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Care Quality Commission – regulating health and social care

The Care Quality Commission (the Commission) is the independent regulator of health and adult social care in England. It is a non-departmental public body accountable to Parliament, sponsored by the Department of Health (the Department). The Commission has two main purposes: to make sure health and social care services provide people with safe, effective, compassionate, high-quality care; and to encourage providers to improve the quality of care.

The Commission regulates providers across three sectors: hospitals, adult social care and primary medical services. It registers, monitors and inspects providers, and publishes its assessments and provider ratings. The Commission can also take enforcement action when care falls below fundamental standards.

We have reported on the Commission twice before, in 2011 and 2015. Our 2015 report found that the Commission had made progress in updating its regulatory model. However, challenges remained around its ability to assess its overall impact, establish a stable workforce, improve its data on regulated bodies and monitor its own performance. Following the Committee of Public Accounts’ (the Committee) report in December 2015, the Committee requested further work to assess the progress the Commission was making.

Since our 2015 report, the Commission has introduced a new five-year strategy, which includes a move to a more intelligence-driven regulatory approach, and its funding will reduce by 13% between 2015-16 and 2019-20. These changes come at a time when health and social care providers are facing very high levels of demand and financial challenge. The Commission has also implemented new responsibilities, including from April 2015 the market oversight of ‘difficult-to-replace’ providers of adult social care.

This report looks at whether the Commission is taking appropriate action to address the risks to people’s care through examining:

  • the extent to which the Commission’s current performance is ensuring high-quality care and encouraging improvement;
  • how the Commission uses its resources and measures its performance; and
  • how the Commission is preparing to implement its new strategy with a smaller budget and for potential longer-term changes in the delivery of care.

In looking at the Commission’s regulatory activity we focus on its core functions of: registration; monitoring; inspecting and rating; and responding to concerns and taking enforcement action.