Avoiding a war on two fronts

Every provider is familiar with the necessary interaction and inspection programme of the CQC. This article focusses on that relationship when another body is added into the mix, such as a placing authority.

We are seeing an increasing number of cases in which We are seeing an increasing number of cases in which providers are at the centre of a ‘tug of war’ between their regulator and another body to which they may be accountable.

In one recent case, the regulator and the placing authority for the majority of the provider’s residents used a joined-up approach often to the exclusion of the provider. It appeared to the provider that decisions were being made on a joint basis without consultation with the provider and without the appropriate opportunity to challenge each body.

In another case we have dealt with, the CQC decided upon enforcement action in relation to a provider which a significant placing authority was keen to continue to use following a long and successful relationship. In this case, the Authority’s continued support was powerful evidence in successfully contesting the CQC’s action. In such cases, it is key to avoid a war on two fronts. If the CQC identifies concerns then it will be necessary to provide reassurance to your commissioners in parallel with reassurance to the CQC themselves. If placing authorities have identified concerns, then early discussions and prompt resolution will ensure that any commissioning issues do not escalate to the level of regulation.

If the CQC and commissioning bodies do appear to be working in tandem, then it will be important to identify the key issues for each body and provide reassurances that will satisfy both within their particular remit. As ever, if problems have occurred, prompt acceptance and detailed proposals for redress will be important. However, if concerns have arisen by way of a misunderstanding or a lack of information then it is important that these are challenged. In these circumstances, swift and expert external assistance may be necessary to prevent an issue escalating.

You must assume that regulators and commissioners will discuss issues between themselves. It will not assist the practicalities, or in terms of reputation, to assume or demand a strict detachment between the various bodies. However, it may be necessary to remind each of the remit of their roles and the extent of their powers in relation to specific findings.

In summary, the involvement of a number of bodies following a concern may look and feel both overwhelming and unjust. We suggest the following top tips to avoid or successfully navigate a war on multiple fronts:

• Do not bury your head in the sand – acknowledge concerns early on and carry out your own assessment of merit
• Assume that the regulator and the commissioners will talk and pre-empt this if possible to avoid the appearance of concealment
• Correct misunderstandings, mistakes or a lack of evidence at the earliest opportunity
• Establish the remit of each interested body and any timeframes for complaint and/or challenge
• If independent expert advice is required, seek it early

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