CQC update for adult social care providers

The Care Quality Commission (CQC) will change the way it assesses and rates providers.

The QCQ said the changes will enable it to be more flexible in how it assesses and rates providers, and recognise the ongoing challenges that many providers face as it moves into the next stage of the pandemic.

It will help the watchdog work towards its ambition to be a more dynamic, proportionate and flexible regulator in line with its new strategy from 2021.

What this means for providers of health and social care

The CQC says its purpose has not changed, it will continue to make sure health and social care services provide people with safe, effective, compassionate and high-quality care, and to encourage services to improve. However, it needs to make some changes to help it do this.

It will no longer set a maximum interval, based on previous ratings, between inspections.

Previously, it has always needed to carry out a site visit to give a rating. Going forward, it will start to use a wider range of regulatory approaches to assess quality and rate.

Initially, these will be in a limited number of circumstances as it continues to develop the regulatory approach outlined in its strategy. The CQC said it will use its professional judgement to determine when this is appropriate and be clear about its methods when we inspect your services.

It will provide further information about when it will rate a service it implements its strategy.

The CQC said it will use a different regulatory approach for example when:

• making more use of technology to support how it gathers evidence in all services
• updating a rating without a site visit:
  • where it has gathered evidence of a deterioration in quality or taken enforcement action – it’s less likely to do this in some settings such as residential settings, where it’s necessary to observe care or the environment
  • where it asks a provider to show that they have addressed the concerns that affected their rating in a previous inspection

The watchdog said it won’t always carry out site visits to rate homecare services, following the successful pilots it carried out in 2020.

It will continue to assess whether services are safe, effective, caring, responsive and well-led using its assessment frameworks for healthcare and adult social care. It will also carry on using inspections where it focuses its assessments on specific areas.

Adult social care providers and GP providers

The CQC will continue to use inspections that are more focused to update ratings for these providers in line with its published guidance. A more flexible approach to assessing and rating other primary care services will also be developing further.

NHS trusts

The CQC’s consultation response sets out changes to how it will rate NHS trusts from Spring 2022. 

Using information from monitoring, it will be proportionate when deciding which core services to include in the inspection. It will use its ratings principles in a more flexible way and use its professional judgement to depart from these where appropriate, either in response to concerns or where there has been improvement.

Key things these changes do not affect

• The CQC will carry on using its assessment frameworks and ratings characteristics.
• Inspection teams will still use the five key questions and key lines of enquiry (KLOEs) to structure their assessments.
• It will continue to gather the valuable views of people who use services, and staff, to inform its assessments and ratings.
• Health and social care services will still be rated as either: outstanding, good, requires improvement or inadequate.
• It will continue to use its ratings principles.
• It will still publish reports about the services we inspect.
• The reporting and factual accuracy process is unchanged.
• The process to request a rating review still applies.
• The enforcement policy is unchanged.
• It will continue to carry out Mental Health Act (MHA) monitoring visits to protect the rights of vulnerable people.

As the CQC develops its approach to assessing and rating it will update this information. This includes other changes proposed in the consultation – specifically removing ratings for population groups in our inspections of GP practices and changes to NHS trust level ratings.

Photo Credit – Scott Graham