Every CQC inspection is a big moment for your home care agency. But inspections don’t have to be stressful. By ensuring that you and your team are prepared, you can reduce the amount of time and stress that goes into inspections. And you can attain the rating your agency deserves.
How inspections actually work
CQC inspections are designed to assess quality of care and the impact it has on patient health and wellbeing. Services are judged against the regulations according to a strict framework.
Inspections last two days on average, but they can be shorter for smaller care providers. Inspectors take time to talk to owners, managers, frontline staff, external stakeholders, customers and their relatives in order to construct a comprehensive picture of your service. It’s important to note that care agencies usually receive no notice of an inspection, so it pays to be prepared. In fact, Debbie Westhead, a CQC deputy chief inspector of adult social care, recommends being “inspection-ready” at all times.
Familiarise yourself with the key lines of enquiry
First things first, familiarise yourself with CQC’s guidelines. Developing a strong sense of that the inspectors are looking for is essential, since it enables you to focus on the right areas in your preparations.
CQC inspectors use five key lines of enquiry (KLOEs) to assess whether adult social care services are safe, effective, caring, responsive to people’s needs and well-led. Based and your responses and their research, the CQC will give you an overall rating of “outstanding”, “good”, “requires improvement”, or “inadequate” against each of the KLOEs. That will then feed into an overall rating.
The key thing here is to get the grips with the KLOEs, note the characteristics of each rating and how you match up to these, taking action to ensure compliance. Inspectors are looking for your agency to demonstrate that it is:
Safe — clients are protected from abuse and avoidable harm.
Effective — care, treatment and support achieve good outcomes, promote a good quality of life and are based on the best available evidence.
Caring — your service involves and treats people with compassion, kindness, dignity and respect.
Responsive — services meet clients’ needs.
Well-led — leadership, management and governance of your organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture.
In November 2017 the KLOEs were updated, along with the prompts that feed into the key lines. This involved merging two previous versions for residential and community care, adding new content to strengthen specific areas and reflect current practice, and making changes to the wording to aid understanding.
So, it’s worth revisiting the framework to ensure there’s no surprises lurking in your next inspection. This handy document highlights what’s changed since 2015.
Showcase the quality of your team
CQC inspectors take their role very seriously, so it’s a good idea to ensure management attend the inspection in order to demonstrate that it’s being given the respect and attention it deserves.
Attendees should include you as owner, your registered manager and other senior members of staff. Ultimately it’s the registered care provider’s responsibility to assist CQC inspectors in finding evidence to support that your agency can convincingly answer the KLOEs, but having key members of your team on hand to contribute will create an atmosphere that feels collaborative rather than adversarial.
Your role is to prepare your team by helping them to understand the importance of the inspection and the type of questions they are likely to be asked. It’s a good idea to practice these in advance, so they’re relaxed and confident on the day. You might even consider seeking help from a specialist care consultant, who can conduct a mock inspection to identify areas requiring improvement and help you compile an action plan to address any gaps in your service before they’re identified by an inspection.
Invite your clients into the process
Your patients are the most important thing about your agency. They’re the reason you’re in business, so it makes sense to include them in the inspection process where relevant.
Obviously, this demands careful management, but giving inspectors access to your patients will show that you have nothing to hide. In fact, it will demonstrate that you’re proud of the care you provide and happy to be judged based on patient feedback.
If this feels like a step too far, that’s fine. It’s still valuable to seek honest feedback from patients when preparing for the inspection. No agency is perfect, and it’s better to receive feedback on your strengths and weaknesses before the inspection, so you can spot issues that might arise and demonstrate to the inspectors that you have taken remediative action.
Nail the paperwork
The CQC is hot on documentation. They might ask to see anything from health and safety policies, client monitoring processes, employment records or client information.
Birdie’s digital offering enables you to effortlessly provide medication records, care notes and other forms of client monitoring. Documentary evidence is absolutely key to demonstrating compliance, so it’s helpful to maintain digital records rather than rely on old fashioned paper documents which are much harder to create, store and retrieve, especially under the time pressure of an ongoing inspection.
It’s also a good idea to provide minutes of meetings in order to show that you are taking the KLOEs seriously before and after inspections, not only during them. Include examples of how you have taken action to address issues as they have arisen. Policies, procedures and processes are important to the CQC, but they are also looking for what happens in practice.
The amended framework document released in November 2017 includes new key lines of enquiry in relation to integration and information sharing, technology, information governance and data security, medicines, end of life care and personalisation, social action and the use of volunteers. These are significant changes, so it’s a good idea to review your systems and update your approach where relevant, to ensure compliance.
Inspections don’t have to be painful
In order to support compliance and improve ratings, care agency owners should leverage the power of technology in order to streamline their processes, systems and documentation.
That’s where Birdie comes in. We believe that documentation doesn’t have to be time consuming and painful. By working with us, you can transition to digital painlessly and quickly, transforming your business in the process. We have written about this in some depth in a previous blog post on the advantages of paperless record keeping, so it’s worth taking a look in order to understand the benefits for you and your business of using Birdie.
If you’re interested in digital care planning then get in touch — we provide free demo and training and you’ll be up and running in no time.
Our technology can help care agency owners everywhere to navigate the CQC inspection process and an ‘Outstanding’ rating. We’ve built Birdie to support care agencies to deliver truly enhanced care, and we strongly believe our technology can support you to achieve the best possible rating for your agency.