Is the CQC Holding Care Providers Accountable in the Right Way?

Care provider of Bodmin care home was recently fined over £160,000 after a resident died following unsafe treatment. The provider admitted failure to provide safe care and the case was brought under Regulation 22 of the Health and Social Care Act 2008.

The person who died had complex needs and a known risk of choking. Their care plan did not have the most up-to-date speech and language therapy guidance. Staff were left without the correct instructions. The result was tragic.

On the surface, the outcome seems clear. The provider failed, the regulator acted, and a fine was imposed. But this made me reflect more deeply. Is it fair that providers carry the full weight of responsibility when so many people and steps are involved in care delivery? Or is this simply how corporate accountability works?

What Others Have Said

When I shared my thoughts on LinkedIn, I heard from many people in the sector, including experienced care consultants and former CQC inspectors.

They all agreed on one thing. Prosecutions are never straightforward. To move forward, the CQC must prove beyond reasonable doubt that the provider was responsible. The case must also pass the public interest test. I was told that out of every 40 cases considered, maybe one will go to court.

Some pointed out that corporate manslaughter is underused in the care sector. They highlighted serious cases of institutional neglect that may have justified stronger legal action. Others reminded me that while individual staff may act poorly, it is the provider’s systems, training, and oversight that are usually judged.

As one person put it: “Who else should be accountable when it goes wrong?”

What I Have Seen in Practice

I have worked in care homes since 2009 and became a registered nurse in the UK in 2013. I trained in India before moving here. One of the things that stood out to me after arriving was the level of investment in systems and regulation.

From a regulatory point of view, though, these systems and processes are there to build public confidence, and that is how it should be.

In reality, care failures rarely come down to one person or one moment. In a CQC-regulated setting, there are layers of responsibility. There are registered managers. There are risk assessments. There are reviews and updates to care plans.

Even with all of this in place, things can still go wrong. Guidance might be given by a specialist but never added to the care file. Reviews might be completed but not followed through. Staff might be trained but still cut corners under pressure or due to fatigue.

The Data Tells a Quiet Story

I looked at the figures published by the CQC. Between May 2009 and March 2025, they brought only 114 criminal prosecutions. When you consider how large the adult social care sector is, that number is very small.

Most of the time, failures are handled through learning and improvement notices rather than legal action. It makes sense. It is hard to prove liability when so many people are involved and when the mistakes build up over time rather than happening in one moment.

Aspiration pneumonia is a good example. A resident might become very unwell. Not because anyone meant harm, but because feeding guidance wasn’t followed, or there wasn’t enough time to provide proper support. Sometimes, despite training, staff are not as careful as they should be. May be they are too rushed to follow best practice. If the resident dies, the paperwork may list a natural cause. But it may still have been preventable.

And in cases like this, who is held responsible? Most of the time, nobody is.

A Shared Responsibility

Yes, providers are responsible for putting systems in place. They fund the training, hire the staff, and create the audits. But when accountability always stops with them, and the rest of the system is not looked at properly, we lose the opportunity to understand what really went wrong.

Fines are necessary. But if a care organisation is large and profitable, a fine may not feel like much of a consequence. And if prosecutions stay rare, we may never hear about some of the care failings that cause harm behind the scenes.

I am not saying every mistake should lead to court. I know the system cannot be perfect. But we are caring for real people, and the families who trust us have every right to expect safety.

Real change comes when caring people take responsibility together. When supervision is done properly. We need honesty in how we talk about these things. Only then can the system really improve.

It’s time we ask what accountability really means, not just where the blame goes