Nearly half of Care Quality Commission staff now view their work neutrally or negatively, according to the regulator's latest internal survey, marking the lowest recorded level of organisational pride in the CQC's history. The figures represent a sharp deterioration in workforce morale and come at a moment when the watchdog is already under scrutiny from an independent review that found serious failings in how it operates.
The survey results sit alongside the findings of the Dash Review, an independent assessment led by Dr Penny Dash, which concluded that the CQC had developed significant failings in its operational effectiveness. That review identified declining inspection activity, a growing backlog in provider registrations, and a regulatory framework that staff and external observers regard as no longer fit for purpose. The internal survey suggests that frontline employees share that assessment and that confidence in the organisation's direction has not recovered since those findings were published.
Inspection volumes have fallen considerably in recent years. Providers waiting for registration decisions face delays that, in some cases, have extended to the point where services are operating without current regulatory clearance. Staff have described an organisation that is struggling to process its own workload, with the consequences visible both in its published outputs and in the daily experience of those employed to deliver them.
A significant source of internal frustration has been the introduction of a new regulatory platform and provider portal. Staff describe the IT rollout as poorly managed, with systems that have impeded rather than supported their ability to carry out routine assessments. Basic administrative tasks that were previously straightforward have become time-consuming, and the technology has not delivered the operational gains that were used to justify its introduction.
The move towards generalist inspection teams has generated separate and deeper concern. The CQC restructured its workforce in a way that shifted inspectors away from sector-specific roles and into broader teams with responsibility across different care settings. Many staff believe this has eroded the specialist knowledge that effective regulation requires. Inspectors who spent years building expertise in, for example, acute hospital care or learning disability services found themselves redeployed in ways that rendered that knowledge less relevant. Relationships with providers, developed over time and considered important to the quality of assessment, have in many cases broken down as a result.
The survey findings also reflect a wider cultural problem. Staff have described senior leadership as unresponsive to concerns raised from within the organisation. The language used in internal communications to characterise the workforce's mood includes words such as demoralised and angry, terms that do not suggest a body capable of absorbing further disruption without consequence. Experienced inspectors have been leaving at a rate that those within the organisation describe as unsustainable. Sickness levels have risen. The departure of staff who understand how to identify poor care, and who have the relationships and institutional knowledge to act on what they find, represents a practical problem for the regulator's ability to do its job, not merely a human resources concern.
The broader risk is to patients and service users. The CQC exists to identify failing services before harm becomes entrenched. An organisation whose own workforce has lost confidence in it, and whose inspection capacity has contracted, is less likely to detect problems early. Care homes, GP surgeries, and NHS trusts that might previously have been subject to timely scrutiny are instead waiting longer for oversight that may, when it arrives, be carried out by inspectors without the specialist background the task demands.
Calls for reform focus on restoring a clearer inspection model with sector-led teams and a revised assessment framework that staff regard as credible. Whether the CQC's leadership can deliver that while also addressing the retention crisis it faces is a question the survey results make harder to answer with confidence.
