CQC special measures are enforced to ensure that inadequate services do not continue to deliver inadequate care, but the pressures they impose are immense. When a service is placed into special measures following inspection, hurdles are presented for teams, leaders, and providers across the board.
A service will be placed into special measures under two conditions: firstly, if a service is rated inadequate following inspection. And secondly, if a service is found to be inadequate under at least one of the regulator’s five key questions, CQC special measures will be issued with a timeframe, and the service will be re-inspected within six months.
Outcomes from CQC Special Measures
Services are placed into special measures for multiple reasons. To protect service users, push for improvement, and establish a timeframe for meaningful change.
At the time of writing, improvement is measured against the CQC’s Single Assessment Framework. This entails 34 Quality Statements and the Five Key Questions – it is worth noting that the regulators are currently shifting towards a new framework which will revolve around 24 more specific Key Lines of Enquiry (KLOEs).
These processes can lead to the following outcomes:
Re-Inspection
An absolute for any service under special measures. Typically enforced to encourage rapid improvement, the CQC will re-inspect a service within six months of being placed into special measures. This is a comprehensive, whole-site inspection that will not just address previously identified issues.
So, even if a service only failed under one of the Key Questions, the others must remain key during improvement periods.
- Safe
- Effective
- Caring
- Responsive
- Well-led
Leaving Special Measures
Once all ratings for the Five Key Questions are above ‘Inadequate,’ then a service will be relieved of special measures. Although the influence of leadership must also be clear. Improvement must be clearly implemented by the accountable leadership and not be shown to be a reactive measure. Leaving special measures is a declaration of proactive, measurable improvement to healthcare operations rather than a simple tick-box exercise.
Registration Impacts
Registration is a reflection of both paper and practice, so special measures will always pose a threat to registration conditions.
If a provider fails to demonstrate improvement in the CQC’s granted timeframe, alterations or even complete cancellations can be imposed on a service’s registration. CQC issues a Notice of Proposal (NOP) under these circumstances, in which providers have a 28-day window to appeal. If the appeal is not put forward or is unsuccessful, the service’s registration is then cancelled, meaning total closure of all regulated activities. This will arrive via a Notice of Decision (NOD).
The Importance of Turnaround Support
Healthcare leadership can quickly feel like a reactive firefighting task. But special measures and inadequate ratings don’t have to be managed alone.
Edmonds Governance & Strategy provides regular insights from a former CQC leader to guide Registered Managers and leadership through the latest. Our support empowers leaders from registration to regulation, championing services through adversity with experience built from both sides of the regulatory coin.
Get turnaround support from a CQC expert, contact us today.
