What impact will the new CQC regime have on providers? – Redautz Solicitor

Ridouts hosted a roundtable discussion with providers to discuss the developing CQC regime, consider what’s going on, share knowledge and discuss the potential impact of the regime on business . The provider owns nearly 60 of her homes and had a wealth of experience to share. Although the discussion was wide and varied, we focused on three main themes:

1. New inspection regime, impact of new scoring system, anticipated FAC process and potential concerns
2. How does a provider portal help or hinder provider relationships and information flow?
3. Impact of new visitor regulations coming into force in April 2024

New inspection system

The morning began with a speech from Ridouts’ Head of Marketing and Compliance, Caroline Barker, who highlighted potential concerns about inspections based on the new Single Assessment Framework. CQC appears to be moving towards using the term ‘assessment’ rather than inspection. When CQC carries out an inspection, it is required by law to produce an inspection report and send it to the provider for review/checking. Ms Caroline asked whether the reference to an “ongoing assessment” was a way to circumvent the draft inspection report and therefore the process of questioning its factual accuracy.

The new system was introduced in part to provide more up-to-date ratings, but what the department has seen so far is that it does not amount to “continuous” inspection and the scoring system was potentially flawed. For the two inspection reports produced and issued under the new regime, CQC has so far reviewed only 14% of the quality statements, with the ‘current’ rating based on around 400 historical assessments. It was pointed out that most of the remains. 6 years old. This raises concerns about the reliability of the report and, of course, its ability to challenge the historical facts that make up the majority of current assessments.

One provider reported that CQC staff were “scared” and felt CQC was entering the service with an agenda. This will, of course, be linked to the CQC’s emphasis on risk-based inspections over the past three years. CQC is no longer looking for ‘good’, but rather evidence to support the information that led to the initial inspection. The discussion centered on CQC’s focus on showcasing the voices of service users throughout its report. One health care provider explained that she had received reports from families who spoke to CQC over an hour and a half that they felt CQC was trying to “trip” them up. The general feeling was that CQC was starting to focus on the negatives rather than the positives.

Ratings are the cornerstone of a provider’s business, but most people don’t look beyond the headline rating. Similarities have recently been drawn between Ofsted and his CQC’s systems following the Ruth Perry Inquiry and the Education Select Committee’s recommendations, which included a recommendation to move away from single-word ratings and rating restrictions. CQC’s rating headings are taken from the Ofsted system, he said, but CQC does not make single-word ratings to provide explanations in its reports. Its approach is no different to Ofsted, he said, but CQC appears to be trying to differentiate itself in some way. It also states that there is no rating limiter, but it is clear that there is a rating limiter.

It was highlighted that there appeared to be no internal standards for inspectors to judge. Questions arose about how inspectors determine where a provider falls within the determination range. Will it be subjective? Can we say they used professional judgment? One of the reasons for introducing the single assessment framework was due to inconsistencies between inspectors and regions that had been noted by providers over the years. Scoring systems are set up to promote consistency, but without an objective standard for inspectors to benchmark against, the system risks not solving one of the problems it was introduced to improve. I will bear it. One provider pointed out that previously, CQC inspectors reasonably exercised their professional judgment and gave providers an opportunity to correct anything during an inspection. This means that smaller concerns will be corrected and not noted on the inspection report. It was thought that the CQC would now include such remedial trivialities that would be disproportionately featured in the report.

All agreed that providers should be available for CQC inspection at any time. It was discussed that it was important to have evidence folders to showcase examples of positive and good work being done by providers, but one provider said that CQC inspectors had previously rejected this type of evidence. I reported. It could be argued that if the inspector is actually attending the service, this time should be devoted to careful observation, as the documents can be viewed remotely, but this does not mean that the examiner does not have access to the information provided by the provider on the portal. It only works if you can share the document with her CQC.

provider portal

This led us to consider provider portals and how they would work going forward. Senior Associate Laura Shelton shared her CQC views at her Care Show last year. The CQC had expressed concerns about how the new portal would work in practice and the potential for providers to simply flood the portal with paperwork that was not viable for them. It is entirely understandable that providers may feel the need to do this if they feel that they are not being listened to by the CQC, or that the focus is on finding negative points.

At this time, not all providers have access to the portal and functionality is limited. Ridouts is currently assisting providers in providing factually accurate comments on reports under the new regime. They are not given portal access, but simply a link to the draft report. This link does not allow you to upload attachments. Evidence supporting the submission will be sent via email, but we hope this is not an attempt to limit meaningful challenges, but rather a feature issue that will be fixed as the system develops. Additionally, if supporting documentation needs to be sent to her CQC outside of the portal, it would rather defeat the purpose of the portal as there would be one central location where all information is available to both parties. It will be. One provider shared that her CCTV with audio was installed in a common area and this proved invaluable in verifying the accuracy of her CQC reports.

In general, concerns arose about deploying the portal and understanding its functionality. CQC said providers will be able to view all information held by CQC. Because Caroline and Laura knew that discussions often took place with commissioners and third parties without a provider’s knowledge, especially if her CQC was considering taking action against a provider. , I had doubts about this reality. One provider noted that the portal controls regulated data and questioned whether a provider’s inability to use the system would be considered a violation. Everyone knows that changing his IT system at work can cause difficulties, but it takes time to implement and get used to an IT system. However, CQC was essentially asking providers to use the system without having access to check its functionality.

Laura Shelton highlighted that in her experience, the CQC has moved away from a collaborative approach with providers. This was supported by her experience with two providers. Both men were not allowed to email the inspector directly and were asked to email the CQC inquiry email address. CQC has introduced a large team, including assessors for off-site assessments and inspectors for on-site inspections. One provider felt that rather than having him as a single point of contact, a larger team might provide a fairer approach for providers. However, Laura stressed that from her own experience, under the new regime, no one was responsible for the problems. She explained that providers always deal with different members of her CQC.

Visitor regulations

Discussion moved to new visitor regulations that will come into effect on April 1, 2024. The regulations come as the coronavirus pandemic has resulted in some restrictions being placed on visits to care homes for good reason. Health care providers felt there was little need for new regulations, as they had facilitated and managed visits well throughout the COVID-19 period. Under regulation 10 of the Health and Social Care (Regulated Activities) Regulations 2014, it was emphasized that providers must always support service users to maintain connections with their local communities, but the new regulations , a “double offense” under Rule 9A and Rule 9A may occur. 10. Ms Caroline Barker pointed out that the guidance issued by her CQC on the new regulations was, of course, her CQC’s interpretation of the law itself. Her CQC consultation on the guidance asked readers to what extent they agreed or disagreed about whether the guidance covered a particular matter, rather than whether it was a fair interpretation of the law, and was very It was an interesting read.

In any work that Ridouts undertakes with providers, it is emphasized that it always brings the CQC back to the law and what that law requires. Laura Shelton summed up this sentiment nicely by questioning how we built a regulatory system where she has to say so much about making regulators comply with the law. .

It was great to share and exchange ideas. Ridouts would like to thank all providers who participated. I would like to know about your experience and whether it is the same or different from the above.

If you would like to find out more about Ridouts’ thoughts and views on the new CQC regime and wider sector issues, please visit our website www.ridout-law.com. You can also subscribe to our newsletter to receive news and commentary directly to your inbox at www.ridout-law.com/subscribe.