12.As part of our consideration of Miss A’s complaint we reviewed the information Miss A provided to us. We also contacted the CQC to request information relating to the complaint. Miss A’s letter of complaint to the CQC outlined her concerns. Specifically, she complained about delays to the approval of her application and the impact this had on her business, ‘misleading advice’ she received from CQC staff, and inconsistencies in the process.
13.Miss A says all these issues have had a detrimental financial impact on her and she has been unable to open her clinic. We thought it may be best to address these different issues individually.
Applications and Delays
14.The CQC’s December 2024 response provided a brief overview of the history of her applications and explained that the CQC received several applications from Miss A to register the Company. Her initial application was submitted in early October 2023 and returned to her approximately two weeks later as it was missing information.
15.Miss A submitted a second application a couple of days later in late October 2023 and this was accepted by the CQC in November 2023. The application was assigned to an inspector six months later in May 2024. The records show that Miss A withdrew her application at that time as she no longer had premises for her business.
16.Miss A tells us that when she submitted the initial application in October 2023, she had premises for her business and had paid a deposit. However, she says that as the registration process took so long, the landlord was unwilling to wait for future rent payments, so she had to cancel the lease. This meant that Miss A withdrew her second application as she no longer had premises for her clinic in May 2024.
17.Miss A submitted a third application in November 2024, and this was returned in early December 2024. The CQC returned this application on the basis that there was information missing. Miss A submitted a fourth application in mid-December 2024 and at the time of the CQC complaints letter, this application was still pending. As we understand it this application was later rejected by the CQC and based on the information she has provided to us, Miss A submitted a fifth application summer 2025. She tells is this is still pending, and she has not received a response from the CQC.
Telephone Call
18.In addition, to her applications, Miss A called the CQC Customer Helpline several times in November 2023, February 2024, June 2024 and December 2024. Miss A is particularly unhappy with the call which took place in November 2023 on the basis that she was given incorrect information by the CQC. This was acknowledged in the CQC’s complaint response.
19.During the November 2023 call, Miss A asked the CQC if it was possible for her to change the address she had submitted for her clinic. As we have mentioned above, Miss A’s original clinic location was no longer available, due to a disagreement with the landlord regarding rent.
20.The CQC records show Miss A was advised that she could submit an application amendment form, with a change of address. However, as the CQC has stated in its December 2024 complaint response, this was incorrect. The only option available to Miss A was to withdraw her application altogether and resubmit it with the new address.
21.Unfortunately, this was not made clear to Miss A until June 2024, after the CQC inspector had been in touch with her about inspecting her business premises. The CQC response acknowledged that this was a significant loss of time for her. We recognise this would be frustrating for Miss A.
22.In response, the CQC apologised for the time it took to identify that she had been given incorrect information. The December 2024 letter acknowledged that Miss A had applied in December 2024 (her fourth application). The CQC said it would validate this application and assist her with any amendments if required, rather than returning the application to her. The CQC went on to say it would prioritise the inspection process to ensure her application is dealt with swiftly.
23.During her complaint correspondence with us, Miss A informed us that the application was prioritised, but her application was rejected by the CQC. Miss A said that documents related to the building premises were unavailable and therefore the CQC said it was unable to approve her application without this information. She submitted her fifth application in late June 2025.
CQC’s Response
24.In relation to her communication with the CQC and the ‘misleading information’, she was given during the telephone call, we can see that this was acknowledged by the CQC. We have explained the reasons for this above.
25.The CQC referred us to its ‘Guidance for Providers’ document which was available at the time of the first registration application. This document states that, ‘Being a provider of care is a serious business, and our application process reflects this’. The document goes on to say that ‘We assess application against our assessment framework. These frameworks will help you understand our expectations at registration’.
26.There are two main frameworks used by the CQC, the ‘Adult social care framework’ and the Healthcare services framework. Our understanding is that Miss A’s application falls under the ‘Healthcare services framework’. This is a detailed document which outlines what the CQC takes into consideration when undertaking its inspections.
27.The ‘Guidance for Providers’ information states that, ‘We must ensure that applicants will provide services that are safe, effective, caring responsive to people’s needs and well-led. For us to be sure about this, we need to ask you for a lot of information. And we need time to assess this information thoroughly’.
28.We asked the CQC about delays Miss A experienced and it said that the CQC is currently experiencing ‘significant backlogs in the processing of registration applications and in assigning applications for assessment by Registration Inspectors’. The CQC said that the backlog had impacted its ability to meet its timescales, which are available on its website. It said that it was now regularly updating its website with bulletins outlining the situation. It said that these bulletins would be updated in future if necessary.
29.The CQC also provided information about the increased demand its service has experienced over the last four years. It described a situation where demand has risen sharply, with an almost 20% increase in applications between 2021/2022 and 2023/2024. It said that this upward demand had started during the Covid-19 pandemic and continues since then.
30.It said that this increase in demand had occurred alongside a period of ‘transformational change and modernisation’ within the CQC itself. The CQC said that this has caused challenges in its ‘staffing and technology’ which in turn has affected its ability to process applications. The impact of this is that it has meant there have been delays in processing some of its applications, which aligns with Miss A’s experience.
31.The CQC referred us to a press release from October 2024 where it explained the changes it intended to introduce to ‘improve its ways of working’. This includes, ‘quicker and more effective registration of assessments and providers’. The CQC’s response also assured us that in addition to this, it is undertaking recruitment drives to increase staffing levels, increasing scrutiny of priority applications and providing more information on its website.
Our view
32.We are sorry to hear of Miss A’s experience when dealing with the CQC and the impact this had on her ability to open her clinic. We can see the multiple application rejections and delays have meant that she has not yet been able to launch her business, and this is clearly very distressing for her.
33.The CQC’s December 2024 complaints response outlines why her first three applications were unsuccessful and provided a solution for ensuing the fourth would be dealt with more quickly. This too was unsuccessful as Miss A did not provide the CQC with a document it requested. We appreciate this must have been very frustrating for her, especially as this application had been prioritised by the CQC.
34.As the CQC’s guidance for providers explains, it needs to be confident and certain that the services which will be provided are safe for the public. Moreover, as the Guidance for providers states, ‘If you cannot meet the standards set out by the 5 key questions, we will refuse your application to register’.
35.The five questions referred to above, is a reference to the framework, which we have explained the CQC uses when reviewing applications. As the wording above makes clear, there is no room for discretion and all five of the criteria must be met.
36.We appreciate it must be deeply disappointing for Miss A that her previously submitted applications were unsuccessful. Unfortunately, there is no scope for the CQC to consider granting an application unless all five of the criteria are met.
37.It is important that the CQC ensure that the businesses it registers fulfil the criteria set out in its framework. The potential ramifications of approving a health-related business when it does not meet the necessary criteria could result in an injury or fatality. While we understand this has been a frustrating period for Miss A, we find the CQC processed her applications in line with its guidance. Therefore, there are no indications of maladministration in how CQC handled Miss A’s applications.
38.In respect of the delays she experienced during her applications, we can see from the information it has provided to us, that the CQC is aware that this is an ongoing concern. The CQC provided us with detailed information outlining how it is addressing this and the various service improvements it has already introduced and is continuing to introduce, to tackle this.
39.We have considered Miss A’s telephone call with the CQC in November 2023 and the incorrect information she received, which did not become apparent until June 2024. Our Principles of Good Administration state that public bodies should communicate effectively and ensure customers are clear about their entitlements. Here, we note CQC provided incorrect information during the phone call, and this misled Miss A. These actions are not in line with our Principles and is an indication of maladministration.
40.When we identify something may have gone wrong, we look to see how this affected the complainant and see whether the organisation has done anything to put it right. Miss A says the CQC’s actions have caused her significant stress and had a negative impact on her mental health. She tells us that these delays have had an impact on her new business and her finances.
41.On a balance of probabilities, we cannot say whether accurate information during the November 2023 call would have resulted in a swifter application and registration process. Miss A’s application submitted after this date was also rejected, and we know from the CQC’s information that the delays to its service were ongoing at this time.
42.We can say that it is likely Miss A will have been annoyed or experienced stress when she found out she could have acted earlier if the correct information had been provided in November 2023. We considered this against our severity of injustice scale and find the stress experienced was a one-off instance and the effect was of a short duration. Therefore, this is a level one injustice where an apology can be enough to put it right.
43.Our Principles of Remedy state public bodies should take steps to put things right if things go wrong. It can do this in different ways, including issuing an apology, accepting responsibility and in some cases providing a financial remedy. Here, we note CQC has apologised for the poor communication and offered to prioritise Miss A’s next application. These actions are in line with our Principles of Remedy and severity of injustice scale.
44.After careful consideration, we are satisfied that the CQC is taking appropriate steps to address the delays its organisation is facing. The CQC are taking steps to ensure that future applications are dealt with in a time sensitive way, while also maintaining the integrity of their application process.
45.We have decided not to take any further action in relation to this complaint as we are satisfied the CQC has done enough to put things right for Miss A. We appreciate Miss A remains frustrated by this experience and we hope her application is accepted soon.
46.We wish Miss A all the best for the future.