Recommendation 50

Inspection as central method of monitoring

The Care Quality Commission should retain an emphasis on inspection as a central method of monitoring non-compliance.

The Care Quality Commission has introduced a fundamentally different and strengthened approach to inspection as the centrepiece of how it assures standards of care.

The Care Quality Commission’s new approach to inspection involves large teams of specialists and public listening events, resulting in judgements about the quality of care rather than compliance with regulations. The new approach is led by the Chief Inspector of Hospitals, Professor Sir Mike Richards; several thousand specialists and members of the public have put themselves forward to join his inspection teams. This level of engagement, and the more relevant outputs, ensures that inspection is at the heart of the Care Quality Commission’s role and purpose. The new approach is designed to support inspection by specialist teams, through inspections which, rather than being focused on regulations, are based on identifying lines of enquiry from whatever quantitative and qualitative information suggest about standards of care.

The Care Quality Commission’s new approach to monitoring the quality and safety of services has been introduced initially in acute hospitals. New Chief Inspectors of General Practice and of Adult Social Care took up post in October 2013, and will now spearhead the extension and development of new approaches to monitoring and inspecting standards of care in those sectors. The Deputy Chief Inspector of Mental Health will report to the Chief Inspector of Hospitals on how this applies to mental health services.


As described in recommendation 38, the Care Quality Commission started piloting its new inspection regime in September 2013 and has been steadily rolling this out to all health and care sectors. The Care Quality Commission is now in the process of inspecting all NHS acute trusts using the new model of inspection.