elderly person and carer in care home under cqc warning notice

The first instalment of a three stage series on CQC enforcement action, this article looks at frequently asked questions regarding CQC warning notices and the best way to deal with them.

Authored by Laura Stanley, Solicitor and Helen Wallwork, Head of the Healthcare Sector.

Who are the CQC and what do they do?

The Care Quality Commission (CQC) is an independent regulator which regulates health and adult social care service providers in England. They cover a number of different types of service providers including care homes, GPs, hospitals and dentists.

The CQC has three key functions:

  1. Registration – registering service providers;
  2. Monitoring and inspection – ensuring that service providers are meeting core standards; and
  3. Enforcement – taking action against service providers who do not meet those standards.

Enforcement action by the CQC

The CQC is entitled to take enforcement action against any service provider which breaches the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and/ or other legislation. These powers allow the CQC to protect the public and to ensure that service providers maintain a good level of care.

With the increasing pressures on service providers because of the Covid-19 pandemic, we are expecting to see a rise in enforcement action taken by the CQC including warning notices.

FAQs in respect of Warning Notices and the best way to deal with them

1 – When will a Warning Notice be issued?

The CQC can issue a Warning Notice when there is a breach of a regulation, other legislation or a condition placed on a registration.

2 – What must the Warning Notice include?

The Warning Notice will be sent to the registered manager. It must include the following information:

  • the relevant legal requirement that the registered person is not complying with;
  • how the registered person did not comply or is continuing not to comply; and
  • the timescale within which the registered person must comply.

3 – How quickly do we need to respond to the Warning Notice?

The CQC is entitled to set the deadline for a response based on what they think is reasonable. When deciding the deadline, the CQC must take into account the level of risk to service users but also make sure the deadline is achievable.

4 – What should I do if I receive a Warning Notice?

When served with a Warning Notice, a service provider should consider its contents very carefully. There is no right to appeal but you can make representations about a Warning Notice.

The CQC does have discretion to publish the Warning Notice and do a press release. This can have a significant impact on the service provider’s reputation. Accordingly, depending on the nature of the Warning Notice, you may wish to seek legal advice when making the representations to ensure you are putting your case forward as strongly as possible.

5 – What representations can I make?

The most common representations are on the following grounds:

  • The Warning Notice contains a serious error;
  • Factual inaccuracies;
  • A failure to be sufficiently clear and precise about the alleged breach; or
  • Setting unrealistic timescales for a response.

6 – What happens next?

The CQC will review the representations and decide whether they are valid or not.  The CQC can decide to either:

  • Not uphold the representations – the decision maker has not agreed with the grounds made in the representations; or
  • Uphold the representations – the decision maker has agreed with the grounds made in the representations.

If the representations are upheld, this may mean the outcome letter will formally record that the CQC has withdrawn the Warning Notice.

CQC Enforcement Series

Other articles in our CQC Enforcement Series include: