CQC Trade Association meeting – 10 July

This month’s meeting attended by Liz Jones, NCF Policy Director was chaired by Debbie Ivanova, one of the deputy Chief Inspectors.

Hot topics/ open discussion

This a new opportunity within the meeting structure to have a frank and open discussion about issues raised by providers:

• New CQC report formats – some concerns have been raised about the new format with providers feeling that the reports lack the context and narrative of the previous format and focus firstly on negatives rather than providing an overall balance of findings
• Electronic care planning – some providers continue to be asked to print off electronic care records for inspectors – this should NOT be happening. Providers do need to enable access to their electronic care records in as flexible a manner as possible but they should not have to produce printed copies.
  • Action for members: ensure that CQC inspectors can view the electronic care records in as flexible a way as possible…. But you do NOT have to print them off. If inspectors continue to ask for printed copies, please let us know at the NCF – email Liz (liz.jones@nationalcareforum.org.uk).

• Discrepancies between inspection feedback on the day and the draft inspection report – some concerns have been raised about this, with providers feeling that the feedback they receive on the day is quite different to the findings they read in their draft inspection report. The CQC say feedback on the day can only include what the inspector has seen during their visit plus the information they have received in advance and it cannot be a comprehensive view of the final inspection picture which is formulated after reflection on all the information available. However, the draft report is intended to be just that – a draft about which a conversation can be had. Providers should feel confident at this point in raising concerns such as discrepancies between feedback and the draft findings plus any other issues they want to raise about the draft report.

Targeted inspections: the CQC want to introduce a third type of inspection – the targeted inspection ( see slides 6 – 12 for more detail). They feel that they need another inspection mechanism to enable them to have a nimble ‘high risk response’ in 3 types of situation:

• To follow up on Warning Notices to be assured improvements have been made
• to follow up on multiple Requirement Notices to be assured action has been taken
• to follow up on serious concerns being raised, eg by members of the public

The targeted inspection is needed they feel as focussed inspections do not currently allow them to visit services of high risk concern quickly, flexibly and responsively. This type of inspection is not intended to make changes to the existing ratings and will focus on the limited areas of maximum concern.  This type of inspection is intended to speed up their ability to check that Warning Notices and Requirement Notices have been met.

They are asking providers the following:

Do you agree the targeted inspection proposals should make it quicker and simpler to follow up on serious concerns and Warning Notices to ensure that people are safe and services are improving?

Some points to consider:

• Do you agree that CQC needs another inspection type to be more responsive to risk and to inspect that Warning Notices are being met?
• Do you agree that targeted inspections focusing on particular and limited areas of concern or risk cannot provide sufficient evidence to justify raising ratings?

Action for members: please do give us your views on this proposal – please email Liz (liz.jones@nationalcareforum.org.uk)

Ratings Analysis: the slides include an analysis of the current ratings for active services published up to 27 June 2019. A key point made by the CQC is that the picture now compared to 2017 when they had their first full picture of ratings is that there has been a reduction in the variations between regions and the regions with lower quality ratings have improved since then.

Care home market entries and exits: some interesting data, but it does not include any analysis of how many services have changed from offering nursing care to residential care only, so it only provides a partial picture in terms of the overall picture of nursing and residential provision.

Smiling Matters: oral health care in care homes: this report has been well received. The CQC plan to include 2 new questions in their inspection process relating to dental health

Factual accuracy changes: in April, the CQC updated their guidance on how to submit factual accuracy corrections; they have now removed the character limit on the response form that is used to submit factual accuracy corrections. They also ask that if providers are sending in additional documents to support their factual accuracy changes, please clearly reference which section in the documents you want to draw the inspector’s attention to.

Restraint, seclusion and segregation thematic review: phase 2 activity for this review has begun and runs from July until October:

• It will focus on adult social care for people with learning disabilities, including supported living, residential settings, low secure and rehabilitation wards and inspectors will be asking additional  questions in sections of these services within this period that are intended to help them really explore the culture of the services they are inspecting.
• 27 deep dive visits will also take place. These are not inspections but form part of the overall review process. Providers will receive notice if one of their service has been selected for a deep dive visit.

NMC Strategy: the NMC are launching a consultation on the strategic themes for their next five year strategy (2020 0- 2025). The formal launch is 24 July ans consultation runs until 16 October.  Their emerging themes are:

• Dynamic approach to how we shape practice
• Building our relationship with the public
• Strengthening the relationship with our professions
• Collaborating with others
• Using and sharing research, data and intelligence

More detail can be found in the slides (download them here) and we are keen to hear views from members so we can ensure and effective NCF response. The NMC is keen to take their consultation out to the social care sector, so we will see how we can best facilitate a session for members.

As ever, our monthly CQC meetings are a chance for your voices to be heard on all things CQC – do let Liz know (liz.jones@nationalcareforum.org.uk) if there are any issues/ topics/ questions you would like her to raise.

Click here to read Query responses from Adult Social Care Trade Associations meeting June/July 2019