The Care Quality Commission (CQC) is changing the way it assesses service providers. Ed Watkinson, Residential Care and Inspection Specialist with Quality Compliance System (QCS), the leading provider of content, guidance and standards for the social care sector, shares what he thinks these changes will be, what the impact is likely to be, and what providers need to do to be prepared.
The CQC published a new strategy in 2021 for the whole of health and social care sector, with the main objective of allowing the regulator to become ‘more flexible’ in how it assesses and rates providers.
The changes outlined in the strategy build on what was learned during the pandemic, when the CQC was forced to operate more remotely with services. The new way of working will profoundly alter the relationship between the CQC and providers, which will be more on-going in nature, as the regulator moves from an inspection-based framework to continual assessment.
The CQC also wants to support the development of an Integrated Care Systems (ICS), which pools the knowledge and experience of all the services within a community – from hospitals to GPs, dentists to social care.
There will be a much stronger focus on outcomes for people; the new direction really does put users at the centre of things and reflects what is most important to people using services. While there are many changes, it’s more of an evolution not a revolution, as it builds on what the CQC is currently doing, rather than tearing up the rule book and starting from scratch.
The regulator will actively seek the views of people using services, and the organisations involved with them. This information will be used to assess service quality, possibly without a face-to-face visit.
How to stay up to date with the changes
Latest information indicates the CQC will involve people in clarifying the changes now, will test new ideas in the summer, and implement the programme in full in Spring 2023 – although this may change.
QCS will keep providers informed, and ensure its system is updated to reflect the changes. By using the QCS management system, service providers can stay up to date with all policies and procedures changes. They will also have access to all the audits, mock inspections, and surveys to provide the evidence needed to show they are providing a high-quality service.
What’s staying the same
Although the CQC’s new ‘assessment framework’ is still in development, it is based on the published strategy so there is already a lot we know about what will change and what will not.
Firstly, the five key questions the CQC asks of all care services are staying in place. So CQC will still want answers to the following: are you safe, effective, caring, responsive and well led? But how they reach their decision will change.
The five key questions will be re-phrased as ‘I’ statements. This means they will be looking at the provider from the perspective of a person using services and clarify what they should expect.
Although the ratings stay the same – outstanding, good, requires improvement, inadequate – how they are achieved will be very different. The regulator is proposing to gather information and evidence on an ongoing basis. This will be received in a defined way from the provider, people using services and others with involvement in the service, such as the Local Authority.
The Key Lines of Enquiry (KLOEs) will be replaced with Quality Statements, phrased as ‘we’ statements from the perspective of the provider – an expectation of what they will do. There are between five and eight Quality Statements under each of the five key questions, each detailing what ‘good’ looks like.
What will change?
The CQC plans to stop on-site inspections within a prescribed timeframe, and will remove the link between rating and time between inspections. But they will base activity more on the evidence they receive about the perceived risk to people using services, while continual assessment will be used more than inspections to assess the quality of services.
An ‘always on’ system will provide an up-to-date and consistent view of services. It is proposed that ratings can be changed without a site visit if the evidence indicates that improvements have been made, or quality has fallen. Inspections will happen when they are the only way to observe first-hand what the issues are.
The CQC has said it will be transparent in the way it works, the information it has about services and what it will do about the issues raised. It seems all evidence sources will be scored, which will feed into the scoring of the individual Quality Statements and then to each Key Question.
The CQC is clear that the way it will inform the public will also change, with a desire to present findings in a simpler, snappier, more user-friendly manner.
Staying up to date and in touch
Overall then, the CQC will work to achieve its aims of becoming smarter, more flexible, more focused on what is important to people that use services and ensure services are safe.
For service providers, in addition to using the QCS system to stay up to date, they can sign up to receive the latest CQC information on the regulator’s website. And more importantly, ensure they have the right processes in place for auditing their own service as well as being in touch with the views of people who use or interact with their service.
You can also catchup on our recent webinar for free with Ed on the latest CQC Inspection changes here
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