The CQC regulations provide guidance to providers of health and adult social care services. Find out how the CQC regulate, who they regulate and more.

Overview

  • For care providers in the UK, compliance with CQC regulations is essential to the success of their business, as well as to the safety and wellbeing of their clients.
  • There are two CQC regulations followed by 28 regulation outcomes1.
  • The CQC aims to provide person-centred care, enforce transparency, and encourage continuous improvement through the regulations.
Guide to the Care Quality Commission (CQC) Regulations

The independent regulator of healthcare and social care services, the Care Quality Commission (CQC), supervises and keeps track of the level of care delivered by social and medical care organisations in the UK. The primary goal of the CQC is to control and guarantee that care services adhere to the fundamental criteria of security, effectiveness, and quality while providing care solutions to patients. Therefore, compliance with CQC regulations is crucial for care providers in the UK to secure business and ensure wellness of their patients.

Being a care insurance and risk management specialist in the UK, Gallagher aims to provide guidance on the importance of complying with CQC regulations, the CQC regulated activities, and the benefits of care insurance for care service providers.

The following guide answers the following questions:

What are the CQC regulations?

The CQC created a regulations guideline with the assistance of health and adult social service providers who use services, organisations that advocate for those providers, other regulators and professional associations.

What is CQC Regulation?

CQC Regulation/s means guidance issued by the Care Quality Commission (CQC) dated March 2015 on The Scope of Registration under the Health and Social Care Act 2008 or any other guidance subsequently published later by the CQC substituting the Scope of Registration dated March 2015. The guidance specifies how to apply the regulations to different types of services. The CQC considers the size and type of service and the relevance of the regulation to the regulated activity provided.

The CQC has mandated two groups of regulations that providers of health and social care must meet:

  1. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – These regulations set out 13 fundamental standards2 that ensure the provision of regulated activities and the care provided to people must not fall. The HSCA 2008 (Regulated Activities) Regulations 2014 include the core requirements for care services that involve consent, person-centred care, premise safety, equipment suitability, fit and proper staff, transparency through a duty of candour (openness and transparency from their care provider), and the public presentation of CQC performance assessment ratings.
  2. Care Quality Commission (Registration) Regulations 2009 – The CQC Registration Regulations 2009 came into practice on 1 April 2010. These regulations were applied to enforce the registration requirements for the way people provide or manage a regulated activity in England. These regulations set out a set of requirements that providers must have regard to in relation to their registration, including their financial position, fees, statement of purpose, and the circumstances needed to make notifications to CQC.

How does the CQC regulate?

The CQC’s overall operating model summarises how to register, monitor, inspect, and award ratings to providers, take enforcement action and provide an independent voice on the quality of care.

Below are the four main components through which the CQC carries out regulatory work.

  1. Registration – Any care provider who is subject to the Health and Social Care Act 2008 must register and present documentation demonstrating their ability to deliver care that satisfies all applicable legal requirements. When considering new applications for registration, the CQC takes into account the duty of candour and the fit and proper person requirement for directors.
  2. Inspection and Monitoring – After approving an application, the CQC focuses their inspections on the quality and safety of services, based on the things that matter to people. Here they consider the five CQC standards about the service; are they safe, effective, caring, responsive to people’s needs, and are they well-led? Each inspection is unique and is utilised in a variety of circumstances.
  3. Enforcement – The CQC takes quick action against the care providers who are not complying with the government-mandated regulations and are practicing poor care. The enforcement they carry out is always proportionate to broken rules and never goes too far. With the CQC’s new enforcement policy, anyone offering improper care services will face quick prosecutions of regulations breach.
  4. Ratings and Publication – The inspection teams use 'Key Lines of Enquiry' (KLOE) and prompt to assess service quality, determine ratings on the five key questions, and provide an overall service rating using a four-point scale. The ratings of each inspection carried out are published on reports and websites in order to help the public make an informed decision about the care services they should use.

What is KLOE?

Key Lines Of Enquiry (KLOE) are tools that regulatory bodies, such as the CQC, use to assess adult social care services and to award a quality rating. Inspectors use a set of five uniform standards to judge if a care facility is safe, efficient, compassionate, responsive, and well-led. Based on these five KLOE, inspectors will assign care providers a rating of exceptional, good, requires improvement, or inadequate.

What services does CQC regulate?

The Health and Social Act of 2008 and the regulations outlined in that Act provide CQC the authority to regulate all healthcare and social services. Therefore, to be able to offer care legally, any registered care service provider delivering a regulated activity must register with the CQC. Know who needs to register with the CQC.

The CQC regulates the following kinds of services:

  • NHS Services: This category encompasses a range of medical services offered by the National Health Service (NHS), including clinics, community health services, and acute and community-based hospitals. The CQC makes sure that these services give patients safe and efficient care.
  • Independent Healthcare: Private healthcare facilities, including private hospitals, clinics, and specialty treatment facilities, are included in this category.
  • Dentists: The CQC also oversees dental offices. This includes making sure that patients receive safe and suitable dental care from dental clinics.
  • Adult Social Care: This refers to a variety of services offered to individuals who need help with everyday tasks or have certain medical requirements. It comprises residential care facilities, nursing homes, domiciliary care, and various forms of community-based care.
  • Mental Health Services: The CQC addresses a range of mental health services, including community mental health services, inpatient psychiatric facilities, and locations that offer care and treatment for people with mental health issues.

What are CQC regulated activities?

A regulated activity identified by the CQC refers to an activity involving, or connected with, the provision of health or social care. Each regulated activity specifies the purposes of the Health and Social Care Act 2008. There are about 14 regulated activities listed by the CQC3. They are as follows:

  1. Personal care
  2. Accommodation for persons who require nursing or personal care
  3. Accommodation for persons who require treatment for substance misuse
  4. Treatment of disease, disorder, or injury
  5. Assessment of medical treatment for people detained under the Mental Health Act 1983
  6. Surgical procedures
  7. Diagnostic and screening procedures
  8. Management of supply of blood and blood-derived products
  9. Transport services, triage and medical advice provided remotely
  10. Maternity and midwifery services
  11. Termination of pregnancies
  12. Services in slimming clinics
  13. Nursing care
  14. Family planning services

The importance of the above-regulated activities lies in patient safety, quality of care, public trust through report and ratings, accountability, and fostering a culture of continuous improvement through learning and growth.

What more do care service providers need to consider?

Promoting the provision of high-quality healthcare while limiting potential legal liabilities is pivotal for healthcare professionals, nursing homes, and carers. Providers must safeguard their business by care insurance from legal claims and financial damages resulting from accidents while providing care.

As a risk management specialist in care services for over 25 years, Gallagher helps ensure legal compliance while preserving financial stability by providing custom insurance plans that are flexible. Our care insurance coverage protects business continuity and patient confidence by paying for legal fees, settlements, and damages associated with malpractice claims.

Know more about our care home insurance or speak to one of our specialists on the below contact details.

For more information on the CQC regulations or to speak with a member of the Gallagher Care Team, call us on 0800 062 2325 or complete the form provided on this page and we will be in touch.

Sources

1. Summary of regulations, outcomes and judgement framework – Care Quality Commission

2. The fundamental standards – Care Quality Commission

3. Scope of Registration: Regulated Activities – Care Quality Commission
Regulations for service providers and managers – Care Quality Commission

 

Disclaimer

The sole purpose of this guide is to provide guidance on the issues covered. This article is not intended to give legal advice, and, accordingly, it should not be relied upon. It should not be regarded as a comprehensive statement of the law and/or market practice in this area. We make no claims as to the completeness or accuracy of the information contained herein or in the links which were live at the date of publication. You should not act upon (or should refrain from acting upon) information in this publication without first seeking specific legal and/or specialist advice. Arthur J. Gallagher Insurance Brokers Limited accepts no liability for any inaccuracy, omission or mistake in this publication, nor will we be responsible for any loss which may be suffered as a result of any person relying on the information contained herein.

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