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CQC Standards – The 13 Fundamental Standards and How to Follow Them

Adhere to the CQC fundamental standards of quality and safety with essential guidance on compliance with the national care regulations for your next inspection. The 13 fundamental CQC standards explained below.

What are the CQC Standards?

These fundamental standards are the standards that care must never fall below while care is being given.

Person-centred care

You must have care or treatment that is tailored to you and meets your needs and preferences.

Dignity and respect

You must be treated with dignity and respect at all times while you are receiving care and treatment.

This includes making sure:

  • You have privacy when you need and want it
  • Everybody is treated as equals
  • You are given any support you need to help you remain independent and involved in your local community

Consent

You (or anybody legally acting on your behalf) must give your consent before any care or treatment is given to you.

Safety

You must not be given unsafe care or treatment or be put at risk of harm that could be avoided.

Providers must assess the risks to your health and safety during any care or treatment and make sure their staff have the qualifications, competence, skills, and experience to keep you safe.

Safeguarding from abuse

You must not suffer any form of abuse or improper treatment while receiving care.

This includes:

  • Neglect
  • Degrading treatment
  • Unnecessary or disproportionate restraint
  • Inappropriate limits on your freedom

Food and drink

You must have enough to eat and drink to keep you in good health while you receive care and treatment.

Premise and equipment

The places where you receive care and treatment and the equipment used in it must be clean, suitable, and looked after properly.

The equipment used in your care and treatment must also be secure and used properly.

Complaints

You must be able to complain about your care and treatment.

The provider of your care must have a system in place so they can handle and respond to your complaint. They must investigate it thoroughly and take action if problems are identified.

Good governance

The provider of your care must have plans that ensure they can meet these standards.

They must have effective governance and systems to check on the quality and safety of care. These must help the service improve and reduce any risks to your health, safety, and welfare.

Staffing

The provider of your care must have enough suitably qualified, competent, and experienced staff to make sure they can meet these standards.

Their staff must be given the support, training, and supervision they need to help them do their job.

Fit and proper staff

The provider of your care must only employ people who can provide care and treatment appropriate to their role. They must have strong recruitment procedures in place and carry out relevant checks such as on applicants' criminal records and work history.

Duty of candour

The provider of your care must be open and transparent with you about your care and treatment.

Should something go wrong, they must tell you what has happened, provide support, and apologise.

Display of ratings

The provider of your care must display their CQC rating in a place where you can see it. They must also include this information on their website and make our latest report on their service available to you.

Updates to the CQC Standards

Any and all updates to the CQC Standards will be communicated via its website.

How to use these to ensure compliance with the CQC?

Personalisation has always been a fundamental principle within the QCS system. All policies promote the individual application of process rather than blanket application, but most importantly of all care planning is made the central pivot of all processes in the Service. The QCS system encompasses the strategy that all activity in the Service happens because one or more care plans call for it.

If an activity is not called for in a care plan, the question must be asked: “why is it happening?” The answer could be “because we have always done it”, which is wasteful and potentially depersonalising and therefore should cease, or because of some underlying legal requirement, in which case the requirement should be double-checked for validity and only imposed if there are no alternatives.

To ensure the people who use services are put at the heart of planning and are involved in every aspect of their care and support, the CQC focus their inspections on the quality and safety of services, based on the things that matter to people. They ask five key questions about the service. These are:

  • Are they safe? Safe: you are protected from abuse and avoidable harm.
  • Are they effective? Effective: you care, treatment and support achieve good outcomes, helps you to maintain quality of life and Is based on the best available evidence.
  • Are they caring? Caring: staff Involve and treat you with compassion, kindness, dignity, and respect.
  • Are they responsive to people's needs? Responsive: services are organised so that they meet your needs.
  • Are they well led? Well-led: the leadership, management, and governance of the organisation make sure It's providing high-quality care that's based around your Individual needs, that It encourages learning and innovation, and that It promotes and open and fair culture.

The Keys Lines of Enquiry (KLOES)

These five key questions are broken down into a further set of questions. These called the Key Lines of Enquiry or you may have heard them referred to as KLOE for short. As well as the Key Questions and the KLOE, CQC also uses Prompts. An example of how this fits together is shown below:

CHART

Sources of Evidence

To help the inspection teams focus their inspections, they use a standard set of KLOEs and prompts. To support this, CQC published the Adult Social Care Key Lines of Enquiry and Prompts: Sources of Evidence.

So, for example, sitting alongside the prompts, CQC can look at the following in relation to Safe and the KLOE s1.

CHART

What are the benefits of following QCS' approach to CQC fundamental standards?

An advantage of this approach is inspectors can be consistent when they undertake inspections of the same service over time, and between services. But from a provider’s perspective, you will need to be able to provide the inspection team with the evidence. They will also want to see evidence in other areas that link not only with the CQC Fundamental Standards but also CQC’s strategic objectives such as;

  • Whether services work in a person-centred way to meet the needs of people from all equality groups, for example lesbian, gay, bisexual, and transgender people (LGBT+)
  • Whether services are meeting the Accessible Information Standard, which looks at how providers identify, record, flag, share information about, and meet the information and communication needs of people relating to disability, impairment or sensory loss
  • How leaders and managers are promoting equality, diversity, and human rights in their service, including for their staff
  • Whether people from different groups have equal access to care pathways and all parts of the service.

But the true measure of how a service performs, is what the people who use the services think.

  • Are the services you provide meeting their needs, wishes and expectations?
  • Are your services putting them truly at the heart of the delivery in other words creating person centred care and are service users involved fully to ensure they achieve positive outcomes?

To assess this, CQC use information from: conversations they have with service users, from commissioners of services, safeguarding incidents, whistleblowing concerns, accidents, incidents, and short observational framework for inspection, a tool used to capture the views of people who may not be able to express their views themselves. All of this helps CQC to form a judgement about the quality of the service and determine a rating for each of the five key questions.

The Key Questions including Safe are embedded throughout the QCS Management system; QCS does not regard the Health and Safety Policy or the Safeguarding Policy as the only source of ‘Safe’ evidence. Every policy is assessed to confirm its contribution to safe care and practice and the other Key questions before publication, on the principle that policies and procedure form an intrinsic part of every aspect of a care service.

While in the ideal world all staff know and understand all policies, a robust management system ensures that a staff member who only reads the policy related to their current activity is working to safe principles in that activity.

Need help adhering to the CQC Standards?

The effective use of the care planning cycle embedded in the QCS format makes responsiveness easier. The service user is constantly reminded that they have the right to be represented in the process and in control of it, and the staff user is supported along a path which encourages them to constantly review the effectiveness of the care and support is provided. This human rights-based approach is reflected in every policy QCS publishes, with every policy created and reviewed through the prism of human rights.

The QCS Management system is fully compliant with the Fundamental Standards. It's backed by the QCS Customer Care team to answer questions and concerns, with 24/7 access via your desktop and mobile app. This means that QCS management system users have immediate access to the tools to support them through registration and inspection.

Philippa Shirtcliffe

Head of Care Quality QCS

Updated: 11th May 2020

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