The Care Quality Commission (CQC) has set out how it will support CQC inspection teams to improve how they identify and respond to services at risk of developing closed cultures.

New guidance has been drawn up for CQC inspection teams to help them recognise a poor culture in an organisation that has an increased risk of harm, including abuse and human rights breaches.

The CQC believes that closed cultures are more likely to develop in services "where people are removed from their communities, where people stay for months or years at a time, where there is weak leadership and where staff often lack the right skills, training or experience to support people".

They are also more likely to develop where there’s a lack of positive and open engagement between staff and with people using services and their families.

Certain services and groups of people are at greater risk, including services that provide care for people with a learning disability and/or autistic people, and older people who may not have regular contact with families, according to the regulator.

All CQC inspectors and regulatory colleagues will be required to undertake a series of training sessions throughout summer 2020 on the guidance, and on closed cultures more broadly.

The aim is to improve the CQC's ability to hear from people who use services in closed cultures, give more weight to what they say and then improve the CQC's ability to act on concerns.

Inspectors need to be able to effectively identify where there’s a closed culture and be able to prioritise these services for monitoring and inspection. The CQC also aims to improve its ability to collect and use intelligence to inform an understanding of these risks. It also wants to use the information gathered through inspection activity and elsewhere to work with and influence system partners to the changes that are outside of CQC’s remit.

The guidance, Identifying and Responding to Closed Cultures, is available at:

Last reviewed 30 June 2020