Barry Price, QCS Specialist, uncovers how looking at CQC ratings and reports could help improve your service?
I sat here this morning, as I usually do, scouring the internet for nuggets that give me an insight into what is happening in the world of social care and the wonderful world of compliance. This is over and above the barrage of updates and emails that the world seems to receive on a Friday at 5pm.
So, today’s gem was ‘Our latest inspection ratings,’ and I decided to delve deeper into the stats.
Of all the services inspected and rated as outstanding,10% per cent of these were care homes and 20% were services in your own home.
For the services inspected and rated as inadequate, 46% were attributed to care homes and 22% were services in your own home including homecare.
The Key Lines of Enquiry (KLOE)
Delving into this data, the results were mixed especially in being safe, effective and well-led.
The charts below demonstrate how many KLOEs achieved Inadequate, Requires Improvement, Good or Outstanding on inspection.
Care Homes rated outstanding
[table id=20 /] All services were rated outstanding in being effective and well-led.
Homecare agencies rated outstanding
[table id=21 /] All services were rated outstanding in being effective and 75% rated outstanding in being well- led.
Care homes rated inadequate
[table id=22 /] All services were rated inadequate in being well-led and 94%of services were inadequate in being safe.
Homecare agencies rated Inadequate
[table id=23 /] All services were rated inadequate in the areas covering safe and well-led
How can these reports help you?
I started to look at some of the comments and features in the reports available online to discover and understand what it takes to make a service outstanding. The following doesn’t cover everything, but you should find it useful. Some statements are taken directly from the reports, and others are my interpretation of what the inspection team evidenced.
- Good record management: The inspection looked at staff files in relation to recruitment and a variety of records relating to the management of the service, including audits and safety checks were reviewed.
- The provider electronically submitted evidence.
- The service had strongly embedded the standards of the dementia care well-being framework to support people living with dementia.
- Two very active dementia champions were in place.
- The effective use of the Pain Assessment in Advanced Dementia Scale (PAINAD) was visible.
- Integration of the careful care planning and careful observations framework was visible and in use.
- The service gave people visual and verbal choices of food. People at risk of malnutrition were given yellow plates to help staff identify people who require extra support while eating.
- Using technology was evident such as headphones with speakers for people with a hearing impairment. The use of enlarged font size for letters/documents, enlarged print books and magazines were available for those people with a visual impairment.
- Further use of technology such as YouTube for people to access church services organised by the local church.
- Environmental changes had been made in line with the Kings Fund Recommendations and Guidance.
- Those assessed as at risk of choking and fluid intake needs were not being managed safely.
- Staff had not been recruited safely.
- Staff did not have the skills and competencies to carry out their role. For example, risk of choking needed staff on duty that were trained in dysphagia [swallowing difficulties], no staff had training on duty.
- Accessible Information Standards – people with communication needs did not have visual planners when these could help them.
- The provider did not have sufficient oversight of the service and governance systems were not effective in driving improvement.
- Care was not person-centred and had failed to promote people’s dignity and human rights.
- The provider had not been alert to the culture within the service and had not spent enough time with staff and people and discussing behaviours and values.
- The culture in the service was not always positive. Staff told us that morale was low, and they were unable to say what the vision and values of the service were.
- Lessons were not being effectively learned from incidents to ensure that risks to people were reduced. Incident reports were not consistently being completed or analysed and some incidents were not being recorded.
- During our inspection we observed one person having to request drinks on two occasions, despite it being a very hot day.
Do you recognise any of these statements in your service?
As a manager you may find it useful to visit the CQC website and review CQC inspection reports of services in your area. You may also want to register for alerts on services near you that are about to be inspected. Why?
I find it useful especially when I read reports and see glaringly obvious concerns, I then discuss them in team and management meetings. It may prompt me to review other areas highlighted above such as choking risk assessments or training to ensure that areas noticed locally can be addressed ahead of any inspection.
On a plus side there are also particularly good lessons to learn from outstanding reports. Are there any things you noticed above that you may be able to use for your service such as contacting your local churches to see if they offer a YouTube service or use yellow plates. For QCS customers, how many of you make effective use of the “Recite Me” tool on your dashboard?
Among your management teams you could download aspects of reports to use as exercises in meetings and evidence this learning. Discuss an issue raised in a report and what steps you as a team would take to address it. What good ideas did you see in a report and how could you implement this in your service?
So, now I hope you can see how reports and CQC ratings people’s inspections might help you increase your own inspection rating.