14th June 2017

Care Quality Commission – Changes to your inspection process

The CQC have released the results of their first consultation on the ‘next phase of regulation’. This consultation took place between December 2016 and February 2017. They were expecting to let people know about the results a few weeks ago but had to delay publication until after the General Election.

The full consultation response can be viewed here.

The consultation asked for views on how CQC should develop and evolve their approach as they move into the next phase of their regulatory model. The consultation focused on the CQC principles for regulating new models of care; changes to assessment frameworks; strengthening the guidance on registering services for people with a learning disability and/or autism, and changes to the way CQC regulate NHS Trusts. QCS are abreast of all the issues and are fully aware of the consultation, and the implications of the revisions made to the KLOES for how you run or manage your service and to the policies that you use. We will ensure that all system content will reflect the changes, and provide updated information to support you at all times.

The headline statement from the consultation is that there have been changes, but they are to be seen more as an evolution and refining of the model than wholesale changes. The CQC are still going to ask whether services are safe, effective, caring responsive and well led and will use the evidence to come to a judgement and rate services as inadequate, requires improvement, good or outstanding.

The changes to the consultation document have been made to reflect what people have said during the consultation process and to more clearly align content across health and social care .

The main points from the final results that you need to be aware of are:

  • The number of assessment frameworks have reduced from 11 to 2. With there now being one for health services and one for adult social care services
  • For adult social care services, this means that there will be one assessment framework for both community services and residential services
  • For GPs and Dentists, the health assessment framework will apply
  • For adult social care services and for GP practices the revised framework will apply from November 2017
  • For dental services, the framework will be used from April 2018
  • For adult social care, there are 5 new KLOES that cover the following themes:
    • Safeguarding
    • Lessons learned from mistakes
    • Needs assessment and the use of best practice
    • Governance within the service
    • Engagement and involvement
  • There are numerous changes to the wording and scope of many of the prompts that underpin the KLOEs and there is an increased focus on systems, leadership, processes, security of records, sharing of information, learning from mistakes and improvements, use of best practice, communication and the Equality Act, use of technology, end of life care, governance, engagement and how services evidence improvement
  • Very few themes have moved within the existing framework, and CQC have kept a consistent approach to which key question the information is placed
  • In the consultation, it was proposed that the KLOE relating to consent and the Mental Capacity Act be located under the responsive question, however, CQC have decided that it will be remaining under the effective question.
  • The revised KLOES, prompts and characteristics can be viewed here
  • And the revised KLOES, prompts and characteristics with the changes from the 2015 framework can be viewed here

QCS will adapt our policies, procedures and information to reflect the changes that will be made to the CQC assessment framework, and these will be ready for use by you before they come into effect in November 2017. As always, our focus will be to ensure that you have all the information that you need, and that the management system will continue to be comprehensive, timely and effective to enable you to continue to deliver high-quality care and support.

At the same time as the results of this first consultation, the CQC have also released a second consultation on the next phase of regulation. This consultation is now open and they would like comments by the 8th August 2017. In this consultation, they are announcing proposals for the next phase of Regulation for Primary Medical Services and Adult Social Care including, these proposals include:

  • Replacing the Provider Information Return (PIR) with an annual online information collection process, so the information provided will be more detached from the date of the inspection.
  • Review of the frequency of inspection, dependent upon the rating given
  • A review for GPs of how CQC assess and rate the quality of care for different population groups that surgeries support
  • Changes to registration including who is defined as a provider and who needs to register
  • A new process for monitoring and inspecting new complex providers
  • Looking at options for a new provider-level assessment, for providers that run multiple services
  • How CQC propose to encourage areas to improve, and this could include monitoring a range of registered services across health and social care within an area
  • Changes to the way CQC carries out its role to Fit and Proper Person Requirement

However, these are just the headlines from the consultation and we would encourage you to look at the consultation in more detail and make your views known, as this is your chance to influence the future direction of how your service is regulated by CQC. More information can be found here. The consultation closes 8 August 2017.

We will be keeping in touch regularly over the coming months to let you know how we are reflecting the changes in the QCS system and to keep you informed about the latest thinking from CQC.

*All information is correct at the time of publishing

Ed Watkinson

QCS Director of Care Quality

Ed serves as part of the Senior Management team at QCS. He is lead on the development of new quality assurance, compliance and care management policies and procedures. Read more

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