Welcome to the first Duffy & Shaw blog of 2024, and we hope everyone had a great Holiday and New Year.
The first CQC report under the new approach has been published…
As all providers will know, CQC continues to implement their new Assessment Framework across the country, with a view that this will be completed by the end of February 2024. CQC has published its first provider report under the new framework, and we have reviewed this to provide feedback and comments to providers as to what to expect and how this compares to old reports.
CQC told us providers would initially be assessed with some key ‘priority’ quality statements. CQC have not published their priority quality statements (which they said they would). However, this report, alongside updates from NCF provides some evidence that these may be the quality statements CQC may assess providers against in the first instance.
The assessed provider, Abigail Court (Domicillary Care) – Care Quality Commission, were assessed under the following Key Questions, Topic Areas and associated Quality Statements:
For this first assessment, 5 out of the 34 quality statements were chosen, only 15% of those available to CQC to assess against. You can see in the report that all 34 quality statements have been awarded a score, with 29 of the 34 quality statements scores based on previous inspection judgements.
Interestingly, no ‘Well Led’ or ‘Effective’ quality statements were assessed, and the majority (3 of the 5) were from the ‘Safe’ Question. Here at Duffy & Shaw, we can see why the Safe domain has three quality statements selected: Safe is inherently risky, and areas of non-compliance in Safe generally lead to increased risk of harm or actual harm experienced by people. However, we want to learn more from CQC about omitting a quality statement from Well-Led. The Well-Led domain is all about governance, learning, systems and leadership.
When things are going wrong in Well-Led, it can often lead to risks of poor care and breaches of the regulations, so it’s interesting that CQC did not select any quality statements from this key question.
Exploring the new style ‘assessments’ on the CQC website
In line with the new Single Assessment Framework, terminology has changed from an ‘inspection’ report (old reports) to an assessment. The ‘Overall’ section includes all of the ratings for the 5 key questions, and a paragraph on CQC’s ‘view of the service’, and ‘people’s experience of the service.’
The report identifies that the inspection lasted 6 days, with a day on-site. This may indicate the time the inspection team needed to get to grips with the new approach and also demonstrates that most of the assessment was spent by CQC analysing information supplied by the provider.
Each key question identifies the associated quality statements, and each has been assigned a score. Quality statements are scored at either 4, 3, 2, or 1, and these scores equate to:
The service scored 3 across the board, including:
- The 5 quality statements that were assessed, and
- Those that were not (i.e. those based on the service’s previous rating).
CQC aggregated the scores, leading to an overall percentage of 75/100 for each key question. That meant this service was rated Good in each key question and Good overall.
Each assessed quality statement included a summary (three short paragraphs) of the key points that led to the score.
Where a quality statement was not assessed, the report shows,
‘We did not look at this quality statement during this assessment. The score for this quality statement is based on the previous rating for this key question.’
Did CQC get to the heart of people’s experiences?
Our thoughts are somewhat in line with the elements they looked at. The overall ‘People’s experiences of this service’ section stated, ‘People told us they felt safe, knew staff well and felt confident to raise any concerns. People told us they were involved in planning their care and were asked for feedback regularly, and there is a focus on what people have told them within the individual quality statements assessed.
There are limitations to the report, which some people looking for information about a service may require when assessing the assessment accuracy, e.g. how many people or staff were able to share their experiences. It is important to be able to make our own judgements about the robustness of the evidence, and the assessment does not allow for this.
Regarding CQC’s aim of ‘Smarter Regulation’, it’s too soon to assess their success. The assessment is certainly easier to read. It’s much shorter, accessible and provides a succinct summary of the key points (and scores), people, families, commissioners and others may need to make informed decisions about care services. Handy, too, is the move to HTML, making reading reports much more accessible on phones, tablets, etc.
What next for CQC and the Assessment Framework?
In terms of rollout, services in the South, London, and East are now live with the single assessment framework; services in the Midlands and North expect to go live later in January and early February 2024, and registration changes/new registration applications will start to be assessed under the new system by the end of February 2024.
CQC will contact registered managers and nominated individuals to confirm when they have moved to the single assessment framework. Don’t expect there to be an immediate ‘knock at the door’ when they go live, but when CQC decides to assess your service, the assessment will be conducted under the new approach.
The new Provider Portal also continues to be rolled out. We suggest you ensure CQC has the correct contact details for your nominated individual as they will be emailed with the organisation’s invitation to join the portal.
We’re here to support you…
If you need help getting ready for the new assessment framework and upcoming inspection, we’re here to offer the support you need.
Our webinar, Preparing For The New Inspection Framework (written by an ex-CQC inspector), provides you with all the information you need to prepare.
We also provide coaching and mentoring for registered managers.