June 22, 2017

Phase 1 of the CQC consultation: changes providers need to know about

Next phase

As part of its five-year Shaping the Future strategy, the Care Quality Commission (CQC) is seeking feedback from adult social care providers about its proposals.  Phase 1 of the CQC consultation asked providers for their views on the regulator’s plans for changing the framework used when services are being inspected.

There were almost 500 responses to the consultation and providers told the CQC that they generally supported the proposed changes. Some, however, expressed concerns that inspectors and the inspection framework can be inconsistent and wanted reassurance from the regulator that they will continue to inspect and rate services robustly without being unnecessarily intrusive or imposing undue administrative requirements.

As a result, the CQC has merged the two residential and community care frameworks for adult social care and published a new consolidated version of the Key Lines of Enquiry (“KLOEs”) and ratings characteristics. The consolidated framework is intended to simplify the process of inspecting organisations that provide more than one type of service.  It also aims to improve the transparency of inspections and ratings decisions, making it easier for the public to compare services and improving the likelihood of inspections being conducted consistently on the ground.

What changes do providers need to know about?

The new framework will come into effect for inspections after November 2017. It is well worth providers taking the time to read through the framework and familiarising themselves with the new prompts and ratings characteristics.

1.  The five key areas have not changed and still focus on whether a service is Safe, Effective, Caring, Responsive and Well-Led.

2.  Many of the changes, and new KLOEs or prompts, have been introduced to align the assessment framework with the health care framework. The new KLOEs are in Safe, Effective and Well-Led and in our view clarify the current position, rather than add anything new:

  • Safe: how do systems, processes and practice safeguard people from abuse?
  • Safe: are lessons learned and improvements made when things go wrong?
  • Effective: are people’s needs and choices assessed and care, treatment and support delivered in line with current legislation, standards and evidence-based guidance to achieve effective outcomes?
  • Well-led: does the governance framework ensure that responsibilities are clear and that quality performance, risks and regulatory requirements are understood and managed?
  • Well-led: how are the people who use the service, the public and staff engaged and involved?

3.  There will be an increased focus on leadership to ensure that there is clear accountability for the quality of care being provided.

4.  CQC will make use of up-to-date local feedback and insight information, not just past performance, to determine how and when to inspect.

5.  They plan to better align their inspection processes with their partners at national and local level.

6.  They say they will adopt a fairer and more proportionate approach to providers who have taken over poorly performing services, but will continue to intervene where there is a risk of poor care.

7.  There will be an increased focus on the systems and processes a provider or service has in place and how these are used to evolve, improve and learn from mistakes.

8.  The use of technology is given greater attention, particularly in the context of how it is used to support service users in receiving care and how effectively it is used by staff.

9.  Providers will be expected to demonstrate that staff are fully engaged in the service and take responsibility for their own learning and understanding.

10.  Outstanding ratings will be awarded where providers can demonstrate they are consistently responsive to the needs of service users, and innovative in their approach to their services.

The next phase of consultation

In the next part of its consultation on proposed changes to regulation, the CQC will be seeking feedback from providers about how they propose to:

  • improve the structure of registration, and clarify our definition of registered providers
  • monitor, inspect and rate new models of care and large or complex providers
  • increase the use of regional knowledge to improve services locally
  • carry out our their role in relation to the fit and proper persons requirement, particularly where concerns are raised by third parties.

If you'd like, you can take part and share your views with the CQC right here. Phase 2 is open from 12 June to 8 August 2017.

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