Recommendation 30

Immediate steps if suspected breach of standards

Accepted
The healthcare regulator must be free to require or recommend immediate protective steps where there is reasonable cause to suspect a breach of fundamental standards, even if it has yet to reach a concluded view or acquire all the evidence. The test should be whether it has reasonable grounds in the public interest to make the interim requirement or recommendation.

As part of the overall single failure regime (see recommendation 19) it is important that where the Care Quality Commission identify breaches of fundamental standards that it is able to act quickly.  As such the Care Quality Commission will retain its ability to stop a service from providing care if it is putting people at immediate risk of harm as outlined by the Health and Social Care Act 2008.  The Act states that where the Care Quality Commission has ‘reasonable cause’ to believe that unless it acts people may be exposed to the risk of harm, it may impose, or vary a condition of a provider’s registration or suspend it from the point written notice is given as part of an urgent response.

In addition, subject to the passage of regulations, during 2014 the Care Quality Commission will also have new powers to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first. See recommendation 28 for further details.

The powers outlined above are supported by the Care Quality Commission’s new regulatory model, and its new approach to inspections.  This approach is outlined in more detail in recommendations 50 and 51.

Update

The Care Act 2014 has created an additional form of warning notice specifically for NHS Trusts and Foundation Trusts. The Care Quality Commission can now issue these where it judges that a trust requires significant improvement (not necessarily tied to breaches of regulations). This warning notice can lead to the provider entering the failure regime. Also, subject to the passage of regulations during 2014, the Care Quality Commission will have new powers to prosecute a provider for failing to provide fundamental levels of care, without having to issue a formal warning first. The intention is that regulations will be in place in April 2015.