Legal eye: ‘How can we challenge our CQC rating?’

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Joanna Sharr of Ridouts answers your legal questions

‘As part of the data monitoring process for our CQC inspection we provided detail of commissioners, local authorities, and other organisations making referrals to our service. Since we did this our personal relationship with a senior individual in one of these organisations has gone sour, and we believe this has adversely affected our rating. How can we challenge this, while avoiding a public argument with the individual involved?’

Joanna answers: The Provider Information Return (‘PIR’) is the information submitted by providers to CQC before CQC’s inspections and is viewed by CQC as an important part of the inspection process. The information provided by services as part of the PIR is used by CQC to help plan inspections and will be considered alongside all other sources of evidence to develop CQC’s inspection report.

Whilst negative comments can adversely affect inspection reports, CQC should not accept such comments and criticisms at face value without seeking to corroborate such evidence before it makes a judgement about a service. Judgements and ratings made by CQC in inspection reports should also be proportionate to the evidence before it and CQC should follow its own guidance in this respect. It is our firm’s experience that CQC can fail to follow its own policies and guidance, which makes it all the more important for providers to challenge CQC’s draft inspection reports through the factual accuracy process.

It would be perfectly reasonable for a provider to challenge comments made by a third party if those comments were unreasonable or were not supported by evidence; both CQC and the individual in question should be accountable for statements that are used to form judgements. The provider could challenge the evidence by requesting copies of the inspection notes, by checking that that the comments are backed up by other evidence in the draft report, or by assessing whether the comments could be countered by other evidence. The provider has five days from publication of the CQC report to seek a ratings review. CQC states that the only grounds for requesting a review are that the inspector did not follow the process for making and aggregating ratings decisions; the review does not offer providers a further forum to challenge the facts or judgements.

In light of the service’s concerns about the deteriorating relationship with one of its commissioners, it would be advisable for the service to focus on maintaining and developing its relationships with its commissioning bodies and third party stakeholders. Ways that relationships with commissioners could be fostered include, for example, holding an open day to address any concerns that commissioners may have or by writing to stakeholders to seek their views. Not only would this encourage an open dialogue but it could also be used as evidence at CQC’s next inspection that the service was driving improvement by seeking feedback. We recommend that this service is prepared for the next inspection by addressing any concerns that CQC made in its last reporting, and ensure that it is compliant in all respects. We would encourage all services to challenge CQC’s findings through the factual accuracy process if CQC’s draft inspection reports do not stand up to scrutiny.

Joanna Sharr is a solicitor at Ridouts LLP. Visit www.ridout-law.com

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