No more boots on the ground

As healthcare providers will be aware, the CQC is rolling out a new ‘Single Assessment Framework’. The practical details of how this will work are not entirely clear, and there is no doubt that CQC will need to refine its processes over the coming months.

What is clear, however, is that we are moving away from direct inspections and toward evidence gathering and reliance on third-party information. CQC has changed its process from ‘inspection’ to ‘assessment’, moving away from a ‘do the work on site’ approach.

Quality statements and evidence categories

CQC will replace the current ‘Key Questions’ with 34 ‘Quality Statements’ or QS. These QS relate to areas across five key questions: Safe, Effective, Responsive, Compassionate, and Appropriate Instruction.

To assess services against these QSs, CQC sets out six categories of evidence to assess, with each category of evidence scored from 1 to 4.

The six categories of evidence are:

1. People’s experiences with health and care services
2. Feedback from staff and leaders
3. Feedback from partners
4. observation
5. process
6. result

Observations are the fourth category of evidence in CQC’s new inspection regime and include both off-site and on-site observations.

It is clear from these categories of evidence that CQC is moving away from its traditional approach based on inspecting services in the field, with only one of the six categories being directly based on what CQC inspectors have observed in services. Only one. However, the “observational” evidence category includes off-site observations collected from local Healthwatch and other partners and through expert experience programs. Evidence from these other institutions Nursing care environmentwhich is in the “observation” category rather than the “feedback” category.

The other five categories of evidence all rely on nonobservational evidence.

As a result, it is expected that physical inspections of services will only occur if there are concerns or evidence collection can only be done on-site.

Impact on care homes

This new approach means care homes need to take a more proactive approach to CQC regulation. The provider will need to proactively provide evidence to her CQC on an ongoing basis, rather than responding to her CQC inspections carried out once every two or three years. The idea behind this is to enable the CQC to provide dynamic, up-to-date risk assessments and reassess service providers much more frequently than current inspection frameworks.

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