CQC Factual Accuracy: Challenging Inspection Findings

How to challenge regulatory findings through formal, appropriate factual accuracy processes.

Why Factual Accuracy Is Important

The CQC’s shift to the Singular Assessment Framework has introduced new complexities to the healthcare sector. And with providers having to adapt to new guidelines and regulatory procedures, leaders can’t help but feel the prospects of ‘Requires Improvement’ and ‘Inadequate’ ratings are looming.

When poor inspection ratings are published, a service is placed on the back foot. With stakeholder relations potentially damaged, Registered Managers and care teams can often find themselves in a cycle of crisis management. This opposes proactive improvement and delivery of care. And while the CQC is a vital stakeholder for any care service, challenging the CQC’s findings through factual accuracy reviews should be encouraged if a case can be made.

With Edmonds Governance & Strategy, every piece of advice is informed by a former senior CQC inspector and Director of Governance and Quality Improvement. Having faced regulation from each angle, we put together a few tips for challenging the CQC’s findings.

Submitting A Factual Accuracy Challenge

Following a CQC assessment, Registered Managers are presented with a draft report. This will entail the preliminary inspection findings, judgments, breaches of regulation, and a proposed inspection rating.

Then, a response window is granted. The time a provider is given to respond often depends on the type of service being provided. For example, a GP would be given 10 working days to respond. While this should not be used as a process to challenge the draft judgments, the findings behind these judgments can be checked against the provided evidence.

If a solid ground can be found to claim that a judgment is factually inaccurate, an effective challenge can lead to a change.

Once all potential inaccuracies, misrepresentations, or omissions are finalised, this process is then handled through the CQC’s portal. But to fully support this challenge, evidence is vital. A properly structured factual accuracy challenge will clearly state:

What Evidence Fits Into A CQC Factual Accuracy Challenge?

Each challenge entry does have a 2,000-character limit, so being clear is pivotal. The same stands for evidence. Effective evidence stems from thorough documentation, including:

The purpose of this evidence is to provide a concise snapshot in relation to the assessment of findings. Therefore, the point of contradiction should be clear. For example, if the draft report details a safety check to have been missed, a signed and dated log from documentation records should be attached as a response.

Or in other cases, findings can be based on isolated incidents. In response to this, a provider could provide a collection of records surrounding policy, training and quality assurance to showcase that the incident was not standard practice.

What Steps Can Be Taken After?

If no response is delivered in the provider’s given window, the CQC will assume all report findings to be accurate. But, if a provider is still unhappy with either the assessment or process, there are steps that can be taken outside of the preliminary draft window to challenge either the rating process or assessment process, including:

Submit a formal complaint:

If there are reasonable grounds to appeal against the inspection process, a formal complaint can be submitted. This diverts from the idea of factual accuracy and rather focuses on the overall fairness of the inspection’s process and means of conduct.

Polite, informative complaints should be sent to the CQC, providing details of the inspection’s procedural failings in these contexts.

Applying for a ratings process review:

If the deadline was missed, the report can still be challenged 15 working days after the publication.

However, it is important to know that the judgment alone is not to be challenged, but rather the grounds and findings that led to the CQC’s final decision. This can be submitted via the CQC’s online portal; however, there is a 500-word limit, making the response much more limited than what is offered in the preliminary window.

Submit representations about proposed enforcement activity:

‘Requires Improvement’ and ‘Inadequate’ ratings will often be partnered with enforcement notices.

Services will have 10 working days to make written representations and 28 calendar days to submit these representations. However, it is important to note that factual accuracy comments cannot be made as part of the enforcement representations process; these will remain completely separate.

As part of this process, evidence can be submitted to demonstrate improvement or to represent what was not considered during the inspection. This can create a case for proportionality. If due, providers can use evidence to argue that the proposed enforcement activities are an unreasonable response to the report’s findings.

Helpful Tips Surrounding Factual Accuracy:

Familiarise your leadership team with the process. Ensuring an understanding of the process of completing and submitting a response via the CQC portal.
Understand the CQC’s guidance for providers with the factual accuracy process. Make use of the scenarios and possible outcomes that are provided by the regulators.
Always enforce proactive documentation. This will provide a wider understanding of your service’s standards and procedures outside the snapshot of the CQC inspection day.
Highlight actions that have been taken since inspection day. Provide supporting evidence of this that can be demonstrated to regulators. Inspectors could consider this and amend reports to reflect this.
If key evidence has been omitted, refer to this in response and submit clear supporting evidence.

Assure That Your Service's Quality Is Fairly Represented

Edmonds Governance & Strategy support providers, with all processes and insights guided by a former senior CQC inspector, Practice Manager and Director of Governance and Quality Improvement. With advice informed by experience on both ends of regulation, get in touch and protect your service from potential scrutiny today.