Our monthly update for everyone interested in health and social care.

People who use mental health services are still not getting the support they need

Our latest survey of people using community mental health services finds that some people are not able to access care when they need it.

We asked over 14,000 people about their experiences of community mental health services. We found that 40% of the people who responded said they were were waiting too long for care. A third of people (33%) waited 3 months or more for their first treatment and 4 in 10 people said they did not receive any support while they waited.

We use the results from the annual survey to build an understanding of the risk and quality of services. Where survey findings provide evidence of a change to the level of quality, we use the results to inform our assessments.

Trusts use the results to identify and make the changes they need to improve the experience of people who use their services

Join Julian Hartley in conversation with the Patient Association's Rachel Power

Sir Julian Hartley, our Chief Executive, will be taking part in a webinar to talk about his vision for re-building a trusted approach to regulation. He will also discuss his approach for leadership, and how regulation can help drive services to improve.

The event is being run by the Patients Association, an independent patient charity campaigning for improvements in health and social care for patients. It will be hosted by their Chief Executive, Rachel Power, from 9.30am on Friday 20 June.

The webinar is free and is open to healthcare providers, patient advocates, policymakers, and anyone who uses care services.

Book your free place for the webinar (Patients Association)

Spotting the red flags for harmful cultures in health care

The Patient Experience Library has published Responding to challenge, a research report looking at how to identify ‘red flags’ (early warning signals) and harmful patterns of behaviour in health and social care.

We commissioned the Patient Experience Library to look at warning signals from 10 years of avoidable harm inquiries in health and social care. The report uses real-life examples to show the red flags for what could indicate a poor culture.

The Patient Experience Library also developed a Red Flag Tracker tool. This is an online resource based on the evidence used for the report. The tool can help anyone who feels something is “not quite right” to check their initial concerns against evidence.

Continuing our journey to improve and return to good regulation

In a blog published earlier this month, our Chief Executive, Sir Julian Hartley, talks about the importance of purpose in our work and the steps we’re taking to improve.

Julian writes about the latest phase of engagement to support this work, where we asked for feedback on a set of proposals that covered:

Our purpose and vision
What we should be aiming to achieve — our short and long-term goals
How you want us to behave
The principles that guide our regulation

Thousands of colleagues in CQC, people who work in health and social care, members of the public and other stakeholders have shared their thoughts on these proposals over the last few weeks.

Blog: Continuing our journey to improve and return to good regulation

Hearing from providers during our local authority assessments

We are currently assessing how local authorities are meeting their social care duties under Part 1 of the Care Act (2014). As part of our local authority assessments, adult social care providers who are registered with CQC will receive a survey ahead of our local authority site visit, whether or not they are commissioned by the local authority. We are encouraging providers to complete these surveys as they contribute to the evidence we take into consideration in our assessment of a local authority. Feedback from providers is an essential part of our assessments as it enables us to hear about providers' experiences of their local authority.

The survey covers areas including assessment and review, provision of support, market shaping and identification of local needs, safety and safeguarding. We will follow up on the information shared with us in the survey during our local authority site visits when we will speak to groups of providers to gather feedback on their experiences.

Our assessment process for local authorities begins with a request for an information return which is a key part of the information gathering process of our assessments. The timescales for the information gathering process will vary between local authorities, usually taking between 3 to 6 months prior to on-site activity.

Providers will receive a link to the survey after we have initiated the information return request to a local authority. The link to the survey will be sent to a provider’s registered manager and nominated individual. View the list of local authorities we have contacted to start assessment activity. The survey responses are anonymous and confidential.

Use of wheelchairs in care homes

The Medicines and Healthcare products Regulatory Agency (MHRA) and Care Quality Commission (CQC), with input from other relevant organisations, are working together to understand how we can better support the adult social care sector in the safe use of wheelchairs.

Wheelchairs are essential mobility aids that can significantly improve the quality of life for many residents in care homes and nursing homes. However, their safe and effective use depends on staff having the appropriate knowledge and training.

Your participation in this survey will help us understand what information or guidelines and/or support will support staff to use wheelchairs safely in care settings. It should take about 5 minutes to complete.

Take the survey

Community mental health survey 2024 results published

Our annual survey looks at the experiences of people who use community mental health services. The 2024 survey received feedback from 14,619 people who received treatment for a mental health condition between 1 April and 31 May 2024.

Unfortunately, the results show that some people are not able to access care when they need it. Key areas for improvement included quality of care, crisis care, support while waiting, planning and involvement in care, and support with other areas of life. However, there are some areas with positive results, such as support to access care or treatment, medication, and privacy of care settings.

Results for people using child and adolescent mental health services indicated poorer experiences across multiple areas of care, and survey respondents using older people’s mental health services generally reported more positive experiences of interacting with their mental health team.

Press release

Supported Living Improvement Coalition

In 2021, CQC established the Supported Living Improvement Coalition, working with partners to address concerns about the variation in people’s experience of supported living services. It brought people together to identify and embed the improvements we need to see.

Some of the areas of focus of the coalition were then taken forward by sub-groups. One of those groups explored the importance of respectful and inclusive language and communication in health and social care.

The group has published a suite of resources aimed at helping people working in services which include:

Findings and recommendations from survey activity
Links to good examples of communication
Links to online learning relating to communicating respectfully and inclusively
An ‘effective communication pledge’ that provider organisations can use to signal their commitment to respectful and inclusive communication.

Phase 2 of the Care Workforce Pathway

The care workforce pathway is the universal career structure for the adult social care workforce, setting out advice to care professionals for both staff development and career progression. It helps support career and training decisions which in turn creates more attractive working environments and sustainable workforce growth.

The initiative began last year when Department of Health and Social Care (DHSC), in partnership with Skills for Care, published the first part of the pathway, focusing on direct care roles.

DHSC has now published the second part of the pathway, to include 4 more role categories. These include deputy managers, registered managers, and personal assistants, as well as a new enhanced care worker role category. The pathway will continue to develop, recognising the complex roles and care needs of the sector today.

CQC encourages all providers to adopt the pathway as a means of good practice and supporting employers to meet CQC’s regulations for safe, compassionate, high-quality care. Providers should consider how to use the Pathway to support the upskilling and development of their workforce.

Find out more on GOV.UK

New and updated clinical searches

We have has been informed of a serious incident where a patient on bisphosphonates sustained bilateral atypical femoral fractures due to inadequate monitoring. In response, a new search has been added to the medicines usage bundle to improve prescribing safety and raise awareness of the risks. Bisphosphonates, used to treat or prevent osteoporosis, must be taken correctly and can have serious side effects. Patients should be reviewed 12–16 weeks after starting treatment to check for side effects and ensure compliance, followed by annual reviews. A full reassessment, including consideration of a DEXA scan, is recommended after five years or sooner if clinical risk factors change or a new fracture occurs.

The new searches are:

On Bisphosphonate – Check as first issued >5 years ago
On Bisphosphonate – Check as first issued >5 years ago + no DEXA in last 5y

Additionally, The NICE CKS guidance for DOAC (Direct Oral Anticoagulant) monitoring has been updated to recommend more frequent blood tests, particularly for patients over 75 or those with frailty. Patients should have full blood count, renal, and liver function tests on each monitoring visit and at least annually, the frequency being dependent on renal function. For older or frail patients, testing should occur every four months. If creatinine clearance (CrCl) is below 60 mL/min, monitoring frequency should be based on CrCl divided by 10 (for example, every 3 months if CrCl is 30). Additional tests are advised if an intercurrent illness affects kidney or liver function. To support these changes, existing clinical searches have been updated. Standard searches continue to identify at-risk patients but may include slightly extended intervals, while enhanced searches align directly with the updated NICE guidance. Red text highlights the new wording and searches.

Find out more

Our monthly update for everyone interested in health and social care

Independent review of CQC technology published

An independent review of the technology that supported our transformation has found that the primary cause of our technology failure was a failed organisational transformation. It adds that the technology used for our regulatory platform and provider portal are salvageable but required substantial development and rebuilding work.

The report sets out the scale of the problems that resulted in the failure of our technology and the impact that transformation had across CQC. It makes 23 recommendations, which can be grouped into 5 broad areas covering: culture; data and digital; governance; operating model; and change management.

The next step will be to develop an action plan to deliver the recommendations, which we plan to co-develop with CQC colleagues, providers, people who use services, and wider stakeholders. This will be presented at a future board meeting. This, along with work we are doing in partnership to develop the CQC Way and a series of regional roadshows to support our improvement work, will help us get back to delivering our purpose – to make sure people receive safe and effective care, and to help providers improve.

Read the executive summary

Read the report

CQC calls for national action to tackle system-wide issues in community mental health

Our 2023/24 Monitoring the Mental Health Act report, published this month, finds that many people with mental health needs are not getting the care they need.

Monitoring the Mental Health Act is our annual report on the use of the Mental Health Act (MHA). It looks at how providers are caring for patients, and whether patients' rights are being protected.

As part of our monitoring activity in 2023/2024, we interviewed over 4,500 people who were detained under the Mental Health Act or ‘sectioned’, covering 870 wards. We also spoke with people's relatives and people who had been previously detained. This year’s report once again raises the issue that a lack of staff, beds, and training, are leading to harmful gaps in care and treatment.

Dr Arun Chopra appointed as Chief Inspector of Mental Health

Dr Arun Chopra has been appointed as our first Chief Inspector of Mental Health.

The creation of the new role recognises the crucial importance of mental health services in supporting people to lead fuller, healthier lives, and the need for specialist expertise in regulating these services.

Arun was previously Medical Director of the Mental Welfare Commission for Scotland (2020-2024) and is one of the most recent recipients of the President’s Medal, awarded annually by the Royal College of Psychiatrists to individuals who have made a significant contribution towards improving the lives of people with mental illness.

He recently returned to frontline clinical work as a Consultant Inpatient Psychiatrist at the Royal Edinburgh Hospital.

Dr Chopra will take up his role at CQC in May.

News: Dr Arun Chopra appointed as CQC’s first Chief Inspector of Mental Health

How we're using your feedback to take action

We've published an update on the action we're taking to help us be the strong, effective regulator that people who use and work in health and care services need and deserve.

To help us make sure we provide the public with up-to-date information about services, we are making some changes to:

increase the number of assessments we carry out
clear our backlog of registration applications
allow us to act promptly on information of concern cases and notifications.

We're focusing on several key areas that people who use services, providers, and other stakeholders have told us matter most.

To help us, we will continue to gather your thoughts and feedback on what we do, including on ratings characteristics, our provider handbook, our assessment framework and how we work together as part of our CQC Way.

Your views and experience are vital to help us build systems that work for all parts of the health and social care sector. We are committed to making this a genuine partnership that drives positive change across the sector.

Taking action on your feedback

Sir Mike Richards announced as the preferred candidate for Chair

Wes Streeting, the Secretary of State for Health and Social Care, has named Professor Sir Mike Richards CBE as his preferred candidate for the next Chair of CQC.

Sir Mike became our first Chief Inspector of Hospitals in July 2013, retiring in January 2017. In 2024, he was commissioned by our Board to look at the impact of the changes we made to our assessment approach following the publication of our 2021 strategy.

He has a clinical background as a consultant medical oncologist and spent over 20 years operating as a hospital physician in the NHS. In 1999 he was appointed as DHSC’s first National Cancer Director.

Subject to approval by the Health and Social Care Select Committee, Sir Mike will take over from the current Chair, Ian Dilks, once his appointment ends.

Digital services in NHS General Practices: new advice on preventing discrimination

The Equality and Human Rights Commission (EHRC) have published new advice to help General Practices (GP) embed equality considerations in the NHS services they provide, specifically around guarding against the digital exclusion of patients.

Digitisation is helping NHS GPs to provide vital services in their communities, but not everyone can access digital services. The EHRC wants to help practices make decisions about their digitalisation with their Public Sector Equality Duty (PSED) responsibilities in mind.

The PSED is a legal requirement to have due regard to three aims in everyday decision and policy-making. The PSED applies to all GP practices that deliver NHS services.

This information explains when it applies and other important information to help advance and promote equality in general practice.

Read more

Information for Healthcare Food Providers: cluster of Listeria monocytogenes

Investigations are ongoing into a cluster of Listeria monocytogenes (LM) cases linked to two mousse desserts (chocolate and vanilla, and strawberry and vanilla). These products match clinical isolates from the outbreak, and other desserts may also be affected.

The Food Standards Agency (FSA), UKHSA, and local authorities are investigating. NHS hospitals have been advised to remove these products, and care homes are also instructed not to serve the affected mousse. Schools are not impacted, as they do not serve high-risk consumer groups.

Actions Required:

Withdraw from food service and sale all desserts at healthcare settings (regardless of brand), manufactured at B. & A. Susca Limited, Pine Street, Off Bennett Street, Hyde, Cheshire, SK14 4TG. This is a precautionary measure while investigations continue.
Place on hold/quarantine desserts removed from service/sale, until further advice is provided by the Local Authority and FSA. Disposal is not required.
Other Cool Delight brand desserts not from this manufacturing site are not affected. If unsure whether a product is from this site, place it on hold and contact the supplier to confirm its origin.

While LM levels in the affected products are below the legal threshold for healthy consumers, immunocompromised individuals, including hospital patients and pregnant women, are at greater risk.

For more information on Listeria, please visit this link. You can also read the FSA’s evidence to NHS food review.

Monitoring the Mental Health Act in 2023/24

Our annual report sets out our activity and findings during 2023/24 from our engagement with people who are subject to the Mental Health Act 1983 (MHA), as well as a review of services registered to assess, treat, and care for people detained using the MHA.

This year’s report highlights again the issues that lack of staff, beds, and training are causing and are leading to harmful gaps in care and treatment. The demand is far outstripping capacity, leading to people being placed far from home, their family, and their friends. There aren’t enough staff to support all patients, and while many people describe healthcare workers as ‘caring’ and ‘wonderful’, there are ongoing concerns with staff numbers and training.

Young people, people from ethnic minority groups, and people from areas of deprivation face the biggest barriers to accessing care. We remain concerned that a lack of suitable community resources continues to lead to inappropriate hospitalisation of people with a learning disability and autistic people.

We are calling for national action to tackle system-wide issues in community mental health. Better funding, improved community support, and a specialised and sustainable workforce is required to ensure that people receive the care they need.

Information for Healthcare Food Providers: cluster of Listeria monocytogenes

Actions Required:

Withdraw from food service and sale all desserts at healthcare settings (regardless of brand), manufactured at B. & A. Susca Limited, Pine Street, Off Bennett Street, Hyde, Cheshire, SK14 4TG. This is a precautionary measure while investigations continue.
Place on hold/quarantine desserts removed from service/sale, until further advice is provided by the Local Authority and FSA. Disposal is not required.
Other Cool Delight brand desserts not from this manufacturing site are not affected. If unsure whether a product is from this site, place it on hold and contact the supplier to confirm its origin.

While LM levels in the affected products are below the legal threshold for healthy consumers, immunocompromised individuals, including hospital patients and pregnant women, are at greater risk.

For more information on Listeria, please visit this link. You can also read the FSA’s evidence to NHS food review.

An update on assessments of integrated care systems

Under the Health and Social Care Act 2022 CQC was given new responsibilities to assess whether integrated care systems (ICSs) are meeting the needs of their local populations. We initially paused our work on this in early 2024 to refine our approach to ICS assessments and the delay was further impacted by the General Election in July 2024 and the Dash review in October 2024.

Following uncertainty as a result of the recent government announcement that NHS England will be brought back under the Department of Health and Social Care (DHSC) along with reductions planned for ICBs, DHSC has withdrawn its request for a proposal from CQC on the future of ICS assessment activity.

This work will pause for at least six months which will allow us to focus on our 4 priorities and 5 foundational improvements.

As part of the CQC teams’ regular updates and engagement sessions, please see the latest slide deck for information. If you have any questions, or need further support, please email CQCTeam@merseycare.nhs.uk

Our monthly update for everyone interested in health and social care

An update on 'the CQC Way'

Julian Hartley, Chief Executive of CQC

In a new blog, our Chief Executive Sir Julian Hartley talks about the start of developing ‘the CQC Way’.

The blog covers how we’re co-designing this work, how it supports the urgent improvements we need to make, and Julian's belief that effective regulation is at the heart of a health and social care system that delivers the outcomes people need.

Read the blog

New Interim Chief Inspector of Healthcare

We have appointed Professor Aidan Fowler as interim Chief Inspector of Healthcare covering Secondary and Specialist Care and Primary and Community Care. Aidan is currently National Director of Patient Safety in England at NHS England (NHSE), and a Deputy Chief Medical Officer at the Department of Health and Social Care (DHSC).

Aidan is expected to be in the role for 6 months, on secondment from NHSE, while permanent Chief Inspectors are appointed. Aidan takes up the Interim Chief Inspector role from 24 February 2025. Chris Dzikiti, who is currently interim Chief Inspector of Healthcare, will become Interim Executive Director of Operations and Executive Lead for Mental Health.

The recruitment process for a permanent Chief Inspector of Hospitals and a Chief Inspector of Primary and Community Care is ongoing.

Read more

Secretary of State announces preferred candidate for Chair of CQC

On 26 February the Secretary of State for Health and Social Care, Wes Streeting MP, named Professor Sir Mike Richards CBE as his preferred candidate for next Chair of CQC.

Subject to approval by the Health and Social Care Select Committee, Mike Richards will take over from current Chair, Ian Dilks, once his appointment ends.

We welcome this announcement and will issue a full statement following the Committee's pre-appointment hearing.

More information

CQC research study exploring equitable access, experience, and outcomes for black men in mental health services

Help Improve Mental Health Services for Black Men!

We invite you to contribute your expertise to an important research project aimed at improving mental health services for Black men. Commissioned by the Care Quality Commission, this study seeks to improve access, experience, and outcomes for Black men within mental health services. University College London (UCL) is conducting this qualitative research through interviews to gather valuable insights that will help guide improvements.

We are recruiting interview participants from key stakeholder groups, including mental health services, to share your views.

We are particularly interested in hearing from professionals working in mental health services—such as those in community groups, early intervention, or psychiatric wards—to participate in a 30-minute online interview between February and March 2025.

If you are interested in participating, please contact ailey.mcleod@ucl.ac.uk or e.beecham@ucl.ac.uk at UCL. If you would like more information, please contact yen.truong@cqc.org.uk at CQC.

We look forward to your involvement.

UK’s Adverse Weather and Health Plan

Researchers at the London School of Hygiene & Tropical Medicine are conducting an evaluation of the UK’s Adverse Weather and Health Plan (AWHP). The AWHP was created by the UKHSA in 2023 and aims to protect individuals and communities from the health effects of adverse weather.

The evaluation is focusing on how the AWHP is being implemented in local health and social care organisations in England and includes a short survey to understand awareness and use of the AWHP and/or similar local plans. The survey should take no more than five minutes to complete.

This evaluation is targeting frontline NHS and social care staff and managers, local authorities, service delivery staff and the voluntary sector. If you are part of one of these groups, please consider filling out the survey to share your views.

If you have any questions, please get in touch with Dr Beth Jakubowski.

Take the survey

Share for Better Care Week

This week is Share for Better Care Week. Join us to help more people speak up about their care.

Your feedback about health and social care matters. It helps services to spot and identify what’s working well, and what areas need to improve.

You can help make a difference by supporting Share for Better Care Week, which runs until 2 March.

Whether you work in health and social care or receive support from these services, you can play your part by encouraging others to give a few minutes of their time to share feedback about their care.

Find out more about Share for Better Care Week and how you can get involved

Tell us what maternity care was like for you in 2025

CQC’s 2025 national maternity survey is happening soon. The annual survey asks women and other people who have used maternity services about their experience of maternity care.

NHS hospital trusts will be inviting people to take part in this year’s survey from April. Taking part is voluntary and all answers are conﬁdential and anonymous.

Nicola Wise, our Director of Secondary and Specialist Healthcare, said:

“If you are invited to complete the survey, we really want to hear from you. We need you to tell us what works well and what you think needs to change. Please help us to drive the action required, so everyone using maternity services can have a positive experience every time.”

If you are invited to take part, you will be sent a letter from the NHS hospital trust where you received your maternity care. The letter will include a link to complete the survey online. It will also explain how to complete the survey in an alternative format if you prefer.

News: Tell us what your maternity care was like for you in 2025

Our response to the Care Provider Alliance's review of the single assessment framework

We have given our response to the Care Provider Alliance's review of our single assessment framework.

We commissioned the review last autumn to gather the views of adult social care providers about the assessment framework and ask what they want from regulation. This work sits alongside the review by Professor Sir Mike Richards.

The Care Provider Alliance's report is built on feedback from over 1,200 survey respondents and the views of more than 100 providers shared through 5 workshops.

Sir Julian Hartley, our Chief Executive, said:

“We welcome this report which has been instrumental in ensuring we hear the voices of a wide range of adult social care providers, as the findings are a robust reflection of their views and experiences.”

The report includes 11 recommendations and key messages from the survey, which we will now review in more detail to consider their implementation. Some recommendations will be subject to further discussion, policy change or consultation.

We are determined to improve providers’ experience of regulation through developing a handbook which describes what we expect from providers, what they can expect from CQC, as well as giving our staff the tools and time to do their job. We are strengthening sector leadership in CQC and want to continue to work with the CPA to oversee progress. This report provides a good agenda for shared work over the coming months.

New framework launched to help integrated care systems reduce inequalities

Working in partnership with National Voices and the Point of Care Foundation, we have developed a self-assessment and improvement framework for integrated care systems (ICSs) to help them address health inequalities.

The aim of the framework is to support ICSs to improve how they tackle health inequalities through honest conversations, gathering insights and developing practical actions through engagement linked to people and community strategies.

The framework is the result of extensive co-design, involving input from public health practitioners, ICS leaders, engagement experts, voluntary, community and social enterprise (VCSE) partners, and people with lived experience.

This work was funded with a grant from the Regulators’ Pioneer Fund. The fund is currently being delivered by the Department for Science, Innovation and Technology (DSIT).

Other news

Subscribe to our WhatsApp channel, where we share the latest updates on our new regulatory approach.
Our Independent Care (Education) and Treatment Reviews — Making a difference. Rebecca Bauers, CQC’s Director for people with a learning disability and autistic people, describes the impact that our work on Independent Care (Education) and Treatment Reviews is having on people’s lives. Read blog.

Our monthly update for everyone interested in health and social care

Julian Hartley: Returning to ‘good’ regulation and looking ahead

In a new blog post, our new Chief Executive, Julian Hartley, reflects on his first 6 weeks in the role and looks ahead to the work that we will be doing over the coming months.

Julian writes about the immediate action we are taking to make sure we:

can publish reports in a timely way
increase the number of assessments
clear our registration backlog
act promptly on information of concern and notifications.

The blog post also looks at how we will re-focus on our purpose and make sure that we have the right values guiding our work. This work will involve developing a set of behavioural expectations for how we’ll work together with providers, the public and stakeholders.

Blog: Returning to ‘good’ regulation and looking ahead

Improving care for people with a learning disability and autistic people

Rebecca Bauers, our Director for people with a learning disability and autistic people, has written a blog describing the impact that our work on Independent Care (Education) and Treatment Reviews (IC(E)TR) is having on people’s lives.

The Department of Health and Social Care asked us to lead on IC(E)TRs for the next 2 years. We are working jointly with NHS England for the first year before taking full responsibility in the second year.

Since beginning our IC(E)TR programme in May 2024, we’re already seeing examples of positive outcomes for people.

Among those who have had a review, we’ve seen:

One person successfully discharged from long-term segregation in a high-secure setting
A young person successfully moved to more appropriate adult services in single-person accommodation that better meets their needs
Another person discharged into their own accommodation in the community.

These successes demonstrate how these reviews can make real differences to people’s lives, supporting individuals to move to less restrictive environments when appropriate.

In the blog post, Rebecca shares some of the things we've learned from doing the reviews, along with what we plan for the future.

Last month, Rebecca also wrote a blog giving an update on an update to our position on reducing restrictive practice, particularly on the use of intubation.

New local authority assessments published

We have published new reports assessing how local authorities are meeting their responsibilities to make sure people have access to adult social care and support.

The new reports look at:

London Borough of Barnet
Bath and North East Somerset Council
London Borough of Ealing
Northumberland County Council
Wiltshire Council
Metropolitan Borough of Wirral

Each report looks at 9 areas spread across 4 themes to check how well each authority is meeting its responsibilities. Areas are given a score out of 1 to 4. A score of 1 is given when evidence shows significant shortfalls for this area, and 4 when evidence shows an exceptional standard is being met.

Local authority assessment reports

Help shape our work

Our pages on the Go Vocal service help you shape the work that we do.

Go Vocal gives you an easy way to get involved with our work and share your ideas and opinions. We use it to bring together groups of people, collect your views, conduct surveys and run quick polls.

What you tell us helps us understand the things that are important to you. We can use what we learn to make our services and information better for everyone.

The things we're working on change all the time. Join using the links below and you'll be sent an email when new information or projects are added. You can also sign in to see what activities are currently live and ready for you to take part in.

Sign up and get involved

News from the Care Quality Commission - December 2024

Newsletter

A regular update for providers and professionals working in healthcare services

Message from Sir Julian Hartley

As the year draws to a close, I want to take the opportunity to firstly say thank you to everyone who has been so welcoming, candid and frank with me during my first month as Chief Executive of CQC. I’m grateful to everyone who I have met with so far and who have shared their thoughts and reflections with me – I look forward to meeting many more of you in the coming months.

There’s no doubt that this year has been incredibly challenging for CQC, as well as the health and care system as a whole, but it has been so encouraging to see how many people are willing to work together to support us to be the regulator we all want us to be – supporting health and social care services to provide people with safe, effective, compassionate, high quality care.

We have already started making changes to do this, such as stopping scoring and reporting at evidence category level for provider assessments started after 2 December. One of the main reasons for this being that we have heard that our scoring model is too complex and hard to understand. This is just one of many changes we need to make to urgently improve.

In the new year I’ll be sharing more information on our priorities for the coming months, but the changes we make will definitely be focused on ensuring the regulation we carry out meets its core purpose – to keep people safe and ensure they receive the care they deserve. I’m absolutely committed to working in partnership with people who use services, health and social care providers and stakeholders to do this.

I want to thank you to you, as health and social care professionals, for everything you do to keep people safe and deliver care, particularly when it isn’t easy. Working in health and social care means you don’t always get a break over the festive period, but I hope you’re able to take some down time and spend time with loved ones. I look forward to writing to you in 2025 with more updates on how we are working to improve.

CQC fees scheme for 2025/26

The CQC fees scheme for providers, which covers our costs of provider regulation, will not change next year – in 2025/26.

This means that, for many providers, your fees will have remained the same for the last 6 years, unless you have changed your registration – for example, by adding locations or service types.

As in previous years, NHS trusts, NHS GPs and community social care providers may see a change to their fees from April 2025 (up or down), as we update the variables (turnover, list size, number of people using the service) used to calculate their fees.

Since there is no change to our fees scheme, we will not be consulting on fees for provider regulation this year.

Find out more about our fees scheme

National Quality Board - Principles for assessing and managing risks across integrated care systems

The National Quality Board (NQB) has published principles for assessing and managing risks across integrated care systems.

The document outlines principles for managing quality risks within integrated care systems, particularly in rapidly changing environments. It supports the delivery of safe, effective, and personalised care while addressing inequalities across health services.

The principles sit alongside previously published NQB guidance.

The Society of Radiographers Ultrasound Census 2024

The Society of Radiographers (SOR) is calling on sonographer managers across the NHS and independent sectors to participate in the 2024 ultrasound census.

The SoR encourages sonographer managers to share their experiences, highlight challenges, and showcase good practices through the census.

Input from both NHS and independent providers is crucial for fulfilling Professional Standards Authority (PSA) requirements and shaping the future of sonographer practice.

The survey will be open until Tuesday 17 January 2025.

Take the survey

Other news

In April 2024, the Department of Health and Social Care (DHSC) published a consultation, seeking views on removing making changes to some of CQC’s regulations. Specifically to 1) remove the expiry date of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and replace it with a 5-yearly review 2) making changes to CQC regulations relating to ‘treatment (not first aid) in a sports ground or gymnasium’ and ‘temporary arrangements to deliver medical care (not first aid) at sporting or cultural events’ 3) introducing a new requirement to notify CQC of the use of restraint, segregation and seclusion in mental health units. On 18 December, DHSC published their response to that consultation.
We are aware of a scam where a company that claims to be CQC is emailing registered providers selling in-house training for staff on our inspections and how to get a rating of outstanding. The email includes information copied from our website and a fake CQC logo. We never charge a fee for any guidance, webinars and other face-to-face engagement events and we do not offer training for staff. If you are considering investing in training for your staff, you should make sure the training provider is advertised as independent from CQC and let us know of any examples of training companies that claim otherwise.

Get ready to make a difference from 24 February 2025 as we launch Share for Better Care Week, a national week of action about helping more people have a stronger voice in their care. Mark your calendars and sign up for our Share for Better Care briefing call on 21 January to find out how you can support our campaign! Let's come together and ask our communities, "Will you share for better care?".
National Voices have recently published a joint blog with Chris Dzikiti about our Share for Better Care campaign, reflecting on the importance of sharing experiences of care, especially for people experiencing health inequalities.

Keep up to date with the latest on how we're improving how we work on our website.
The Government have announced an update on the extension to the banning order on puberty blockers. The full details can be found on the GOV.UK website.
GP mythbuster 41: Smartcards, and GP mythbuster 91: Patient safety alerts have been updated on our website.
Cold weather can significantly impact people’s health and well-being. The UK Health Security Agency (UKHSA) has guidance on reducing risks for people living in care homes or receiving care at home over winter.
The Digital Care Hub is raising awareness across the care sector of how to avoid falling victim to a scam. Check our their informative videos across X and LinkedIn.

News from the Care Quality Commission - November 2024

Newsletter

A regular update for providers and professionals working in healthcare services

Improving how we work

From 2 December, we will be making some urgent interim changes to our approach to provider assessments.

We will stop scoring and reporting at evidence category level for provider assessments. This will mean that we will only produce scores at quality statement level.

This change will mean we will be able to deliver more assessments, at a faster pace, that better reflect the quality in a service.

We will update our guidance to reflect this change.

Find out more about what this change means for you

Maternity survey 2024

This survey looked at the experiences of pregnant women and new mothers who used NHS maternity services in 2024.

Women who gave birth between February 1 and February 29, 2024 (and in January for trusts with fewer than 300 eligible births in February), were invited to take part. The fieldwork was conducted from May to August 2024, with 18,951 responses received, resulting in a 41% response rate.

Overall, the results highlight areas of improvement over the past year, especially in access to mental health support during pregnancy. However, it also reveals ongoing challenges in maternity care, with reports of poorer experiences in certain aspects. These include communication during labour and birth, the information provided during hospital care after birth, and involvement in postnatal care - areas where feedback suggests a longer-term decline in positive feedback.

In September we published our maternity improvement resource, informed by findings from our National Maternity Inspection Programme. This shares practical examples of where providers can drive improvement in triage, incident management, leadership and culture, and health equity.

Read the results

Read the news story

Maternity improvement resource

Share For Better Care - empowering people to improve health and social care through feedback

We recently we held a webinar with Healthwatch England, hosted by one of our campaign partners the Patients Association.

Attended by 180 people, a mixture of the public, health and social care staff and other stakeholders – it was a really engaging event with challenging but fair questions.

Peoples’ experiences can provide vital lessons for the health and care sector, helping it understand what is working and what needs improvement.

Watch the webinar and:

hear about their campaign, which aims to support more people to have their say on health and care services
understand the barriers that exist to giving feedback and potential solutions
listen to patients explain first-hand their experience of providing feedback and how this improved their care
discuss the current ways people provide feedback and what more can be done to ensure peoples' voices are heard.

Please look out for our joint blog with National Voices coming out in the next few weeks.

Watch the webinar

National Patient Safety Alert

Profiling, adjustable or medical beds (beds) are used extensively in hospitals, care homes and people’s own homes. It is essential that these beds and associated equipment are used correctly and safely to minimize the risk of injury or death to bed occupants.

The Medicines and Healthcare products Regulatory Agency (MHRA) continue to receive reports of adverse incidents involving beds and equipment, the most serious leading to injury and death.

The following guidance, published by the MHRA sets out good practice, aimed at anyone with responsibility for the provision, prescription, use, maintenance, and fitting of beds and associated equipment. This includes the importance of appropriate staff training, correctly following manufacturers' instructions and adequate service and maintenance of beds and equipment.

Useful links:

MHRA NPSA (relating to beds and equipment)
MHRA bedrails guidance
MHRA medical device guidance
MHRA medical device checklist

It may not be immediately obvious to consider a bed as a medical device and it is worth noting although the medical device guidance doesn’t list profiling/adjustable beds as a medical device, the accompanying checklist does.

New online immigration status (eVisa)

We are advising you of a change to some immigration documents. Biometric residence permits (BRP) and biometric residence cards (BRC), are being replaced with digital proof of immigration, called an eVisa.

From 31 October, new visa applicants are being issued with eVisas, and existing visa holders who currently prove their rights with a BRP, BRC or a passport containing a visa vignette or ink stamp, will need to create a UKVI account to access their eVisa. This needs to be completed by 31st December 2024.

Some helpful guidance on how to create an eVisa account:

Information on what people need to do and by when, including for those who hold a physical immigration document, and a list of grant funded organisations offering support
Guidance videos explaining how to access and use eVisa
Download the eVisa Partner Pack - this includes factsheets and guides for organisations, helpful materials to inform your colleagues/organisations you may collaborate with of the transition to eVisa, including a suggested email to send and drag and drop copy for intranets.

Information on eVisas

Guidance videos

Download the eVisa Partner Pack

Urgent and emergency care survey 2024

A recent survey of over 45,500 people who used NHS urgent and emergency care (UEC) services in 2024 revealed generally positive interactions with staff. However, significant challenges were reported, including long waits for assessment and insufficient support for managing pain or controlling symptoms. This comprehensive survey examined the experiences of patients accessing Type 1 and Type 3 UEC services.

The survey used two tailored questionnaires to capture feedback for each service type. Results were analysed at both the trust level and the overall England level, providing a detailed view of patient experiences across the country. Type 1 services encompass A&E departments, often referred to as casualty or emergency departments, while Type 3 services include urgent treatment centres, commonly known as minor injury units. Importantly, the survey only considered services directly managed by acute NHS trusts.

Read the results

Read the news story

News from the Care Quality Commission - October 2024

Newsletter

A regular update for providers and professionals working in adult social care.

Feedback on ratings characteristics

Following the reviews into our regulatory approach led by Dr Penny Dash and Professor Sir Mike Richards we want to work with you to make improvements to how we regulate.

Over the next few months, we'll be offering opportunities to work with us to co-design elements of our regulatory approach, through sessions, surveys like this and more.

We’ve heard that you’d like more information on what we consider to be good and outstanding care.

To support this, we’re starting a period of engagement to help develop new ratings characteristics that will describe what we would expect to see at different ratings levels.

We're sharing a draft set of ratings characteristics. We want to know if you think these give enough information / which areas need more detail.

Watch the recording of our recent session on ratings characteristics.

Take part in the survey

Your Voice Matters: Join Our "Share For Better Care" Webinar - Empowering patients to improve health and social care through feedback

Patients' experiences can provide vital lessons for health and care services, helping them understand what is working and what needs improvement. However, not everyone knows how to speak up about their care, and health and care services could be better at telling people how they can provide feedback and why this matters.

The Patients Association is hosting a webinar on Wednesday 6 November 10-11 a.m. to discuss this issue.

Join the CQC, Healthwatch England, and the Patients Association to:

Hear about their campaign, which aims to support more people to have their say on health and care services
Understand the barriers that exist to giving feedback and potential solutions
Listen to patients explain first-hand their experience of providing feedback and how this improved their care
Discuss the current ways people provide feedback and what more can be done to ensure patients' voices are heard.

With the NHS currently consulting on its 10-year plan to reform, it's never been a better time to discuss how we can ensure patients have a stronger voice today and in the future.

Register now

Change NHS consultation

The NHS has been there for us for over 76 years. But to make sure the NHS is here for the next 76 years, doing all it can to support the health of everyone, they need your help.

They want to have the biggest ever conversation about the future of the NHS.

It doesn’t matter whether you have a lot or a little to say. Your views, experiences and ideas will shape a new 10 Year Health Plan for England.

This is open to everyone. If you are a member of the public or someone who works in health and care in England, go to start here, to tell us how the NHS needs to change.

If you are contributing as a representative of an organisation, complete the organisation questionnaire. This is an early opportunity to share your insights as we begin an extensive programme of engagement to develop the 10 Year Health Plan.

If you register your email address, NHS will stay in touch to seek your views as the 10 Year Health Plan develops.

Share your views

Research reveals how older adults can thrive in a care home

‘Thriving in Residential Care’ is groundbreaking new research from My Home Life England, part of City St George’s, University of London, which reveals the diverse experiences of older people living in care homes across the UK.

One of the largest ever qualitative research studies on older people’s experiences of living in residential care, the research identifies some challenges, but reveals proportionally many more benefits of living in a care home.

The insights, heard directly from older people, care teams and families, shine a light on six key ways that older people can thrive in a care home, if the conditions are right.

Find out what supports older people to live well and thrive in residential care.

Watch the video

New trends in the adult social care workforce

Skills for Care’s new report highlights key workforce trends, including recruitment, retention, pay, and demographics and workforce projections. The report also explores factors impacting CQC ratings.

Key findings include:

1.705 million filled posts and 131,000 vacancies, bringing the total to 1.84 million—the highest on record.
Turnover rates for care workers (29.9%) and registered managers (19.4%) were at their lowest since 2017/18.
The proportion of male workers increased to 21%, up from 18% historically.
The local authority and independent sectors workforce’s average age, which had been rising, dropped to 43.7 years in 2023/24
These changes have been influenced by an increase in international recruitment. Internationally recruited workers were more likely to be male (29%) and an average age of 34.1.

These findings rely on data from the Adult Social Care Workforce Data Set, which helps providers access training funding and manage records.

Read the full report

Calling all health and adult social care professionals working in England!

The Institute for Employment Studies are researching workforce inequalities in health and social care and want to hear from you! They want to understand how employees with certain characteristics are unequally treated while at work, including discrimination, bullying or harassment, not being fairly considered for promotion, or not being able to get issues like these recognised or resolved when they arise.

The survey takes 20 minutes to complete and will provide evidence of how workforce inequalities are experienced and observed in the health and social care sector. The survey can be accessed here. The survey will close on 10 November. If you have any questions, please contact workforce-inequalities@employment-studies.co.uk.

Take the survey

Keeping information safe: Data protection and cyber security in social care

Care providers need to store and share information securely, on paper and digitally. It's essential to delivering person-centred care, based on good information. And it’s a legal and regulatory requirement.

Digital Care Hub are working with the Care Provider Alliance and their Better Security, Better Care team to understand the data protection and cyber security challenges you face. They will work with them to deliver free support on the key issues. To help them with this, please complete this short survey

Complete this short survey

You may be aware but a reminder of Digital Care Hub's new resources below:

To tie in with cyber awareness month we have released new advice on how to deal with a cyber attack.
Digital Care Hub welcomes the recommendations in the BCS Chartered Institute for IT’s landscape review of digitisation in social care.
Transforming adult social care through digitalisation - a landscape review
New case study on why Roses Homecare went digital
Finally, new free training and support that new care services need to do around Data Security and Protection Toolkit.

Other news

What approaches are being taken by regulators to tackle inequalities - and what actually works? CQC commissioned SQW, supported by The King’s Fund Library Service and Dr Tammy Boyce, to deliver a rapid evidence review and series of interviews to explore how regulators can tackle inequalities experienced by those using or needing services. The latest episode of SQW’s Insight for Impact podcast explores key learnings from this research. CQC’s Lucy Wilkinson joins guest speakers from the Equality and Human Rights Commission, the Institute of Regulation and SQW, to discuss the findings from the research, key themes and interesting takeaways. The podcast considers implications for CQC and for regulators in all sectors. Listen to the podcast.
Registration fee invoices: Invoices are currently being sent by post to a provider’s registered address. If you are expecting an invoice and have not received it, please email NCSC.Finance@cqc.org.uk to request a copy. Please include your contact details and provider ID. We will email a copy invoice out as soon as possible. We are managing a large number of enquiries at present.
In a recent guest blog, Robyn Chappell, Lived Experience Advisor, reflects on her experience as part of the Expert Advisory Group for a project with CQC and the Point of Care Foundation, funded by the Regulators’ Pioneer Fund, which is developing an engagement and health inequalities improvement framework for integrated care systems. We also share an update on how the project is progressing on our website.
Moritz Flockenhaus, one of our Regulatory Policy Managers has published a blog with the AI and Digital Regulations Service for Health and Social Care on 'reflections on building the AI and Digital Regulations Service' - you can read the blog here.
Subscribe to our WhatsApp channel, where we share the latest updates on our new regulatory approach.

News from the Care Quality Commission - September 2024

Newsletter

A regular update for providers and professionals working in healthcare services

Re-building a trusted approach to our regulation

We have set out how we will drive the improvements needed to re-build trust in our regulation.

This involves making immediate changes to support our response to the recommendations in the interim report from Dr Penny Dash and to improve our ways of working ahead of the publication of the final report. These changes will help us to deliver:

a clear and transparent programme of assessment and ratings
quicker and more effective registration and assessments of providers
simpler and clearer reports.

Visit our website to read a summary of the immediate changes we are making. We will share more details soon of what is happening and when. This will include further information on the frequency of assessment and when we expect to carry out more assessments.

Read the summary

New resource aimed at encouraging improvement in NHS maternity services

We have published a series of online resources to support NHS hospital maternity services, sharing good practices and encouraging improvement. Developed with input from providers, maternity staff, and stakeholders, these resources are designed for staff at all levels to enhance the quality of care and drive positive change.

The resources, which complement our recent national maternity inspection report, focus on four key themes:

leadership and culture
safety incidents
triage processes
healthcare equity.

Each theme offers guidance on what good practice looks like, what we assess during inspections, and examples of excellence. We invite feedback through our pop-up survey on our website to help us refine and expand this online resource.

View the online resources

Read the report

Ionising Radiation (Medical Exposure) Regulations annual report 2023/24

The Ionising Radiation (Medical Exposure) Regulations (IR(ME)R) protect individuals from accidental or unintentional exposure to ionising radiation in healthcare settings. Healthcare providers must notify us of incidents that meet reporting thresholds. Our annual report outlines the number and types of errors reported between 1 April 2023 and 31 March 2024, along with key findings from our inspections and enforcement activities during that period.

In 2023/24, we received a total of 819 notifications across all modalities. These incidents represent a small proportion of over 30 million diagnostic imaging exams and 116,000 radiotherapy treatments conducted. Common issues included errors resulting from inadequate identity checks and staffing shortages. The report identifies recurring concerns and offers practical actions for employers to improve safety and compliance with regulations.

Note to providers: With effect from 1 October 2024, IR(ME)R 17 will be amended to the Ionising Radiation (Medical Exposure) (Amendment) Regulations 2024 - or 'IR(ME)R Amendments 2024’.

Statutory Instrument and Explanatory memorandum: The Ionising Radiation (Medical Exposure) (Amendment) Regulations 2024 (legislation.gov.uk) and The Ionising Radiation (Medical Exposure) (Amendment) Regulations 2024 (legislation.gov.uk).

The accompanying IR(ME)R guidance has also been updated to support interpretation of the new provisions: Ionising Radiation (Medical Exposure) Regulations 2017: guidance - GOV.UK (www.gov.uk).

Read the report

Notifications

There are a range of statutory notifications that every provider must report to CQC. The legislation allows NHS trusts to submit some statutory notifications via the national system commissioned by NHS England. This used to be the National Reporting and Learning System (NRLS) and is now Learn from Patient Safety Events (LfPSE). This is set out in notifications guidance for providers.It is important to note that independent providers must still make direct notifications to CQC. This is because of the way the legislation is written. This means that, even if an independent provider is able to report the incident via the national system set up by NHS England, they must also make a direct notification to CQC.The August edition of our provider bulletin did not make this distinction, but we hope this is now clear.

Notifications guidance for providers

Workforce inequalities in health and social care survey

The Institute for Employment Studies are researching workforce inequalities in health and social care and want to hear from you.

They want to understand how employees with certain characteristics are unequally treated while at work, including discrimination, bullying or harassment, not being fairly considered for promotion, or not being able to get issues like these recognised or resolved when they arise.

The survey takes 20 minutes to complete and will provide evidence of how workforce inequalities are experienced and observed in the health and social care sector, providing a better understanding of the frequency and types of workforce inequalities. If you have any questions, please email workforce-inequalities@employment-studies.co.uk.

Take the survey

Other news

Subscribe to our WhatsApp channel, where we share the latest updates on our new regulatory approach.
Moritz Flockenhaus, Regulatory Policy Manager at CQC, has published a blog with the AI and Digital Regulations Service for Health and Social Care on 'reflections on building the AI and Digital Regulations Service'.
Adult Community Mental Health Trusts – Requests for information - We’d like to thank colleagues at Adult Community Mental Health Trusts (ACMHT) who responded to our recent requests for information to support our understanding of ACMHT individual services and teams, and to understand what actions have been taken following the special review of mental health services at Nottinghamshire NHS Foundation Trust. We are also holding 3 provider engagement events in early November for ACMHT to support with our planning of ACMHT thematic reviews. The nominated individual from your trust will have received the invite to these events and asked to nominate 2 individuals to attend. We look forward to seeing you there.
In a new guest blog, Robyn Chappell, Lived Experience Advisor, reflects on her experience as part of the Expert Advisory Group for a project with CQC and the Point of Care Foundation, funded by the Regulators’ Pioneer Fund, which is developing an engagement and health inequalities improvement framework for integrated care systems. We also share an update on how the project is progressing on our website.

CQC Preparedness Session - September 2024

News from the Care Quality Commission - August 2024

Newsletter

Our monthly update for everyone interested in health and social care

Final part of our special review of mental health services at Nottinghamshire Healthcare NHS Foundation Trust published

Following the conviction of Valdo Calocane in January 2024 for the killings of Ian Coates, Grace O’Malley-Kumar and Barnaby Webber, Rt Hon Victoria Atkins MP, former Secretary of State for Health and Social Care, commissioned us to carry out a rapid review of Nottinghamshire Healthcare NHS Foundation Trust (NHFT).

We were asked to look at 3 specific areas:

A rapid review of the available evidence related to the care of Valdo Calocane
An assessment of patient safety and quality of care provided by NHFT
An assessment of progress made at Rampton Hospital since the most recent CQC inspection activity

We looked at areas 2 and 3 in a report published earlier this year.

Our review looking at area 1 has now also been published.

This review finds that there appear to have been a series of errors, omissions, and misjudgements in Valdo Calocane's care. Key among these were:

Inconsistent approaches to risk assessment.
Poor care planning and engagement.
The decision to discharge Valdo Calocane back to his GP in September 2022

The review also found that if the decision had been made to treat Valdo Calocane under section 3 of the Mental Health Act (MHA) 1983 on his fourth admission to hospital further options would have been available for his care and treatment in the community.

Adult inpatient survey: Find the results for your local trust

We asked over 63,500 people who stayed in hospital for at least one night in late 2023 about their care.

The survey asked people to give their opinions on the care they received, including quality of information and communication with staff, whether they were given enough privacy, the amount of support given to help them eat and drink, and on their discharge arrangements.

Nationally, results covering waiting times have continued to decline.

People’s experience of being discharged from hospital also remained poor. Only 33% of respondents said they were involved ‘a great deal’ in decisions about their discharge.

However, the majority of respondents were still positive about their interactions with doctors and nurses - as has been the case in previous years.

Six local authority assessments published

We have published 6 new reports under our new responsibilities to assess how local authorities are meeting their responsibilities to make sure people have access to adult social care and support.

The six new reports look at:

Bracknell Forest Council, rated good
London Borough of Brent, rated requires improvement
County Durham, rated good
Derby City Council, rated requires improvement
Derbyshire County Council, rated good
Hertfordshire County Council, rated good

The reports look at 9 areas spread across 4 themes to check how well the authority is meeting their responsibilities. Each area is given a score out of 1 to 4. A score of 1 is given when evidence shows significant shortfalls for this area, and 4 when evidence shows an exceptional standard is being met.

Looking at the support adult social care services receive on the safe management of medicines

We commissioned research company Ipsos to look at what support adult social care providers receive to make sure medicines are managed safely. We also asked them to look at how the support impacts the quality of care providers are able to deliver.

The research found that adult social care services have access to a wide range of different types of medicines support from a variety of sources, but that not all care providers receive support from community pharmacy or other healthcare professionals.

Providers also told the researchers that further support would be welcomed in the form of training, consistent advice and guidance and easier contact with pharmacies and healthcare professionals.

This work was carried out as part of our research and evaluation programme. The programme helps us:

understand what makes a good service and how we can help providers improve
become a smarter and more flexible regulator
check and understand our impact

We share what we find. This is to help drive improvement in health and care and make sure all parts of the system are using the same evidence base.

Annual report and accounts published

Our Annual report and accounts (ARA) look at our progress and performance during 2022 to 2023.

The first part of the report looks at the work that we've done, progress towards our objectives and targets, and our impact as a regulator.

The report also gives an overview of the funding we receive, where our expenditure is incurred and how we aim to demonstrate value for money.

Report: CQC Annual report and accounts (ARA): 2022/23

News from the Care Quality Commission - July 2024

Newsletter from CQC

Our monthly update for everyone interested in health and social care

Our response to the interim findings of the Dash review into our operational effectiveness

Dr Penelope Dash has published the interim findings of her review of our operational effectiveness.

This interim report gives a high-level summary of Dr Dash's early findings. It has been published to help shape the changes needed to start the process of improving CQC.

In response, Kate Terroni, our interim chief executive, said:

"We accept in full the findings and recommendations in this interim review, which identifies clear areas where improvement is urgently needed. Many of these align with areas we have prioritised as part of our work to restore trust with the public and providers by listening better, working together more collaboratively and being honest about what we’ve got wrong.

"We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve."

Professor Sir Mike Richards has been appointed to conduct a targeted review of how the single assessment framework is currently working for NHS trusts and where we can make improvements.

Kate was appointed interim Chief Executive at the start of the month, after Ian Trenholm's departure. Following her appointment, Kate set out 3 urgent and immediate areas of action:

Improve how we’re using our regulatory approach
Fix and improve the portal that providers use to share information with us
Rethink our ways of working

We'll be updating our website with more information about our change programme in the coming weeks.

Helping integrated care systems reduce health inequalities

Four integrated care systems (ICS) will be testing a new framework looking at how they speak with people and communities. The framework helps ICSs check how effective this work is at reducing health inequalities.

The framework has been developed by CQC, National Voices and the Point of Care Foundation.

National Voices and the Point of Care Foundation led the recruitment of ICSs through an open applications process. They received expressions of interest from 11 ICSs and selected 4 for testing:

Black Country ICS
Gloucestershire ICS
Hampshire and Isle of Wight ICS
Nottingham and Nottinghamshire ICS

The successful ICSs were chosen to make sure there was a mix of demographics, geography, level of deprivation and experience in addressing health inequalities. The testing phase will take place during the autumn.

This project is supported by a grant from the Regulators' Pioneers Fund, and work began in February 2024.

More information: Working with National Voices and the Point of Care Foundation on Regulators’ Pioneer Fund project

Our update on the safer management of controlled drugs

Earlier this month we published our annual update on the safer management and use of controlled drugs.

The report shares important insight on the use of controlled drugs in health care and adult social care services.

The annual update draws on prescribing data, feedback from controlled drug local intelligence networks, and our wider inspection and regulatory work. The report will help people working with controlled drugs to strengthen the arrangements for their safe management and use.

Our annual report looking at the quality of care in Defence Medical Services

We've published our latest annual report looking at our independent inspections of Defence Medical Services (DMS).

The Defence Medical Services provide medical care for members of HM Armed Forces. We inspect defence medical treatment facilities to ensure that armed forces personnel and their families have access to the same high-quality care as the rest of society. Our annual reports highlight the key findings from inspections.

In 2023/24, we carried out first inspections and follow-up inspections of services including: medical centres, dental centres, community mental health services, a regional rehabilitation unit, and the Pre-Hospital Emergency Care (PHEC) service for British Forces Cyprus.

Do you work in health or social care?

Shared Learning from 2023 CQC Inspection

Following on from the CQC Inspection in 2023, the trust received 12 Must Do and 30 Should Do actions.

The actions have been progressed through the CQC action plan via Divisional oversight with reporting into the Trustwide CQC Action Plan Assurance Group.

We are now seeing continuing progress for CQC actions with many closed down or in the close down process.

In preparation for discussion at the next Trustwide CQC Action Plan Assurance Group meeting scheduled for Tuesday 13th August 10.30 - 11.30am, divisions are asked to consider the following questions to feedback on:

Could the same CQC issue be picked up in other service areas within or across divisions?
As a division have you rolled out the improvements across relevant service lines or services where the CQC issues could occur?
What do we need to do to make this happen?

News from the Care Quality Commission - June 2024

Newsletter

Our monthly update for everyone interested in health and social care

Ian Trenholm to step down

Ian Trenholm, our Chief Executive, has announced his intention to step down from his role of Chief Executive and as a Board member at the end of the month.

Reflecting on his decision, Ian said:

"During my six years leading CQC, we have made important changes to the way we work in order to help improve care and keep people safe. We are now in the final stages of delivering an ambitious transformation programme - this month saw the delivery of the last big milestone in a complex and challenging programme of work.

"While there will always be more work to do, the conclusion of this stage of the transformation feels like a good time to move on. It has been a privilege to work with such a passionate, committed and talented group of colleagues.

"I am incredibly proud of what we have achieved together, and I am confident that the organisation will continue to evolve to help support the health and care system to provide good, safe care for people."

Kate Terroni, CQC's Deputy Chief Executive will be appointed as Interim Chief Executive. A permanent appointment will be made in due course.

News: Ian Trenholm to step down as CQC's Chief Executive

Help shape our work

Our CitizenLab service helps you shape the work that we do.

CitizenLab gives you an easy way to get involved with our work and share your ideas and opinions. We use it to bring together groups of people, collect your views, conduct surveys and run quick polls.

What you tell us helps us understand the things that are important to you. We can use what we learn to make our services and information better for everyone.

Sign up and get involved

Catch up with the latest blog posts from CQC

Take a look at our latest blog posts:

Exploring our community mental health survey results

In this blog from last month, Chris Dzikiti, our interim Chief Inspector of Health Care, explores the results of the latest community mental health survey, focusing on new insights on child and adolescent mental health services.

Blog: Exploring our Community mental health survey results

Progressing the Patient and Carer Race Equality Framework

Chris Dzikiti and Dr Jacqui Dyer, Mental Health Equalities Advisor at NHS England, talk about the work our two organisations are doing to implement the Patient and Carer Race Equality Framework (PCREF).

Blog: Progressing the Patient and Carer Race Equality Framework — Improving mental health care for racialised communities

See our other blog posts

Our page on Medium

Do you work in health or social care?

CQC Notifications Guidance - June 2024

Please see the below link to our CQC notifications guide, there will be no changes in here to what you are already doing as a division in terms of notifications to CQC but this slide deck will ensure that you have the current information and links all in one place. Guidance and forms can change regularly but the links on the page will always take you to the most recent updates and forms to be used.

CQC Notification Guidance

Location code is something we are asked for quite frequently and so we have added these in (slides 11/12/13).

We hope this is helpful but if you do have any questions at all please let us know and we will be happy to talk you through any element of this.

CQCTeam@merseycare.nhs.uk

Managers Guidance for a CQC Inspection - June 2024

Updated presentation - Managers Guidance to a CQC Inspection for 2024.

Quality Review Visit (QRV) alignment to CQC's Single Assessment Framework (SAF) - June 2024

The QRV report is subject to ongoing review and consultation but we will be linking this review to the published reports that CQC make available following their initial inspections using the new Single Assessment Framework (SAF). We anticipate that the SAF will have a real focus on Safe and Well Led areas therefore we’re currently prioritising reviews of the following –

S1. Learning culture (Safe) – went live 1 June 2024 replacing S1. Incident reporting, including Serious Incidents
S3. Safeguarding (Safe)
S7. Infection prevention and control (Safe)
S8. Medicines optimisation (Safe)
W7. Learning, improvement and innovation (Well Led)
W8. Environmental sustainability – sustainable development (Well Led)

CQC Preparedness Session - April 2024

Guidance on visiting in care homes, hospitals and hospices - April 2024

Guidance on visiting in care homes, hospitals and hospices

On 6 April, new regulations came into effect covering visiting and accompanying in care homes hospitals and hospices and will be part of Care Quality Commission (CQC) inspections going forward.

CQC has published provider guidance to explain how providers can meet the new standard. In addition, the Department of Health and Social Care recently held a series of webinars to help providers understand what is required under the new standard and how it will be enforced by CQC. The recordings of the webinars have been linked in the frequently asked questions document.

If you have any questions, please contact: visiting@dhsc.gov.uk

Slides: https://captrack1aproduksapp.blob.core.windows.net/uploads/f0dfd4c4-7693-44b0-b3d7-3f4c55b3cd63/2024.04.22%20regulation%209a%20webinar%20slides.pdf

Retaining our overall Good CQC rating and Outstanding for well led and caring - 14 April 2023

Mersey Care has again been awarded an overall ‘Good’ rating from the Care Quality Commission (CQC), following an in-depth inspection carried out between November 2022 to January 2023. The Trust continues to be recognised as ‘Outstanding’ for the ‘Well Led’ domain and has now also been recognised as ‘Outstanding’ for the ‘Caring’ domain.

We had two announced and four unannounced inspections at six of our mental health and community health services, as well as one unannounced inspection of Wavertree Bungalow. Across the Trust, 41 inpatient wards/teams were inspected in total. As a requirement of the external re authorisation process, Ashworth Hospital was also visited.

Receiving an overall ‘Good’ rating and improving on the number of overall ‘Outstanding’ domains is a real achievement and a testament to all the hard work and innovation to which every one of you has contributed. This outcome is good, given that the inspection was so soon after the pandemic and just a year after the acquisition of the former North West Boroughs NHS Foundation Trust (NWB) and Southport and Formby community services (SFCS).

Three of the mental health services inspected were rated ‘Good’ and one was rated ‘Requires Improvement’. Two of our community health services were also rated ‘Good’. Wavertree Bungalow was rated ‘Requires Improvement’.

The inspection was not only an opportunity to showcase our work but also to look at our organisation through a different lens. The report describes our organisation as well-managed, and highlights areas of ‘outstanding practice’ in: using data to generate new patient/service insights, allowing staff time to focus on continuous learning and innovation, listening to patients, embedding our reducing restrictive practice work, heading up the first NHS led Global Centre for Research on Mental Health Inequalities and introducing quality improvement initiatives into community inpatient services.

We have recommendations to address, such as improvements to our estate, role specific autism training, and - consistent with other NHS trusts - how we respond to recruitment and staffing challenges, and the impact these pressures have on our patients, service users and staff.

The former Liverpool Community Health NHS Trust inspection and ratings from 2018 have been incorporated into our new ratings, without an inspection of these services, which impacted on the safe and effective domain ratings. We look forward to a re-review of these services so that the great improvements that we know have happened are accurately reflected in our overall rating.

It is worth saying again that this is also our first CQC inspection since the COVID-19 pandemic and the acquisition of NWB and SFCS. We fully recognise it takes time to assimilate teams, services and align cultures. However, this inspection describes very well how we have managed to carry out this change whilst keeping a strong sense of continuous improvement in place.

The Board of Directors hugely appreciate your tremendous efforts to make sure our patients, service users, carers and families receive the treatment, care and support they need. Your dedication, kindness, professionalism and compassion shine through the report and we should all be rightly proud of our collective achievements and the difference we make to the communities we serve.

CQC will continue to monitor our Trust and check improvements have been made, where required.

A huge thank you for all you do, each and every day, and well done.

The Wavertree Bungalow and Well Led Reports are available on our website. New certificates will be distributed in due course.

Information Request System Development - 11 September 2023

As part of continuous improvement, in collaboration with IT colleagues, we are developing a new SharePoint based system to aid and streamline the CQC information request process.

The key objectives of this system development are –

to standardise and automate Trust wide processes for responding to both ad hoc and inspection CQC information requests wherever possible whilst ensuring strict timeframes set by the CQC are met; and
to streamline the divisional and corporate sign off process to improve transparency and efficiency.

The key outcomes of this system development are –

that processing CQC information requests in a standardised and automated Trust wide process will become business as usual for all staff to avoid multiple processes being used. This will reduce confusion around processes, and improve clarity around timescales for responses to be provided and signed off; and
that streamlined divisional and corporate sign off processes updated on the system at each stage of the information request will provide transparency for all staff involved with the information request as to its progress at any given time. This will significantly reduce email traffic and confusion around the progress of information requests and will provide clarity around accountability for the information provided.

This work is ongoing and we will keep you updated as progress is made. In the meantime, all CQC information requests continue to be disseminated by our team via email.

CQC Preparedness Sessions - 12 September 2023

The next CQC Preparedness Session, led by Sandra O'Hear, Deputy Director of Nursing and Quality, will be held on 24th October 2023. These sessions are to ensure that all managers and senior leads are informed of the latest developments from CQC and also receive key messages from corporate leads such as Estates and Patient Safety. If you would like more information or have any queries regarding this, please contact the CQC Team at CQCTeam@merseycare.nhs.uk.

Quality Review Visit (QRV) changes - 17 October 2023

Following the Care Quality Commission (CQC) inspection, we introduced changes to our QRV process to make sure QRVs continue to fully assist us to improve the quality of care we provide to our patients, service users and their carers. These changes also aim to help us prepare better for future inspections.

The additional three new Safe domain standards relate to patient harm, waiting times and caseloads and are subject to ongoing discussion. Whilst these new standards remain important and valid, we recognise that there is a need for greater understanding and clarity on what the gold standard looks like for rating and evidencing.

We want our leaders to feel better equipped to respond well to QRV standards and to engage in future changes to QRVs. Therefore, it’s been agreed that these new standards will be reviewed and redefined by senior Trust and divisional leads.

Although QRV leads will continue to ask teams to supply evidence and respond to questions in relation to the three new standards, this will be for the purpose of refining and defining exactly what’s required. Therefore, ratings for these standards will be paused and temporarily disabled (by rating them as N/A) until 1 January 2024.

Already published QRV reports which include the new Safe domain standards will be retrospectively re-rated over the coming weeks. As such, some team’s Safe domain and overall ratings may change - team leaders will be kept informed.

Alongside these changes, a record will be maintained of how the three new Safe domain standards have been rated. This will be a manual data set available for any required data analysis but it will not be accessible Trust wide.

Trust and divisional leads will be contacted to take part in these valuable ongoing discussions to make sure the clarified ratings and evidence requirements are confirmed and ready for the go live date on 1 January 2024.

Update - Since 1st January 2024, the new Safe domain standards relating to waiting times and caseloads were reintroduced. There are ongoing discussions regarding the new Safe domain standard relating to patient harm which is expected to be reintroduced later in 2024 as part of the new Learning Culture area of enquiry.

CQC Preparedness Session - October 2023

CQC's New Regulatory Approach - roll out January/February 2024

From 23 January 2024, CQC will start using the new regulatory approach with a small number of providers in the North and Midlands regions. From 6 February 2024 CQC will start using the new regulatory approach with all providers in the North and Midlands regions and will include NHS well-led assessments.

New poster for mental health wards - 11 December 2023

New poster for mental health wards

poster

CQC have recently updated their webpage about how people can make a complaint about the Mental Health Act. This includes care while:

detained in hospital
on a guardianship
under a community treatment order.

The Trust has arranged for the posters to be professionally printed and will be sent out to team team in the coming days.

It is a requirement that anyone detained under the Mental Health Act must be helped to understand how to make a complaint if they wish to.

MHA patient information leaflet

CQC have shared some information for any patients detained under the Mental Health Act. The booklet aims to help our patients to understand their rights to meet one of our Mental Health Act Commissioners when CQC are visiting a hospital ward, and what they can expect from CQC.

The information also explains patient rights about taking medication and how to complain if they need to.

Mersey Care has been awarded an overall ‘Good’ rating from the Care Quality Commission (CQC), following an in-depth inspection carried out between November 2022 to January 2023. The Trust continues to be recognised as ‘Outstanding’ for the ‘Well Led’ domain and ‘Outstanding’ for the ‘Caring’ domain. Please see the below links for the detailed reports.

Now that we have received our overall Trust rating, by law we must display our rating. Therefore, please remove any former CQC rating posters and display the new posters which can be found below.

CQC Trust Wide Ratings - 2023

CQC news and updates

News from the Care Quality Commission - April 2025

Newsletter

People who use mental health services are still not getting the support they need

Join Julian Hartley in conversation with the Patient Association's Rachel Power

Spotting the red flags for harmful cultures in health care

Continuing our journey to improve and return to good regulation

Hearing from providers during our local authority assessments

Use of wheelchairs in care homes

Community mental health survey 2024 results published

Supported Living Improvement Coalition

Phase 2 of the Care Workforce Pathway

New and updated clinical searches

News from the Care Quality Commission - March 2025

Newsletter

Independent review of CQC technology published

CQC calls for national action to tackle system-wide issues in community mental health

Dr Arun Chopra appointed as Chief Inspector of Mental Health

How we're using your feedback to take action

Sir Mike Richards announced as the preferred candidate for Chair

Digital services in NHS General Practices: new advice on preventing discrimination

Information for Healthcare Food Providers: cluster of Listeria monocytogenes

Monitoring the Mental Health Act in 2023/24

Information for Healthcare Food Providers: cluster of Listeria monocytogenes

An update on assessments of integrated care systems

CQC Preparedness Session - February 2025

News from the Care Quality Commission - February 2025

Newsletter

An update on 'the CQC Way'

New Interim Chief Inspector of Healthcare

Secretary of State announces preferred candidate for Chair of CQC

CQC research study exploring equitable access, experience, and outcomes for black men in mental health services

Help Improve Mental Health Services for Black Men!

UK’s Adverse Weather and Health Plan

Share for Better Care Week

Tell us what maternity care was like for you in 2025

Our response to the Care Provider Alliance's review of the single assessment framework

New framework launched to help integrated care systems reduce inequalities

Other news

News from the Care Quality Commission - January 2025

Newsletter

Julian Hartley: Returning to ‘good’ regulation and looking ahead

Improving care for people with a learning disability and autistic people

New local authority assessments published

Help shape our work

Archived News 2024

News from the Care Quality Commission - December 2024

Message from Sir Julian Hartley

CQC fees scheme for 2025/26

National Quality Board - Principles for assessing and managing risks across integrated care systems

The Society of Radiographers Ultrasound Census 2024

Other news

News from the Care Quality Commission - November 2024

Improving how we work

Maternity survey 2024

Share For Better Care - empowering people to improve health and social care through feedback

National Patient Safety Alert

New online immigration status (eVisa)

Urgent and emergency care survey 2024

News from the Care Quality Commission - October 2024

Feedback on ratings characteristics

Your Voice Matters: Join Our "Share For Better Care" Webinar - Empowering patients to improve health and social care through feedback

Change NHS consultation

Research reveals how older adults can thrive in a care home

New trends in the adult social care workforce

Calling all health and adult social care professionals working in England!

Keeping information safe: Data protection and cyber security in social care

Other news

News from the Care Quality Commission - September 2024

Re-building a trusted approach to our regulation

New resource aimed at encouraging improvement in NHS maternity services

Ionising Radiation (Medical Exposure) Regulations annual report 2023/24

Notifications

Workforce inequalities in health and social care survey

Other news

CQC Preparedness Session - September 2024

News from the Care Quality Commission - August 2024

Final part of our special review of mental health services at Nottinghamshire Healthcare NHS Foundation Trust published

Adult inpatient survey: Find the results for your local trust

Six local authority assessments published