Our Policy Director, Liz Jones, attending the monthly CQC Trade Association meeting on 9 October 2019.

Hot topics

Use of pre-prepared food.

We were very pleased to have clarification from the CQC about concerns raised by members in relation to some inspectors’ attitudes to and criticism of the use of pre – prepared food. The CQC confirmed that

‘It is incorrect that providers are being criticised for this. Inspectors should be basing their judgement on evidence, whether it is an enjoyable experience for residence and whether it meets their needs, not on opinions of particular types of food.’

The CQC will also issue clarification to their inspectors to remind them of this.

Employment history and reference checks

Liz again raised the issue of the length of time inspectors are asking providers to provide a full employment history for staff plus reference checks. The CQC agreed that clarification was needed on this for both inspectors and providers.

Updates from the CQC

Regulatory sandbox – round 3

They are running round three of their ‘regulatory sandbox’ looking at the issue of personal assistants and other micro-providers and what the role of regulation should be in relation to these sorts of services.  Click here for more info and how to get involved:

The Local Government and Social Care Ombudsman’s annual review of adult social care complaints

Their annual report has been issued this week, highlighting that it upholds 66% of all complaints it receives. They are reminding providers to make sure they are signposting people to the ombudsman’s service at the end of their complaints processes. Given the emphasis in the CMA guidance about robust complaint procedures, this si a timely reminder for us all.

Main items of the meeting

The State of Care 2018/ 19

This report is now available to download from the CQC website.

Digital records

Following numerous discussions at previous meetings where the NCF and other trade associations have raised the importance of the CQC understanding and encouraging innovation and digital technology, the CQC are recognising the importance of the regulatory response to innovation and their role in encouraging, not constraining innovation.

While they understand that technology and new models of care have an essential role in the provision of care both now and in the future, they want to remind us that this should never come at the expense of quality and their inspection approach should always focus on outcomes and impact for people using services. They have worked with inspectors to understand when digital technology enhances care and equally, to be clear about when it doesn’t.

In order to support their approach to regulation and innovation, the CQC are running a Digital Records workshop in November to:

• Have an open dialogue on the use of digital care records and understand each other’s experiences of their regulation
• Develop a shared understanding of what good digital record keeping means and how it facilitates a) good quality care and b) effective assurance including CQC inspection

Action for members: we really value your feedback on this topic – please do get in touch to give us your views and experiences.

Quality Matters: Action 2 Collecting and using data more effectively

The CQC provided an update on this area of Quality Matters work. They outlined the actions within this work stream:

• Action 1: Develop and agree principles for a sector wide approach to data collection from providers e.g. including avoiding duplication and reducing burdens on care providers.
• Action 2: Identify measures of quality and the corresponding data (collected from providers) required and promote to support local organisations to use these standardised measures to improve quality.

These actions have been translated into the overarching question;

How can we develop the Quality Matters shared view of quality in order to;

• underpin a sector wide approach to collecting information from providers
• reduce duplication and burden on care providers
• ensure better care for all

The slides provide more information on their emerging thinking.

Provider/ inspector contract workshop – November

The CQC has listened to numerous, common concerns that Trade Association members have consistently raised about the inspection process. In November, they are running a workshop session with the Trade Associations and CQC inspectors to consider these, as well as to hear about the common issues that inspectors face and to see how to address the concerns of both providers and inspectors.  The aim is to develop something which helps both providers and inspectors get the most out of inspection.

The issues that providers have consistently raised:

Clarity of expectations and consistency of approach

• Some inspectors will always spend time looking at records and policies even when it isn’t clear why they are doing this, for instance, when there are no relevant concerns to follow up.
• Not convinced inspectors always inspect “looking for ‘good'”.
• Inspectors often don’t seem to have read the PIR.
• Inspectors don’t always spend 80% of their time speaking to staff and people who use services on the ‘return to good’ inspections.
• I gave the inspector a lot of information and evidence and they didn’t use it.
• Different inspectors have different views about the same policy or other evidence.
• Some inspectors don’t give any feedback at the end of the onsite visit
• Some providers don’t like signing the summary of findings at end of visit

Achieving outstanding

• Inspectors using the phrase “you can’t be outstanding at your first inspection” or “I don’t have time to assess for outstanding today”.
• It isn’t clear what I need to do to be outstanding.
• Some inspectors say that, following an outstanding inspection, you need to continually innovate to keep that rating.

Behaviours

• Some inspectors adopt a superior attitude

Action for members:  Please feed back to us on this – do these feel like the right issues? What else would you add to list? What is the impact of these issues?

Updated ratings analysis – current ratings for active services up to 23 September 2019.

The slides provide more detailed information, but the headlines are:

• ASC quality has improved slightly compared to last year
• Regional variations are narrowing this year – while all regions improved, the gap between them has also reduced