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Here you will find all the articles, Toolkit items and Q&As relating to CQC inspections.
Scroll down to see the articles, supporting Toolkit documents and Q&As in this section. You will find the most recent ones listed at the top.
Articles
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CQC’s new monitoring approach – has anything changed?
Lucy Bowker, Solicitor at Gordons Partnership Solicitors, asks whether the CQC’s new monitoring approach is anything new. -
Free article: CQC inspection and regulation update
Martin Hodgson provides an update on CQC inspections, including information on the new IPC inspections.
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Free article: CQC’s duty of candour: a legal update
Lucy Bowker provides a refresher on the duty of candour and talks about recent prosecutions under the duty.
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Free article: CQC COVID-19 guidance and procedures
Martin Hodgson provides a round up of the latest news relating to the CQC during the COVID-19 outbreak.
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A new CQC tool – suspending ratings
The CQC has the power to suspend ratings between inspections. Neil Grant asks what this means for managers.
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CQC changes the game regarding the provider information request
Tim Dallinger explains the changes to the way the CQC requires providers to submit provider information requests.
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CQC’s State of Care report
Martin Hodgson looks at the highlights of the 2019 Care Quality Commission (CQC) annual report.
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Free article: How to get to ‘outstanding’
James Glanville, general manager at Sunrise of Westbourne, discusses how the care community came to be rated ‘outstanding’ and how you can best prepare for a CQC inspection.
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CQC’s market oversight function
Errol Archer looks at the importance of the CQC’s market oversight function and what it means for the care sector.
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Free article: CQC's increased focus on 'requires improvement' services
Neil Grant talks about how a care service needs to be rated ‘good’ overall to survive and prosper.
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Free article: Managing inspection: on the day and post-inspection
In his second part of his article on CQC inspections, Paul Ridout talks about how to manage an inspection day and what to do after the inspection.
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Free article: CQC ratings and compliance
Neil Grant of Gordons Solicitors looks at some key compliance issues for care providers and managers.
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Free article: Preparing for a CQC inspection: a provider’s view
Neil Murray, Head of Quality and Compliance at Bluebird Care, gives advice on how best to prepare for a CQC inspection and how you can achieve a top rating.
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Free article: Managing inspection: Preparation
In part one of a two-part article, Paul Ridout discusses the current climate for CQC inspections and how providers should be prepared for inspection.
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Free article: CQC inspection reports
Martin Hodgson talks about the new CQC report highlighting improvements in adult social care.
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Free article: CQC ratings update
Nythan Smith, Ridouts Professional Services Plc, takes a look at how the CQC rates health and social care providers and what providers should do to challenge a rating.
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The CQC State of Care Report 2016-17
Martin Hodgson provides a summary of the latest CQC State of Care report.
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CQC response to their 2nd consultation
Martin Hodgson summarises the CQC response to part 2 of their regulation consultation.
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Free article: CQC's second consultation
Neil Grant at Ridouts looks at CQC’s second consultation on the future regulation of adult social care services and considers how radical the proposals are.
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Free article: CQC inspection - a summary of the changes
Martin Hodgson provides an analysis of the CQC inspection changes.
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Free article: CQC consultation
Martin Hodgson provides a summary of the proposed changes to inspection in the CQC consultation.
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The cutting red tape review
Martin Hodgson looks at a CQC initiative to reduce the administrative burden on providers.
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CQC developments
Martin Hodgson provides a round-up of the latest developments from the CQC, including its final five-year strategy document.
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CQC strategy 2016 to 2021: a radical shift or same old, same old?
Neil Grant, Ridouts, reviews the new CQC proposed five-year strategy.
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Using the provider information return
Tim Dallinger advises on how to complete and use the provider information return.
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Free article: How to improve your service after a CQC inspection
Tim Dallinger advises on how to improve standards following a CQC rating of 'requires improvement' or 'inadequate'.
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Free article: Preparing staff for an inspection
Tim Dallinger looks at the importance of preparing your staff for a CQC inspection.
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Rating reviews - Radical reform leads to new problems
Neil Grant, from Ridouts LLP, provides an update on CQC's rating review process.
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CQC inspection: care home case study
In the latest of a series of case studies about the current changes to the regulatory framework and inspection system we talk to Roisin Ewing of Bay Lodge care home for disabled adults.
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Free article: CQC inspections: site visits
Martin Hodgson looks at the format of a CQC inspection site visit and what providers can expect.
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Free article: Challenging CQC inspection ratings
Samantha Cox of Ridouts solicitors offers practical advice on what to do if you aren’t happy with your rating.
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Free article: What is an effective service?
Tim Dallinger looks at CQC’s expectations of an effective service, and how to demonstrate to CQC that your service is effective.
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Using the CQC provider information return
Completing the PIR is now a legal requirement. Tim Dallinger explains how providers should use the PIR as a continuous improvement tool.
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Good governance
Martin Hodgson looks at what good governance means and how providers can ensure they meet Regulation 17 of the fundamental standards.
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Duty to publish performance ratings
Martin Hodgson looks at the new requirement to publish and display performance ratings.
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Delivering person-centred care
Tim Dallinger looks at fundamental standards Regulation 9: Person-centred care, and how to evidence compliance to CQC. -
CQC’s confusing new regulatory regime
Neil Grant of Ridouts offers practical tips for providers and managers confused by CQC’s new regulatory regime. -
Fundamental standards: A new inspection landscape
With the new fundamental standards in force from April 2015, we look at how these important changes will reshape the inspection landscape.
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CQC inspection: domiciliary care case study
In the second of a series of case studies about the current changes to the regulatory framework and inspection system we talk to Ben Kigozi from Precious Homes Ltd.
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Completing the PIR form
The PIR form has become one of the CQC's key pre-inspection tools. Martin Hodgson provides a practical overview of this important new paperwork.
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Characteristics of an ‘outstanding’ service
What defines an ‘outstanding’ service? Tim Dallinger looks at the achievements and characteristics required and offers advice on attaining a top rating.
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The CQC armoury is falling into place: are you prepared for the changes?
Neil Grant looks at the new CQC provider handbooks and ratings.
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Key lines of enquiry and the provider information return
Andrew Bellingham looks at what the key lines of enquiry and provider information return mean and why they matter.
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CQC inspection: Domiciliary care case study
In the first in a series of case studies about the current changes to the regulatory framework and inspection system, we talk to Nancy Candlin from Halo Homecare.
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Free article: What makes a service safe?
Martin Hodgson looks at the CQC’s key question ‘Is it safe?’
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What makes a service responsive?
Tim Dallinger discusses what providers should do to demonstrate that their service is responsive.
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What makes a service effective?
David Finney considers the CQC’s key question ‘is the service effective?’
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Changes to the New Fundamental Standards Regulations
A look at the results of the Department of Health consultation on Fundamental Standards for health and social care.
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Preparing for the new inspection regime
Tim Dallinger offers advice to providers on how to prepare for the new CQC inspection regime.
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Ensuring your service is well-led
Tim Dallinger looks at the increased emphasis on the role of the registered manager in the new CQC inspection regime, and the importance of ensuring providers are well-led.
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CQC’s proposed regulatory changes
Martin Hodgson looks at the proposed regulatory changes, including the fundamental standards, interim impact assessment and CQC consultation.
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The CQC’s proposed rating system: Protection or punishment?
Neil Grant, Ridouts, looks at the draft provider handbooks published by the Care Quality Commission (CQC) and the proposed new rating system.
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Introducing fundamental standards
We examine the Department of Health consultation on proposals to change CQC registration requirements.
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Flesh on the bone: how CQC regulation is changing in 2014
Neil Grant looks in detail at what to expect from future Care Quality Commission (CQC) inspections.
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The five key questions and the Adult Social Care Outcomes Framework
This article looks at how the new CQC inspection process relates to the Adult Social Care Outcomes Framework and the NHS Outcomes Framework.
Toolkit
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Discussion point – Preparing for inspection: What you could have done differently (all providers)
To download the document click on the link:
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Discussion point – Preparing for inspection: previous inspection report (all providers)
To download the document click on the link:
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Form – What is your CQC inspection report telling you? (all providers)
To download the document click on the link:
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Form – Preparing for a CQC inspection (all providers)
Use the following item in the Toolkit to put the ideas in the article into practice:
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Checklist – Ratings characteristics for key question 1: Is the service safe? (all providers)
Use the following item in the Toolkit to put the ideas in the article into practice:
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Checklist – Ratings characteristics for key question 3: Is the service caring? (all providers)
Use the following item in the Toolkit to put the ideas in the article into practice:
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Form – Key documents to have accessible for a CQC inspection (all providers)
To download this document click on the link:
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Training Q&A - Learning from inspection reports: Is it caring? (questions and answers)
To download this document click on the link:
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Training Q&A - Learning from inspection reports: Is it caring? (questions) (all providers)
To download this document click on the link:
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Form - Audit for compliance with fundamental standard Regulation 20a: Requirement as to display of performance assessments
To download this document click on the link
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Handout - Using the CQC's Guidance for providers on meeting the regulations to ensure compliance (care homes and nursing homes)
To download this document click on the link:
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Checklist - Preparing for a CQC site visit (care homes and nursing homes)
To download this document click on the link:
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Form - Audit for compliance with FS Regulation 17 good governance
To download this document click on the link:
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Form - Audit for compliance with FS Regulation 11 need for consent
To download this document click on the link:
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Form - Audit for compliance with FS Regulation 9 person centred care
To download this document click on the link:
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Policy - Preparing for inspection
To download this toolkit, select 'read more' and click on the link:
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Handout - CQC 'A New Start' consultation - summary of proposed changes
To download this toolkit, select 'read more' and click on the link:
Q&A
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Q. We have heard that the CQC has been issuing the Provider Information Return (PIR) again. If we are asked to complete this, does it mean that our service will be inspected soon?
A. The CQC reintroduced the PIR in mid-2021 after pausing it during the first phases of the COVID-19 pandemic. Just as it was before the COVID-19 pandemic, the PIR is an annual requirement.
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Q. What are the most common areas of non-compliance for home care agencies?
A. A look at CQC reports on home care agencies shows that the key line of enquiry most often rated as inadequate is that for ‘well led’. Invariably this is due to a lack of effective governance in place to monitor the quality and safety of the care provided. In many cases, providers abdicated responsibility, believing that the registered manager was responsible for all aspects of compliance. This shows a lack of understanding of the regulatory framework and compounds the non-compliance. Nominated individuals must have sufficient knowledge to have oversight of the service and monitor the level of compliance.
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Q. What does the CQC mean by a ‘closed culture’ and how should we avoid this happening in our service?
A. The CQC says that a closed culture is a poor culture in a health or care service that increases the risk of harm.
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Q. Our care home has been subject to criticism from the CQC and the local authority contract monitoring officers. This criticism focuses on staffing levels at busy times and arose because of concerns raised anonymously by staff members...
... How should we respond?
A. If the CQC and the local authority have been critical of your service then they will have some evidence to support this. A common mistake made by care providers is to be ruled by emotion rather than reason and to continue to argue with the CQC and/or local authority in most cases to no avail. Think clearly and rationally, review the evidence that resulted in the criticism and consider whether your staffing levels are adequate.
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Q. As it has been quite a while since we had a CQC inspection, how can we prepare our care service for our next CQC inspection?
A. When the Care Quality Commission (CQC) paused on-site inspections as part of its response to the COVID-19 pandemic, it did not remove the requirements placed on all care providers to operate a service that is compliant with the regulations. However, many care providers have been focused on their response to COVID-19 and ensuring compliance may have been of lesser importance. While this is understandable given the circumstances, it does not mean that care providers can use this as an excuse for non-compliance. Care providers have a duty to ensure that services meet the fundamental standards and key lines of enquiry (KLOEs).
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Q. We have recently been inspected by the CQC and we felt that one of the inspection team was rude and overbearing. They continually challenged the registered manager and demanded documents.
Can we make a complaint about their conduct and will this affect our inspection rating?
A. The CQC has a complaints policy, and details of this are available on its website: https://tinyurl.com/whzm876. However, before making a complaint you should consider whether the member of the inspection team behaved in a way that was unprofessional, did not follow the correct procedures or made an administrative mistake. These are the only types of complaint the CQC will consider under its complaints policy. The CQC will not look at complaints about evidence from inspections and the ratings it gives to services. These complaints are handled under separate processes, which are explained on the CQC website at: www.cqc.org.uk/ratingreview.
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Q. What does the CQC expect us to provide in respect of references, application forms and interview records?
A. There is a myth that care providers need to obtain two references for all staff. Regulation 19 and Schedule 3 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 covers this issue in detail. The CQC also produces detailed guidance, which is available on its website.
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Q. I have heard that the CQC ratings will stay with a service even if it is sold to a new provider. Is this true?
A. Yes, this is true, and from 1 April 2019 the CQC regulatory history will stay with a care service. Sometimes a service must re-register as a 'new' location, even though it is continuing to deliver the same service to people. This is usually where there is a change of ownership or address. The CQC website links the previous (archived) and current locations.
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Q. Our inspection report said that we should have PRN protocols in place for variable dose and as required medication. What are PRN protocols?
A. PRN is an abbreviation of Pro Re Nata, which literally translates as ‘or the thing born’. It is commonly used in medicine to mean ‘as needed’ or as the situation arises. Generally abbreviated to p.r.n. or PRN, it refers to the administration of prescribed medication whose timing is left to the service user, nurse or care worker, as opposed to medication that is to be taken according to a fixed schedule. Care plans should contain enough information to support staff to administer medicines when required, as intended by the prescriber.
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Q. Our service has had a poor draft inspection report. We have decided that the cost of making the improvements is too great and we have decided to close the service. Must we still respond to the draft report and submit a factual accuracy response?
A. This is an all too familiar situation. Once the service has been inspected, the regulator will issue a draft report and in due course publish a final report. Even if the care provider applies to cancel the registration of the service, there is no guarantee that the regulator will adopt this. In fact, they may refuse if they plan to take enforcement action. The care provider must respond to the draft report to address issues of concern; this is to ensure that service users are cared for safely until they move to another service. Failure to do this will result in further action by the regulator.
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Q. How can we evidence compliance with the ‘Is it safe?’ S6 KLOE prompt?
A. The S6 KLOE prompt asks two questions. Firstly, ‘How well is the learning from lessons shared to make sure that action is taken to improve safety across relevant parts of the service’. This requires the service to put in place a system to analyse incidents, accidents, safeguarding referrals and CQC notifications and to use the results of the analysis to identify areas for improvement to systems, processes and practice to ensure that the service is safe for the people who use it. Doing this requires events to be investigated thoroughly on an individual basis and analysed methodically on a collective basis.
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Q. At our local registered managers’ forum one of the managers reported that the CQC inspector provided a list of documents that they would like to see. Is there a list of such documents that we should make sure that we have to hand?
A. If the CQC inspection team asks for documents, they will expect a care service to provide such documents in a timely manner. If the service cannot produce the documents promptly, then the CQC may conclude that the documents do not exist. It is important that those who are requested to provide documents understand what they have been asked for and are able to locate these promptly. Table 1 lists some documents that may be requested; this list is also available as a toolkit document to identify the location of each document.
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Q. I have heard that the CQC is now treating the National Institute for Health and Care Excellence guidance on medication as ‘mandatory’ when they inspect services. Is this correct?
A. There are two NICE guidance documents that relate specifically to medication management in social care.
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Q. At a recent CQC inspection, the inspector asked us about the accessible information standard. We were unsure about what they required. What is this standard and what do we have to do about it?
A. The CQC’s key lines of enquiry (KLOEs) require providers to ensure that staff seek accessible ways to communicate with people when their protected and other characteristics under the Equality Act make this necessary. They have to reduce or remove barriers (KLOE prompt C1.3) and identify and meet the information and communication needs of people with a disability or sensory loss, record, highlight and share this information with others when required, and gain people’s consent to do so (KLOE prompt R1.5). A service that does not evidence compliance with the accessible information standard (AIS) will be unable to demonstrate that is either caring or responsive.
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Q. Our service was inspected in the early days of the current inspection framework and we were rated as ‘good’ overall.
Our last inspection was nearly two years ago, and the report was published six weeks later. When can we expect another inspection from CQC?
A. You should expect an inspection visit from the CQC at any time.
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Q. I run a supported living service and have heard about the Care Quality Commission (CQC) using a ‘real tenancy’ test. What is this?
A. Many providers of residential care sought to deregister in the past.
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