A poor inspection rating from the Care Quality Commission (CQC) can have a huge impact on the profitability of your care home. In an article by the Royal College of General Practitioners, research showed that being rated inadequate and placed in special measures can lead to difficulty with recruitment, lack of referrals, and even increased costs. Staff shortages associated with low rated care homes can also lead to lower levels of care for residents, exacerbating the issue of poor performance.
In contrast, care homes rated ‘good’ or ‘outstanding’ were associated with a 12% improvement in residents’ quality of life. Although most care homes are anxious about damaging their relationship with their CQC inspector, challenging the accuracy of a report should be encouraged where there are solid grounds to do so.
As a leading care home consultancy company, the experts at Fulcrum have put together the below short guide on how to challenge an inspection result, when to do it, and how to increase the likelihood of an overturned rating.
When can you challenge a CQC rating?
Following a CQC inspection, the care home manager will be presented with a draft inspection report. This report outlines the findings from the inspection, the ratings for each inspected key question, and any breaches of regulations.
At this stage, a care home manager is given 10 working days to challenge the factual accuracy of the drafted report. Within this timeframe, the accuracy and completeness of the draft report can be challenged. This includes numerical errors, accuracy of evidence, and any additional or omitted information which should be considered
When can’t you challenge a CQC rating?
If no challenge has been made against the draft report within 10 days, it is assumed that the report is accurate. The findings of this report are then used as the basis of your CQC rating.
It is not recommended to challenge a report after the 10-day period, as your chances of success are significantly lower. After this period, the only challenge you will be able to make is to assert that the inspector has not followed the correct process for making rating decisions.
Care homes can only challenge the accuracy and completeness of the evidence on which the ratings within the report are based. If care home managers are simply unhappy with the rating but have no solid evidence to combat it, a challenge cannot and should not be made.
What is the process of submitting a challenge?
To submit a challenge to your draft report, you will need to submit comments and evidence pertaining to inaccuracies in the report. However, once the inspection has been published, care home managers will need to go through the rating review procedure, which is the final formal mechanism which providers can follow to challenge their ratings.
The ratings review process has three stages:
1. The provider has 15 working days from the date of publication of the final report to submit a rating review request. This is submitted through an online form on the CQC website. There is a 500-word limit for the submission.
2. The CQC’s independent rating review team will review your request to decide whether it meets the grounds for review.
3. If a request is not considered to meet the CQC’s grounds, it will be refused. The provider will receive a letter explaining why they were unsuccessful.
4. If a request is considered to have established grounds for a review, CQC staff not involved in the original inspection will review the inspection process and decide whether the rating should be changed.
Find out more about how to submit a rating review on the CQC website.
What is the best way to overturn an inaccurate CQC rating?
Our top three tips for overturning an inaccurate CQC rating are:
• Request your review as soon as you receive the draft report
• Provide robust and comprehensive evidence for your challenges
• Be concise, factual, and polite
By following the above guidance, you should be in with a good chance of overturning an inaccurate report.
Our team of expert care consultants is committed to helping care homes improve. Whether it’s supporting care management teams in implementing new procedures for their staff, providing strategic guidance to care home providers and owners, or providing regulatory guidance to help you pass your CQC inspection, we are happy to help
If you are a care home manager or provider who needs expert advice on how to challenge your CQC rating, or other advice, get in touch with our friendly team today, or read our previous insights.