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Navigating the complexities of CQC domiciliary care registration
Setting up a new business is always an extremely demanding task. But for those in the social care sector, there are added pressures such as CQC registration which often require expert advice and guidance. So, when Tancia Davis wanted to start a business providing domiciliary care in the UK, she turned to QCS for help.
Born and raised in Jamaica, Tancia came to the UK in 2002 at the age of 26. She had always wanted to be a nurse, but her dreams were put on hold when she started a family. However, her passion and determination remained undimmed, and she later completed the necessary nursing and care qualifications.
Says Tancia, “Despite many obstacles, I never lost sight of my dream. Within two years of arriving in the UK I began to pursue my ambition. I first attended Establishment Castle College in Nottingham, to take their three year Access to Nursing course, and then I completed an Adult Nursing degree at the University of Nottingham. I worked in a residential care home for the entire seven years of my studies. After graduation in 2013 I started my journey as a Registered Nurse.”
Tancia worked as a nurse first for the City Hospital in Nottingham and then the Queen Elizabeth Hospital in Birmingham. However, she came to realise that she wanted to start her own domiciliary care business, specialising in person-centred care.
In Tancia’s experience, due to the pressures many hospitals face, some patients don’t always get much quality time over and above task-based support. The same can be said of residential care homes, mainly due to staff shortages. In domiciliary care, however, a greater emphasis is placed on the person and the care and support they require.
With a thorough pre-assessment and properly funded care package, individuals receive quality support in the comfort of their own home, enabling them to maintain independence or recuperate in a familiar environment.
“In the UK, it is the custom to consider residential care when our relatives reach a certain age,” explained Tancia. “In Jamaica, we keep our elderly at home, giving them support when they are frail, when they most need it. It’s this culture that I wanted to bring to my business, to provide that level of care to vulnerable people here.”
Armed with the necessary qualifications and the dedication to work within the social care sector, Tancia registered her Solihull-based business, ‘First Care Health Care Limited’. But she had one major hurdle to overcome — Care Quality Commission (CQC) Registration. Having gathered all the necessary paperwork and supporting documentation, she made her application in October 2020.
However, during the COVID-19 pandemic, the CQC registration process changed to increase due diligence checks. This was in part driven by CQC inspectors being unable to attend in-person service visits, but also to increase the quality of applications being received.
In April 2021, Tancia had her first application returned, with a request for more information and clarity due to the new review process. She was close to giving up but, as an existing QCS customer, she was put in touch with a specialist consultant who was able to offer support and guidance on how to proceed. She says, “QCS were wonderful, they knew the regualations inside out. The help they gave me during this process was unbelievable. They explained what I needed to do every step of the way.”
She revised her application with new documentation showing how she would meet CQC regulations. She evidenced additional work she had carried out around business planning, financial forecasting, and began her interview preparation.
Following re-submission, Tancia responded to the registration team’s request for further information and supporting evidence including a new home-office risk assessment, a routine part of the assessment process. Following re-submission, a fit persons interview and a provider assessment Tancia’s second application was finally approved in August.
She says that QCS not only played a significant role in the registration process but continue to provide support going forward. “It’s an ongoing process. QCS continues to play a part, not just providing guidance on policies, but also the support to implement them. And I can always pick up the phone to get help if I am facing any issues.”
From a domiciliary care perspective, Tancia liked the fact that QCS policies and procedures were fully customised to her business. Particularly useful were registration guidance, templates for business planning, financial forecasting, and care planning as well as fire risk assessments.
The Lone Working Policy and Procedure, for example, guides staff on how to keep safe when working alone and confirms that the staff member must feel confident and competent to work alone. Tancia found the Risk Assessment policies very useful because “when we talk about person-centred care, safety is vital. They helped us with awareness, and to assess the individual and the home.”
Tancia has also singled out the QCS app for praise.“Staff have access to all of QCS's policies on the App. This not only guides them on how to deliver more effective care, but also helps ensure that they are complying with regulations. For me, it is about ensuring that staff are well trained, are keeping up with policy, new legislation and regulations. That, for me, ensures that staff are competent and able to deliver great care."
She explains that as a registered manager and nominated individual, she wants to know that the service users feel supported, and are well taken care of. “It is not about the carers going in and robotically doing a job without compassion. It is how you make the individual feel and how you leave them feeling that really counts.”
Tancia also likes the fact that she can keep her staff files and service user files in one place. ”I can look at policies, and I can do a risk assessment with my service user - all the forms and the templates are there. I don’t have to create them – it’s been done for me, a real time saver. And as all my care plans are on the system, I use it a lot. I would estimate it has increased my efficiency by about 20%. The time it has saved me I can spend on my service users and training my staff.”
When it comes to the future, Tancia remains ambitious. She would like to open more domiciliary care agencies across the country. “I am confident that I will get there as my main objective is to deliver outstanding person-centred care. I won't settle for anything less and nor should those who I support.”
The article was first published in The Carer - Issue 78
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