728-543: The organisation's previous management had been "totally dysfunctional" and admitted that the organisation was "not fit for purpose." On 20 June 2013, Behan and Prior agreed to release the names of previously redacted senior managers within the Grant Thornton report, who it is alleged had suppressed the internal CQC report. The people named were former CQC Chief Executive Cynthia Bower, deputy CEO Jill Finney and media manager Anna Jefferson. All were reportedly present at

1782-460: The potential risk in 2011. A spokesman for the trust said they were working with NHS England to make improvements. In September 2019 the Barking, Havering and Redbridge University Hospitals Trust stated their inspection by the CQC had become drawn out "due to availability of inspectors". In response, the CQC's deputy chief inspector of hospitals Nigel Acheson said that the inspection "remains within

1836-424: The previous five years the 18-week waiting list for planned hospital treatment had increased from involving 3 million patients to 4.4 million. In March 2020 it was announced that most inspections would continue as planned following the outbreak of the coronavirus, and that this position would be kept under review. It was subsequently announced on 16 March that routine inspections were being temporarily paused, however

1890-404: The progress and findings of this review in our Public Board meetings." On 10 June 2019, the CQC released a previously unpublished report from 2015 on the service where it was given a rating of "requires improvement". Ten workers have been arrested by Durham Police and have been questioned about the alleged abuse and neglect of the patients. Non-departmental public body The term includes

1944-611: The public sector (e.g. school governors and police authorities). These appointed bodies performed a large variety of tasks, for example health trusts , or the Welsh Development Agency , and by 1992 were responsible for some 25% of all government expenditure in the UK. According to the Cabinet Office their total expenditure for the financial year 2005–06 was £167 billion. As of March 2020, there were 237 non-departmental public bodies. Critics argued that

1998-692: The published CQC timeframes for inspection." The inspection began on 3 September and is expected to be completed in mid November. In October 2019 Professor Ted Baker, the Chief Inspector of Hospitals at the CQC stated that "little progress" has been made on improving patient safety in the NHS over the last 20 years. In the same month the CQC published their State of Care report. This stated that 44% of A&E departments were rated as requiring improvement and 8% were rated as being inadequate. 36% of NHS Hospitals were given ratings of requiring improvement on safety with 3% considered inadequate in that area. Over

2052-414: The registration process which all new care services must complete, as well as through inspections and monitoring of a range of data sources that can indicate problems with services. Part of the commission's remit is protecting the interests of people whose rights have been restricted under the Mental Health Act . Until 31 March 2009, regulation of health and adult social care in England was carried out by

2106-443: The second quarter of 2015–16. 70% of adult social care inspections had been undertaken and 61% of primary medical services. An exception to this was inspections of hospital acute services where targets were slightly exceeded, an additional two inspections having been made in this sector. In December 2015 the Public Accounts Committee (PAC) was critical of the regulator, and said that it was "behind where it should be, six years after it

2160-399: The service was poor. It could take more than four months for a new service to be registered. She complained that assessments were too subjective. The commission has also been accused of being a barrier to innovation and impeding a shift to digital services because they insisted on paper records, and there were claims that some inspectors did not understand electronic records. Winterbourne View

2214-683: The system was open to abuse as most NDPBs had their members directly appointed by government ministers without an election or consultation with the people. The press , critical of what was perceived as the Conservatives' complacency in power in the 1990s, presented much material interpreted as evidence of questionable government practices. This concern led to the formation of a Committee on Standards in Public Life (the Nolan Committee) which first reported in 1995 and recommended

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2268-461: The target of 50 days. It was intended that 90% of reports should meet the target. The PAC also noted that GPs had felt burdened by the CQC's regulation practices. In response David Behan stated that he accepted the committee's recommendations and did not underestimate the task at hand. In July 2018, the CQC stated that 96 safeguarding concerns had not been passed on to local authorities over the last 12 months. Andrea Sutcliffe, acting chief executive of

2322-486: The year before the abuse was found out, including visits by the Care Quality Commission, Durham council and local NHS bodies. It has since been closed. A former CQC inspector Barry Stanley-Wilkinson has alleged that he had raised concerns about a "very poor culture" at the service in 2015. Stanley-Wilkinson said that he worked at the CQC for a decade and that this was the only report he had written which

2376-450: Was "more likely than not" that Ms Finney had ordered the deletion of an internal report by Louise Dineley, the CQC's head of regulatory risk. The CQC started litigation against Grant Thornton claiming a contribution towards any "damages, interests and/or costs" incurred in the case. Residential establishments, unlike hospitals, can easily be closed, or sold, and reopened with a new identity. Private Eye reported in November 2015 that most of

2430-410: Was a private hospital at Hambrook , South Gloucestershire , owned and operated by Castlebeck. It was exposed in a Panorama investigation into physical and psychological abuse suffered by people with learning disabilities and challenging behaviour , first broadcast in 2011. One senior nurse had reported his concerns directly to CQC, but his complaint was not taken up. The public funded hospital

2484-548: Was announced that the CQC will be asking probing questions to assess data security as part of its inspection process. After the Grenfell Tower fire in June 2017 letters were sent to around 17,000 care homes, hospitals and hospices requesting that they review fire safety processes, paying particular attention to the safety of service users who were more vulnerable due to mobility issues or learning disabilities. In March 2018

2538-424: Was cleared of any wrong-doing and CQC apologised for the distress caused by the allegation. Finney subsequently started litigation seeking at least £1.3 million libel damages from the CQC on the basis that the CQC's current chair David Prior and chief executive David Behan abused their power and acted maliciously in publishing allegations that she ordered a "cover-up" of its failings. The Grant Thornton report said it

2592-473: Was created in shadow form on 1 October 2008 and began operating on 1 April 2009. The commission has three chief inspectors who are also board members: The Commission's board also contains a number of non-executive directors. Previous board members have included: In August 2013 the CQC stated that it was finding it difficult to meet their inspection target of GP practices and had therefore drafted in 'bank' inspectors and authorised staff overtime to deal with

2646-451: Was established". Meg Hillier MP, the chair of the PAC, noted that reports prepared by the CQC contained many errors; one foundation trust said that their staff had found more than 200 errors in a draft CQC report. Hillier said "The fact these errors were picked up offers some reassurance, but this is clearly unacceptable from a public body in which taxpayers are placing their trust." In July 2016

2700-447: Was instigated by a complaint from a member of the public and "an allegation of a "cover-up" submitted by a whistleblower at CQC." It was published on 19 June 2013. Among the findings, the CQC was "accused of quashing an internal review that uncovered weaknesses in its processes" and had allegedly "deleted the review of their failure to act on concerns about University Hospitals of Morecambe Bay NHS Trust." One CQC employee claimed that he

2754-463: Was instructed by a senior manager "to destroy his review because it would expose the regulator to public criticism." The report concluded: "We think that the information contained in the [deleted] report was sufficiently important that the deliberate failure to provide it could properly be characterised as a ' cover-up '." David Prior, who joined the commission as chairman in January 2013, responded that

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2808-409: Was missing its targets for following up on the safeguarding information it received that might indicate that patients are at risk. He also said the CQC would update its oversight in line with the growth of new provider models and would begin looking at care quality along pathways to a greater degree and, for the first time, across localities. The organisation failed to meet its inspection targets during

2862-413: Was not published. In response the CQC stated that reports went through a "rigorous peer review process" and the draft report "did not raise any concerns about abusive practice". They also said: "We are in the process of commissioning a review into what we could have done differently or better in our regulation of Whorlton Hall and these allegations will be fully investigated as part of this. We will update on

2916-510: Was shut down as a result of the abuse that took place. Cynthia Bower , then the chief executive of the commission, resigned ahead of a critical government report in which Winterbourne View was cited. Ash Court is a residential nursing home for the elderly in London, operated by Forest Healthcare . In April 2012 hidden camera footage was broadcast in a BBC Panorama exposé which showed an elderly woman being physically assaulted at Ash Court by

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