One of the most alarming revelations was the lack of relevant experience among CQC inspectors. Dr Dash found instances where hospital inspectors had never set foot in a hospital before their appointment, and care home inspectors were unfamiliar with dementia care. This lack of expertise undermines the credibility of the CQC’s assessments and raises serious concerns about its ability to accurately evaluate the quality of care.

Without adequate clinical knowledge, inspectors are ill-equipped to identify issues that could compromise patient safety and service quality. This gap in expertise is particularly troubling given the CQC’s role in safeguarding vulnerable populations, including elderly residents in care homes and patients with complex medical needs.

The report highlights significant operational failings within the CQC. Inspection levels remain far below pre-COVID standards, with some services going uninspected for over a decade. One in five services have never received an inspection rating, and many providers are left in limbo, uncertain about their status and the quality of their services.

This lack of oversight has serious implications for the health and social care sectors. Providers rely on regular inspections to identify areas for improvement, while service users and their families depend on CQC ratings to make informed choices about care. The backlog of uninspected services and outdated ratings means that many people are making decisions based on incomplete or inaccurate information.

The CQC’s IT infrastructure has been a significant barrier to effective regulation. The provider portal, which was designed to streamline communication and data submission, has instead created frustration and confusion. Providers have reported difficulties in uploading documents, long waiting times for password resets, and a lack of support in navigating the system.

These technical issues not only hinder the CQC’s ability to collect and analyse data but also contribute to a breakdown in communication between the regulator and providers. This disconnect has eroded trust and further complicated the CQC’s efforts to monitor and support improvement across the sector.

The CQC’s credibility has been severely damaged, both within the sector and among the public. The report attributes this to a combination of factors, including the loss of sector expertise due to restructuring and the inconsistent application of the SAF. As a result, many providers feel that the CQC is out of touch with the realities of frontline care and is unable to provide meaningful guidance or support.

This loss of credibility has had a ripple effect, undermining the CQC’s ability to drive improvement and foster a culture of excellence in the health and social care sectors. Providers are less likely to engage with a regulator they perceive as ineffective or out of touch, leading to missed opportunities for collaboration and shared learning.

The report identifies a significant breakdown in communication between the CQC and the providers it regulates. The loss of regular contact between CQC staff and providers has eroded trust and made it difficult for the regulator to offer consistent support and guidance. This issue is compounded by the CQC’s failure to communicate changes to the SAF effectively, leaving many providers confused about what is expected of them.

Effective regulation requires open and ongoing dialogue between the regulator and those it oversees. The CQC’s failure to maintain these relationships has created a disconnect that undermines its ability to support improvement and ensure high standards of care.

The SAF was intended to simplify the inspection process by reducing duplication and providing a more holistic view of service quality. However, the report reveals that the framework has not been implemented effectively. Providers have reported confusion over how the SAF operates, with many expressing frustration over the lack of clear criteria and inconsistent application of standards.

The SAF’s reliance on data from various sources, including service user feedback and provider submissions, has also raised concerns. The report found that this data is often incomplete or not representative, leading to inaccurate or misleading ratings. This has further eroded trust in the CQC’s ability to provide a fair and accurate assessment of service quality.

One of the most significant criticisms of the CQC is its inconsistent and opaque approach to ratings. Providers have reported discrepancies in ratings across different sites within the same organisation, with little explanation for the differences. This lack of transparency has led to confusion and frustration, with many providers feeling that the CQC’s assessments are arbitrary and unhelpful.

The report calls for a comprehensive review of the SAF and a clearer definition of what constitutes good or outstanding care. It also recommends greater transparency in how ratings are determined, with a focus on providing providers with actionable feedback and guidance.

The CQC must take immediate steps to enhance its operational efficiency. This includes increasing the number of inspections and improving the consistency and accuracy of its assessments. The report recommends that the CQC recruit additional experienced staff to support these efforts and provide training to ensure that inspectors have the necessary expertise.

Upgrading the CQC’s IT infrastructure is crucial to enabling smoother interactions with providers and better data management. The report recommends a comprehensive review of the provider portal and regulatory platform to identify and address the issues that are hindering effective communication and data submission.

The CQC needs to re-establish its sector expertise and strengthen relationships with healthcare and social care providers. This will require recruiting experienced inspectors and fostering a culture of collaboration and trust. The report also recommends that the CQC engage more actively with service users and their families to gain a better understanding of their needs and expectations.

The Single Assessment Framework needs a comprehensive review to ensure it is fit for purpose. The report calls for clearer guidelines on how ratings are determined and recommends that the CQC work with providers to develop a shared understanding of what constitutes good or outstanding care.

To restore trust, the CQC must be more transparent about how it determines ratings and more accountable for its decisions. The report recommends that the CQC publish detailed explanations of its ratings and provide providers with clear, actionable feedback.

To ensure these changes are implemented effectively, the Department of Health and Social Care will increase its oversight of the CQC. This includes monthly director-level meetings and regular performance reviews to monitor progress and hold the CQC accountable for delivering the improvements outlined in the report.