What social care providers should take away from the CQC’s new vision
In a bold new vision, the Care Quality Commission (CQC) has set out a strategy, which it says combines “learning and experience” with “valuable contributions from the public, service providers” and its partners.
As a result, the CQC says its strategy, which covers four key themes (‘People and communities’, ‘Smarter regulation’, ‘Safety through learning’ and ‘Accelerating improvement’), will be more “relevant”, more “flexible” and more “responsive” to cope with the ever-increasing challenges that the social care sector faces.
The CQC also says that the new directive will ensure that it achieves its core aims – to not only ensure that social care providers deliver “safe, effective, compassionate high-quality care” but that the CQC gives them the tools to change.
In the first of four articles, Quality Compliance Systems, the leading provider of content, guidance and standards for the social care sector, has asked Ed Watkinson, a former inspector, to explore, examine and demystify the four key themes that make up the new strategy. He begins with ‘People and communities’.
Why People and Communities are central to the CQC’s new strategy.
Working with and for the local community is absolutely central to the new CQC’s vision. It’s also vital that the care services embrace three additional sub-themes that the CQC is also keen to champion. The CQC is heavily committed to banishing inequality in services, and wants to see a culture of equality, diversity and human rights deeply embedded in every service in the land. Care services, if they haven’t already, need to create policies that not only ensure that their services are promoting these key values, but that they can present evidence of the fact that they are central to the culture of the service. That means being aware of the Equality Act and of people’s protected characteristics. Services also need to demonstrate, through their assessment and care planning processes, that a culture of diversity and inclusion is present. If you’re reading this as a Registered Manager, ask yourself – are you aware of people’s individual needs and do you and your staff value and respect them? Outstanding providers, who have worked hard to instil a person-centred culture of care in their service, will create plans that reflect the personal history and beliefs of each service user.
The care plans that social care providers create with service users should be a reflection of the policies, procedures and safe culture that form the foundation blocks of the service. In this respect, QCS, the leading provider of content, guidance and standards for the social care sector, can add great value. As soon as policies change, which has happened a lot during the pandemic, Registered Managers using the QCS system will receive instant updates, ensuring that they are never behind the regulatory curve.
But much more than that, having created a COVID-19 Resource Centre during the Pandemic, QCS has become a leader in providing best practice content, which is designed to help front line mangers and their staff build person-centred cultures within their services.
Local areas
Secondly, the CQC has pledged to pay much greater scrutiny to local areas, systems and also local ancillary services. On one level, this is an attempt by the CQC to promote greater cost efficiency models, while on the other hand, the regulator is striving to nurture a rich culture of collaboration, co-production and co-design within services.
In doing so, the CQC will be much more focused on local areas than it will be on individual providers. What do I mean? Well, take a care home operating in a particular location for instance. Let’s imagine that it’s a residential home in Bedford. The CQC is not going to look at the home as single entity, but it will see it as a part of a wider more holistic and integrated service that in the CQC’s words “builds care around the person”. The CQC will therefore look for evidence of collaboration on many different levels. It will closely observe how care staff interact with residents. It will want to see that there is fruitful partnership between care staff and management, and a good understanding between managers. But at a much deeper level, it wants to know that between the care home, local authority, primary and secondary care services and other local voluntary or community services in Bedford there is a shared understanding of what the local community wants and needs.
The CQC also wants to gain an accurate understanding as to how a particular home supports the bigger picture. It wants to see whether the care home truly understands the issues and pressures experienced in that particular area, how it is coping with them, and suggesting ways in which it can improve outcomes for providers.
I think one of the key differences between the new strategy and the old one, is that the CQC is now being much more objective about what ‘quality care’ should mean to people. In this sense, the CQC is looking to alter its regulatory role and become more of a co-ordinator of resources as well as guiding services towards tools which they can use to aid and accelerate improvement. I believe this represents a profound sea-change compared to previous strategies, where many providers felt – rightly or wrongly – that the CQC was playing the role of a pure regulator focused on enforcement and not working with individual services to drive and guide improvement.
Listening and acting
In order to act in the best interests of the people using services, it is vitally important to listen. In this respect, the CQC will devote significant resources so that service users, their families, or people regarded as important to them, can provide feedback. With increased collaboration, the CQC has promised “to make the most of existing sources of feedback” so those providing information “don’t have to repeat themselves”.
I think the main point to stress on feedback, however, is just how far the CQC has pledged to cast its net when gathering it. It wants to seek the views of the under-represented – people who traditionally don’t have a voice or who may be experiencing ‘closed cultures’. When you consider the systemic abuse that was uncovered at the Winterbourne View care home by Panorama over a decade ago, it can only be a good thing that the CQC plans to shine a greater spotlight on these services.
Overall too, the wider and more comprehensive the feedback it receives from people will prove a great benefit to the CQC. Why? Well, the more opinions that the CQC collects, the more real-time intelligence it will have. This rich seam of information will enable the CQC to develop a more reasoned and rational response as to how it can efficiently and effectively improve regulatory frameworks, ensuring that services pay even closer attention to promoting equality, diversity and human rights than they did before.
The challenge for the CQC, however, will be to develop high-tech systems that can process the increased amount of information gathered – which will come from multiple sources. The hope is that with access to more information, the CQC will be able to take a more proactive approach. This will allow them to be much more responsive in targeting services where poor practice has been identified by a number of different sources.
In the second article, Ed Watkinson will be discussing ‘Smarter regulation’
