One of the four themes of the care quality commission’s (CQC) five year strategy is smarter regulation, described as a more ‘dynamic and flexible regulation that provides up-to-date and high quality information and ratings’.
The CQC states that their assessment of quality will be different. The CQC’s ambition is to:
- Move away from relying on site inspections.
- Move to a more flexible, targeted approach.
- Visit services when there is a clear need to do so e.g. responding to risk.
- Have better conversations with people who live in or use services.
- Build a digital platform to better integrate data.
What will this mean for care providers?
This may mean fewer site inspections for care providers with more reliance on information and data shared with the Care Quality Commission. This may include information, data and feedback from:
- Care providers through risk reviews & monitoring calls, PIR submissions and notifications.
- People’s experiences of living in and receiving services.
- People employed by the care provider.
- Commissioning and contracts departments.
- Safeguarding teams.
Monthly risk reviews & monitoring calls.
From July 2021, the CQC have announced they will be introducing a monthly review of information they hold, this may include monitoring calls to a care service. Whilst monitoring calls are not inspections and providers will not be rated afterwards, they are likely to be a significant part in informing the CQC’s view of a care service, providers must treat monitoring calls seriously.
Providers can prepare for the calls through having the information accessible in the event a call is received, here is a link to the monitoring questions. Monitoring questions for adult social care providers | Care Quality Commission (cqc.org.uk)
Provider information return (PIR).
The CQC submit an invitation to a provider to complete a PIR annually. Providers are given 4 weeks to complete the PIR. The CQC’s guidance on ‘how to complete a provider information return’ is available here Provider information return (PIR): adult social care services | Care Quality Commission (cqc.org.uk)
The PIR is an opportunity to showcase a care service, there is a word count limit in the qualitative responses, providers should work to the word count sharing examples of the work undertaken in the area.
The PIR should be a working document updated on an ongoing basis, so the provider is prepared for when the PIR invitation comes through.
Upon receiving the completed PIR, the CQC will review it along with other information about the care service and decide whether to undertake a site inspection. In the CQC service report tab relating to a care service location, the CQC will advise that a review has been carried out and should they decide not to undertake an inspection it will state: ‘we have not found evidence that we need to carry out an inspection or reassess our rating at this stage’. Should the CQC feel there is a clear reason to visit a service such as responding to risk, they will undertake a site visit.
Care providers are required to submit notifications to the CQC with regards to certain changes, events and incidents. Providing an update with regards to action and progress relating to a notification to the CQC inspector is critical to demonstrate effective and responsive leadership.
People’s experience of living in & receiving services.
People can share experiences with regards to a care service on sites such as homecare.co.uk, carehome.co.uk. Lived experiences can be shared too through a care provider’s website (through case studies/testimonials) and social media channels. People can also provide feedback on their experience, good or bad to the CQC directly. Care services may wish to direct a person who has a positive experience of their service to the CQC feedback portal, link here: https://www.cqc.org.uk/give-feedback-on-care
People employed by the care provider.
Ongoing feedback from the staff team is crucial. Formal surveys should be evaluated, with action plans and outcomes shared with the staff team. This demonstrates the staff team is valued through listening to them and taking action. Encouraging people to come forward with concerns or ideas creates an open and transparent culture, staff will feel comfortable to raise a concern internally, rather than reporting outside of the care service, directly to the CQC for example.
Contracts & commissioning.
As part of their contract monitoring process, commissioning and contracts teams may visit a service to undertake a quality monitoring visit. This visit is an opportunity to showcase a service but also to receive another perspective of the care provision, share learning and inform improvement plans.
Due to the very nature of the work, it is likely that safeguarding teams will be involved in a care service from time to time. A positive and professional approach to this process is critical, along with lessons learned and actions recorded to inform service improvement. Let’s face it things go wrong, even in the best service however, it is how we respond when things go wrong that is important. Feedback from safeguarding with regards to the performance of a care service when responding to a safeguarding matter, is evidence that may inform the assessment of the responsiveness and effectiveness of leadership across the care service.
Whilst not exhaustive, it is likely the Care Quality Commission will consider all of the above when assessing a care service, it is therefore crucial that care providers think beyond the CQC site inspection and take a holistic, consistent approach to quality and compliance, through developing a culture of continuous improvement across their care service.
To find out how I can help you to prepare for the shift to smarter regulation and to develop a culture of continuous improvement, please contact me by email to arrange a no obligation chat.