Not-for-profit quality care for over 25 years

Update from CQC Trade Association Meeting – 26 May 2021

Update on registration
• CQC provided an update on their registration processes and sought views on how it can be improved
• Useful to note that hey deal with 54,000 applications a year, ranging from applications for new registrations to ones seeking to vary current registrations/ make small  changes
• Overall 60% of applications are approved – 10% are returned, another 20% rejected. The biggest chunk of applications relate to the registration of new managers, and then to applications to register new Domiciliary Care Agencies
• They are aware that some aspects of the process are working well and some can be improved. They mentioned they wanted a better approach for new Learning Disability services and also thinking about the process for new models for care.
• Keen to talk to care providers to find out what will help to improve the process? What do we want from the CQC? Keen to encourage conversation pre-registration
• Action – NCF will invite them to come & talk to us about registration
Alcohol use in care homes – very interesting research project
• Being led by Dr Sarah Wadd from the University of Bedford.
• Looking at exploring the issues, challenges and benefits of alcohol use in care homes
• Sounds very inclusive, with a co-production approach
• Looking to recruit care homes in the East of England, via the ENRICH network
• Happy to ask for more info – see the CQC slides for more detail.
Transforming how we regulate services for people with learning disabilities and autistic people
• Useful update from Debbie Ivanova who is leading this work
• The CQC is currently piloting a new methodology for inspection, starting in hospitals. They are also using the Quality of Life tool to see if people have choice, control & independence in their care – even in hospital.
• This is resulting in some degree of enforcement & limits on the numbers of people and new admissions. They are aware it is having an impact in terms of availability of services for people, but it’s not about finding a bed, it’s about finding the right service.
• They will then use the new methodology in social care services, with the continued focus on the right support, right care, right culture.
• The new methodology for inspection for learning disability services and for services for autistic people will inform the development and registration of new services; they MUST be meeting people’s needs.
• CQC is also looking at the regulation of Supported Living; they are concerned that their current approach is not identifying either best practice and poor practice properly.This means vigilance for new registration applications and they be looking at these carefully – they must be inclusive, co-produced and focussed on those using the services.
• Also working closely with the closed cultures team. Need to make sure the early warning signs are spotted
Action for members: make sure you have a look at the updated CQC guidance on closed cultures: https://www.cqc.org.uk/guidance-providers/all-services/how-cqc-identifies-responds-closed-cultures
Note: Debbie is coming to talk to our Learning Disability Forum on 22 June about the work she is leading – don’t miss it!
Developing our Monitoring Approach – please see the slides as well.
• The CQC believe they have made real progress in their ability to be more targeted and focussed in their inspections and want to build on this with a focus on risk
• They believe they are moving to smarter regulation , better use of data and prioritising it to manage risk as well as quality
• From late June, they are changing from transitional approach to a new monthly smarter monitoring approach. This means that each month, they will review all the data they have about registered services. Where that monthly data review does NOT find any evidence of a need to monitor more closely or inspect in the next month, they will issue a statement to that effect to those services.
• Where their evidence does suggest the need for some action, they will undertake either direct monitoring activity and / or an inspection.
• So, for care providers, the monthly ‘ intelligence review’ will result in either direct monitoring and or an inspection or a statement that no action is needed at the moment
• Apparently, this will free up time to focus on both where risk may be higher and where the intelligence suggests an improvement in quality.
• The statement that no action is needed can only be applied to services currently rated as good or outstanding. They expect 65% of services will have no action as a result of the monthly data review. The other 35% will expect something.
• Expressed our NCF concerns about the experience from members about the new approach so far. This was echoed by others; he CQC seem to be ignoring facts in favour of opinions & a focus on the negative not the positive. There is no transparency in the data being used. We
also mentioned the need for providers to be the first point of call- a positive speak up culture is key, and the CQC need to encourage this.
• CQC response: they feel that this approach will be a collaboration to reflect quality improvement in the inspection process.
• CQC Commitment: they will explore the problem that the sector’s impression is that they have stopped looking for good; and they will consider the issues raised about sharing the data/ transparency of the data being used. They see that they need to explain the positives of this new approach.
Operational update
• The CQC are looking closely at visiting practice – they are finding a real discrepancy between the focus on the media that states that visiting bans are in place and the reality of the visiting situation in practice. They have had 40 concerns raised directly about visiting and when they followed up, very few related to a ban on visiting. They did, however, highlight a lack of understanding from family members about what to expect and poor communications from care providers. The CQC expects providers to follow the visiting guidance. They are planning some pilot work to work with providers to talk to relatives about their visiting experience, using experts by experience.
• New IPC tool for supported housing and extra care housing – look out for it in the next CQC bulletin – very conscious that the current IPC tool doesn’t work for Supported Living & extra care housing and so they have created a new one, with input from the sector. Goes live on Monday 31 May. It is not being made mandatory for inspectors to use, but it may not be relevant for the setting, so they cannot use their discretion. It will therefore not be reported on by CQC like the IPC tool for care homes. It does not apply to Shared Lives services at all.
AOB
• CQC strategy launch – 27 May
• CQC publication of COVID sensitive data – no specific date yet but will give the sector a good period of notice about it.

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