Set your expectations
Expectations can often be high at New Year. If only we could go back and hold some of those elaborate promises and social media declarations and settle for what is in our gift.
Looking back to take stock
CQC are taking a look back at what they put in place in 2014. Cuts were not on the cards back then to the extent they are now, and expectations were high. They have proposed some changes that I think we may be thankful for. In their latest consultation: ‘Our next phase of regulation‘, they have tweaked their past offerings to ensure a more efficient future. For example, matching and aligning existing sector frameworks and reducing them from 11 to 2, amongst other proposed changes.
The story so far
I once sat on a team where all sectors were developed, and then the work expanded and new teams were born. The failings of a generic model saw CQC engineer sector specifics, but like each pendulum, at its furthest point it can swing very high and this one comes at a financial cost!
I watched as the sectors grew. Consulting, interpreting and growing KLOES and the teams who put them together grew too. From a personal perspective, the content was very bespoke and that can be the ideal, but just like my husband’s tailored suit on our wedding day… a mix of partial tailoring and tried and tested off the peg would have done the job and may have provided a bit more money elsewhere for something we may have needed more (still waiting for a doorbell and electric can opener).
Don’t panic Mr Mannering!
Flicking through Christmas TV, Dad’s Army reminds me of the nervousness we can feel when we imagine a threat on the horizon. Does this mean huge change and lots of new things to incorporate? CQC reassure us when they say;
‘We are not proposing a significant shift in what we already ask of providers; rather, our proposals for change represent an evolution of our framework.’
Those of you that have trodden the path many a time, will know there is no need to panic. The world will not be changed in a day, and often the new is surprisingly like the past.
11 Frameworks down to 2
There are 11 CQC frameworks, articulated in their own handbook (Adult social care residential, primary medical services etc.) with the same overarching 5 key questions in common woven around the regulations. CQC has reviewed the proposal and has set it out to have just two frameworks, one for health services and one for social care, although where possible the two frameworks read across. This is to simplify the process and offer continuity – especially where a service could offer more than one type of setting.
New emphasis on key questions & changes in placement of KLOES
- CQC have made some changes to existing elements. Caring, Responsive and Well-Led on page 13-14 have received updating to clarify or add to the question itself.
- The colour guide to the appendixes (A1 Healthcare and A2 Adult Social care) are helpful in clearly identifying changes to KLOES and prompts – and if you have difficulties with colour, they have also written ‘change’ and ‘new’ where necessary.
- Don’t be overwhelmed where ‘change’ is highlighted. Many are changes in placement within the same key question.
New prompts and KLOES reflecting new themes
CQC have identified 6 new themes they have considered including in the KLOES and prompts. Technology (found in effective, responsive and well-led) and medicines (found in safe) are two of these. The full list can be found here on page 16.
What have I seen before?
- The framework remains the same and the 5 key questions will be asked, and ratings will still be made where they were before.
- A lot of the KLOES could already be seen to read across all of the frameworks. Even though there will be new elements, most will be aimed at making the framework clearer or adding one of the new themes – which most will already be elements carried out within your service.
What does it actually mean?
Consultation is your time to input. To be listened to and to make suggestions. Until the process is over and evaluated it does not mean a done deal. You can contribute by responding to this consultation up until Tuesday 14 February. There will be a further consultation around Adult Social Care and Primary Care in Spring 2017. A full list of implementation dates can be found here on page 18.
If you have the QCS system it means we will do the initial work around policies for you. Where there are things you need to be made aware of with changes, we will let you know as we always do.
The consultation also proposes changes to:
- Principles for regulating new models of care and complex providers.
- How CQC registers services for people with learning disabilities.
- The way CQC regulate NHS trusts and foundation trusts from April 2017 – including a possible change in the approach to rating them. To find further information go to ‘Our next phase of regulation’.
