Communication – On the day of the inspection
At a conference last week I was fortunate to listen to a presentation from a couple of CQC inspectors who had come along aiming to demystify some of the common misconceptions about CQC inspections. They also wanted to give some tips on how to achieve an outstanding rating. One the initial points they made about inspections was that communication on the day sometimes hasn’t gone so well and that it clearly works well when it’s an adult to adult conversation rather than adult to child.
Leadership – Invest in people
The CQC feels strongly that leadership is the responsibility of the GPs, Practice Managers, Nurse Managers and other Department Managers. They found that staff perform well when they are treated as equals, involved in decision making, engaged in processes and understand exactly what they are expected to do. A clear Practice vision is important too and when we invest in staff they will often have a ‘can do’ attitude.
Safe – The most difficult domain
I mentioned in a previous blog that the CQC focuses a great deal on the Safe domain and the inspectors highlighted that 20 – 25% of Practices fail in this area with pitfalls often process related. It is the most difficult domain to achieve Good and the hardest to achieve Outstanding, although a straw poll around the room showed that most Practices felt they were Good most of the time. There should be evidence of proactive patient safety training and Practices need to go beyond simply ticking boxes.
Infection control, particularly cleanliness and daily testing of fridge temperatures, is something that apparently crops up time and time again at inspections. The inspection team also want to see that DBS checks, or adequate risk assessments, have been done and chaperone training has been provided for relevant staff. These issues are top of the CQCs inspection checklists and its clear that they have zero tolerance towards inadequacies and public safety risks. In addition to this, to achieve Outstanding the CQC would like to see PPGs joining in with some of the work around Public Health involvement to support GPs and clinical staff. They would like PPGs to take their role beyond collecting feedback and fundraising.
Well-Led – It’s about learning and sharing
Significant event reporting and analysis should be team based and promote a learning environment. The CQC Mythbuster on Significant events (see link below) is very informative and there are of course some statutory occurrences that must be reported to the CQC. The CQC is mostly interested in what has been learned and shared, not necessarily what happened. It’s about what has been done to prevent the event from happening again.
How to achieve Outstanding
Latest statistics show that 4% of inspected Practices have achieved Outstanding and the CQC has highlighted some examples of outstanding practice, which they are sharing so that other providers can learn from and improve (see link below). Some of these examples, which cover every KLOE and each of the six patient population groups include:
- Learning from significant events;
- Caring for hard to reach groups;
- Improving access to care;
- Staff development;
- Caring for carers;
- Supporting healthy living;
- Going the extra mile.
Links
CQC Mythbusters – Significant Event Analysis:
http://www.cqc.org.uk/content/nigels-surgery-3-significant-event-analysis-sea
Examples of outstanding practice for GPs:
http://www.cqc.org.uk/content/examples-outstanding-practice-gps
