From when the CQC announced the idea of the Single Assessment Framework (SAF) in July 2022, it has been beset with delays and issues on how to deliver the large aspirations contained within it. If you think about it, this was inevitable as having one set of criteria for both small domiciliary care providers and NHS Foundations Trusts is a huge challenge to deliver whilst ensuring that all services are satisfied.
Defining Quality vs. Regulating It
The Quality Statements, supported by the ‘I’ statements are hard to argue against as far as what quality should look like for those people receiving and delivering care and support. However, it’s one thing to define quality and a much bigger challenge to regulate it, which the CQC is recognising and wrestling with.
Challenges with Technology: Setting Up the Provider Portal
Let’s start with technology, and the challenges CQC is having setting up a ‘provider portal’.
Initially, this is proposed as a system for providers to submit notifications to CQC and allow others rather than the registered manager to also do this. In a world where we can talk to anyone in the world on a phone, we can buy anything we want and have it quickly delivered to our door, surely it can’t be that complex a problem to fix for an organisation with the resources that CQC has at its disposal?
Internal Disruption at the CQC
With the SAF it has meant a lot of internal changes for CQC. There has been a reorganisation of staff teams, with staff being asked to perform different functions and working in different ways, which has caused some disruption, staff turnover and a lack of consistency about who does what at CQC.
Scoring Evidence: A New Approach with Challenges
CQC is also attempting to be more transparent about how it reaches a judgement. They are doing this by scoring evidence, something they haven’t done before, but again this is fraught with difficulty. There are challenges about how evidence is presented to CQC, what criteria they are using to assess the evidence and even CQC are recognising this by stating that scores may be overridden if the inspector feels it doesn’t reflect their view of the service. However, one positive about the scores is that there will be a percentage score, so providers can see how well they are doing within a given rating.
The Shift to Remote Assessments
The CQC are going to be doing a lot more remotely and gathering more evidence from third parties about the quality of your service as opposed to coming to see you, your teams and observing care. This ‘desktop’ assessment process is going to be a challenge for social care that relies on person-centred care, interactions and building relationships. Services are going to have to be data managers rather than relationship managers.
The Road Ahead: Challenges and Continuity
So, what’s next for the CQC and what will the future look like for everyone in social care? Big questions, but I think it’s important that we don’t lose sight of the fact that a lot has stayed the same – the Regulations, the five key questions, and that you will need to show evidence that you are performing well. Regulation might feel messy and disjointed now, with a lack of clarity in so many areas, but we all need to follow the mantra ‘keep calm and carry on’.
