Advice
[ May 7, 2021 by Susan Newton 0 Comments ]

How to Ensure Your Service is Compliant with the CQC

If you are a health or social care provider, ensuring your service is compliant with the Care Quality Commission (CQC) is an important part of the job.

The CQC is the independent regulator of all health and social care in England. They monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety.

As a provider, you must ensure that you service remains compliant with the CQC, by following their standards and frameworks.


What Are the CQC Standards and Frameworks?


Key Lines of Enquiry

The Key Lines of Enquiry (KLOEs) are the five questions the CQC always ask care providers. They create a framework for CQC inspectors to help focus on the issues that matter to people.

The five questions are:

  1. Are they safe?
  2. Are they effective?
  3. Are they caring?
  4. Are they responsive to people’s needs?
  5. Are they well-led?


CQC Fundamental Standards


The Fundamental Standards are standards below which your care must never fall.

Everyone has the right to expect the following standards:

  • Person-centred care
  • Dignity and respect
  • Consent
  • Safety
  • Safeguarding from abuse
  • Food and drink
  • Premises and equipment
  • Complaints
  • Good governance
  • Staffing
  • Fit and proper staff
  • Duty of candour
  • Display of ratings


Prepare for Your Inspection


Inspections carried out by the CQC are usually unannounced, so it is good practice for your provider to be prepared for them.

The focus of CQC inspections are the experiences people have when they receive care and the impact the care has on their health and wellbeing. Judgements are made against regulations and informed by these experiences.

The best way to prepare for an actual CQC inspection is to organise a mock inspection with our team. Mock CQC inspections are a useful tool to help identify, analyse and record areas of good practices and non-complying practices within regulated care settings.



Staff Training


Staff training is a vital aspect of ensuring your service remains compliant with the CQC. Regulation 8 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, ensures that providers employ enough suitably qualified and competent staff to carry out regulatory requirements.

You must ensure that you have an induction programme preparing your staff for their role, involving the appropriate training, professional development and support. If you do not meet these requirements, the CQC may refuse registration if they cannot be satisfied that your provider will continue to comply with this regulation.

To find out more about how CQC Compliance can help your provider remain compliant with the CQC, contact us today.

Advice
[ April 26, 2021 by Admin_M 0 Comments ]

How Can Care Homes Evidence Outstanding Outcomes When Supporting People that Live with Dementia?

By Louise Morris, Head of Care Quality


Having worked alongside dementia care services for several years, I understand the importance of supporting people living with dementia and their families, as well as how a provider should evidence outstanding outcomes regarding the CQC.

Dementia is not a single disease, but a collective term used to describe a decline in memory or brain function that impacts on the person’s daily life.

A person living with dementia may need specialist care, especially as their condition progresses. In many cases, the person might need to move into a care home where their needs will be met more efficiently. When choosing a care home, the latest CQC report is often referred to as an indicator of how well the home is performing and any other areas of concern, therefore it is critical for Care Home providers to showcase their work at inspection.

I started as a Care Assistant in a Residential Care Home when I was a student nurse from 1999-2002. Some of the clients I cared for were living with dementia and I started to learn how to provide outstanding care. Early in my career, it became clear to me how care home providers can influence the experience of living with dementia and how this in turn can affect outcomes and CQC ratings.

From 2015-2020, I supported specialised Dementia Care Homes with quality, compliance and training. This was a particularly important period of my career as I used my working knowledge to coach providers to showcase outstanding outcomes and care in relation to people living with dementia.

Personally, I find working with clients who are living with dementia to be both challenging and very rewarding, but it is not for everyone. Care Homes that use values-based recruitment processes and can evidence resident participation in the selection processes are more likely to achieve good or outstanding ratings.


Help with Daily Activities


Thankfully, gone are the days where care homes used to have a “bath book” and each resident was allotted a specific day for bathing. However, as a care home manager, the subject of assisting with personal hygiene for people living with dementia can be complex. How do you make sure you are meeting everyone’s needs while still offering choice and evidencing the support that you are providing?

A lot of the time, there is no one-size-fits-all response when it comes to care, however each person’s care plan should be reflective of how they are assessed, what support (if any) is needed, how this will be recorded and how often the care plan needs evaluating. Assisting with personal hygiene is a very private activity, so Care Assistants must be sensitive and respectful when carrying out any level of support, including just prompting. Some people living with dementia may choose not to carry out personal hygiene activities and that decision needs to be considered in line with their capacity. Any best interest decisions should be clearly documented, following the providers Consent policy.

Some people living with dementia will also require assistance at mealtimes, since they may not realise that they are thirsty or hungry on their own. Some may respond better to finger food or snacks than sitting down for a meal. Meal and snack choices should be evidenced in care documentation where there are issues with malnutrition, but every person within a care home does not require food monitoring charts.

If a change to the environment is made, people should be monitored carefully for any distress reactions, such as restlessness, agitation and/or irritability. Monitoring frequency and potential triggers is expected, and outcomes should be recorded in care plans.


Social Activities


In my time supporting in dementia care homes, I have witnessed outstanding activities such as miniature horses visiting the residents, cheese and wine tasting and some amazing talent competitions.

Creating opportunities for social engagements for people to enjoy is one of the most important things a care home can do. Activities such as outings, games or a special dining experience can help reduce loneliness and improve self-esteem.

Activities don’t always have to be in groups, however meaningful activities should always be based on the person’s preference. Some individual activities can include:

  • Knitting
  • Cooking
  • Doll therapy
  • Reminiscence work
  • Exercise
  • Reading
  • Music
  • Pet therapy

Homes that achieve good or outstanding tend to have full activities calendars that evidence what is planned across the month. Any activities offered and engagement levels evidenced in each individuals’ care documentation is very good practice.

For more advice about achieving outstanding outcomes for your care home provider, contact us today.

Advice
[ March 19, 2021 by Susan Newton 0 Comments ]

Why Is Quality Assurance Training Important?

Quality Assurance (QA) training is vital for supporting the delivery of high-quality care services. QA is focused on measuring and reviewing the quality of the services that health and social care providers offer, particularly across their whole organisation. QA will finetune recruitment, help to drive change and enable issues to be solved easily.

At CQC Compliance Ltd, we can offer help and support for health and social care providers to advise the best way to carry out quality assurance evaluations and ensure their service is CQC compliant.

How can CQC Compliance Ltd help you?

CQC Compliance Ltd will help you to evaluate your service’s quality assurance.

Using our help and support you will learn which areas of your service to audit and monitor, how to regularly monitor your success in meeting care standards and analysing the results of your audit.

You will also learn how to:

  • Recognise opportunities to improve and develop quality and delivering of services.
  • Design your own plan and tools.
  • Ensure policies and procedures are in place and meet both CQC and legal standards/requirements.
  • Manage and action any improvements needed.
  • Ensure a thorough recruitment process including DBS checks, identification processes and checking an individual’s barred list with the ISA.
  • Maintain high care standards through the monitoring and appraisal of staff.

Mock Inspections

Mock inspections help to provide the tools to assist with meeting the CQC’s requirements for quality assurance.

At CQC Compliance Ltd, we offer mock inspections to help you prepare for the real ones that are conducted by the CQC itself. The inspection will be undertaken by one of our experts, including our very own ex-CQC inspector, who has the experience and knowledge to correctly identify any pitfalls that may be uncovered by the CQC. With an onsite visit, we can identify potential regulation breaches and any other areas of improvement.

Our support includes:

  • A full compliance audit covering the five SCREW questions (Is your service Safe, Caring, Responsive, Effective and Well-Led?) that form the basis of your CQC rating.
  • A report produced following the mock inspection which will identify any potential breaches, areas for improvement and an action plan.
  • A comprehensive series of audits, interviews and checks carried out by a compliance expert.

Compliance Audits

Compliance audits are a comprehensive assessment that is carried out by a member of our team, to examine the current procedures of your service. At CQC Compliance Ltd, our team of experts will work in conjunction with you as provider to ensure that essential compliance and quality assurance standards are met.

We will produce an action plan of developments that can be made to help improve your rating with the CQC. At CQC Compliance Ltd, we tailor our audit visits to your specific requirements and guarantee our support throughout the process.

To find out more about how we can help you to receive personalised quality assurance training, contact us here.

Advice
[ March 11, 2021 by Susan Newton 0 Comments ]

Importance of Ongoing Compliance

Ongoing compliance is essential for health and social care providers to remain compliant with the Care Quality Commission (CQC) and continue to excel within the sector.

We do understand that keeping up to date with changing regulations is extremely time-consuming, particularly when trying to maintain a high standard of care for your provider.

At CQC Compliance Ltd, our team of experts can help you with your ongoing compliance, providing services that are bespoke to you and your provider.

We offer a multitude of services including regular mock CQC inspections, business and marketing guidance, compliance audits, recruitment support as well as 24/7 telephone and email support.

All of these components are essential for a successful CQC registration as a new provider and ongoing compliance as an experienced one.

Training

Ongoing support and training are important for new team members within any care environment. However, this is not always accurately delivered. Training should be about boosting knowledge and performance of staff members, not as a mere box-ticking exercise.

It may seem quite easy to neglect team members in senior roles, particularly if they are doing a good job. However, this can lead to problems and those senior team members may feel unable to ask any questions. Implementing a sound coaching and mentoring programme can mean your team will benefit from ongoing improvement and will feel they have a safe space to address any concerns. Above all, great quality training improves colleague retention, which is invaluable from a compliance point of view.

Mock CQC Inspections

Mock inspections are a crucial aspect of ensuring your health or social care provider remains compliant with the CQC.

The best way to prepare for an actual CQC inspection is to organise a mock inspection with our team. Our inspections are designed to mock replicate the actual process, including interviews, a comprehensive series of audits and checks and identifying potential regulation breaches.

Our audits will include the five SCREW questions, examined by CQC inspectors. These question if your provider is:

  • Safe?
  • Caring?
  • Responsive?
  • Effective?
  • Well-led?

HR Support

Using effective HR is vital in any business. At CQC Compliance Ltd, we can support you in several areas of HR, whether it’s the day-to-day support or in guiding you through more challenging and complex employment issues. Our specialist team are proficient in health and social care HR, with years of experience within the sector. We will get to know your business and the issues you may be facing, ensuring issues are dealt with and risk is minimised for your provider’s future. We can help you keep up to date with changes in Employment Law and ensure that your documents, policies and procedures are fully compliant.

Our support will minimise the workload of your business, so that you can focus on running a successful provider. Whatever the issue, our expert HR team have extensive experience within the industry and will be able to resolve any concern you may have.

To find out more about our ongoing compliance support, visit our dedicated page here.

Advice
[ March 3, 2021 by Susan Newton 0 Comments ]

What To Do When Your CQC Registration Has Been Refused

To set up your own health or social care provider, such as a care home or domiciliary care agency, you must first register with the Care Quality Commission (CQC).

However, it is important to note that there are times when registrations are refused.

When so much depends on having your new venture – or additional care home – registered with the CQC, having your application denied can seem like a disaster.

There are a number of reasons why CQC applications are refused, and most of them are relatively straightforward to tackle.

Missing or Incorrect Data

Sometimes, a CQC application fails to get passed the initial screening phase, before the crucial quality assessment takes place.

When you send in your paperwork, within five days of receipt, the CQC puts your application through a process of validation. This involves checking that all the essential data has been provided, before it is sent to a CQC inspector. If you miss anything out, or there are discrepancies in the information you provide, then the application is refused.

Just to be clear. This is not the CQC rejecting your registration. They are simply indicating that something is wrong or missing.

What Happens Next?

Usually, the CQC returns your application with relevant forms and guides, which clarify what you need to do to ensure your application is successfully validated the next time.

However, what happens if you are not sure what you need to do to resubmit your CQC application correctly? The team at CQC Compliance Ltd can help you to make sure that your paperwork is correct and appropriate to resubmit to the CQC.

We can offer on-going support, to help you to prepare for the next step. This will be an assessment by a CQC inspector. The timing of this visit depends on finding a slot that suits the inspector and your nominated manager that they will be interviewing.

If you have had a registration refused, our involvement makes your compliance with CQC standards more assured.

Can the Application Still Fail?

Once you’ve got your CQC application passed the validation stage, and your assessment takes place, you should receive confirmation of CQC registration promptly.

However, if the inspector is not satisfied with some aspects of your organisation, your registration can still be refused. This could be down to a number of issues, for example, problems with your policies and procedures or your medicines management and staffing levels. If this does happen, you could face a Notice of Proposal to Refuse (NoP).

Receiving a NoP is a more complex issue. If you receive one, it will explain why your registration was unsatisfactory, with a clear outline of the reasons. You then have 28 days to make applications to the CQC about the notice.

The CQC must consider any representations before they come to a decision. If the CQC decide to refuse an application, they will serve a ‘Notice of Decision’ and the applicant is given a further 28 days to appeal against the decision.

For more information about how CQC Compliance Ltd can help you with a failed CQC registration, contact us today.

Advice
[ February 23, 2021 by Susan Newton 0 Comments ]

What Do CQC Inspections Entail?

When establishing a health or social care provider, one of the most stressful things you have to deal with is CQC inspections.

The purpose of CQC inspections is to ensure that service-users are cared for in an effective and dignified way, whilst also supporting those offering care.

CQC inspections are almost always unannounced, which can make them even more stressful if you are ill-prepared. However, they are conducted to ensure that your institution is operating in compliance with the law, not to catch people out. The best way to prepare, is to book a mock CQC inspection with our team, which will go through the process of the actual inspection, as well as producing you a report and improvements for the real thing.

In the meantime, it is important to understand what CQC inspections entail.

The Start of the Visit

At the start of every CQC inspection, the inspection team usually meets with the senior staff and they explain:

• Who the inspection team are
• The purpose and scope of the inspection
• How they will communicate the findings

Inspections of GP practices, GP out-of-hours services and acute hospitals begin with a presentation by the care provider, giving their own view of their performance.

Gathering Evidence

During these visits, inspectors focus on the experience your patients get and the impact that has on their health and wellbeing. The inspection is mainly based on the five Key Lines of Enquiry which aim to prove whether your service is safe, caring, effective, responsive and well-led. To do that, they will speak to patients, staff, family members and members of the patient participation group.

Inspectors will also observe how the staff interacts with the patients to see how well the service responds to the patients’ needs. As most CQC visits are unannounced, you will not be required to provide any paperwork prior to the inspection, but they might ask for it during or after, so always have it ready.

It is important to note that there are two types of inspections:

Comprehensive Inspection

Comprehensive inspections take an in-depth view of the entire service, addressing all of the five Key Lines of Enquiry. The inspection takes a day or two to complete, after which you are given a rating. If the inspectors believe there is a risk to the patients’ safety and wellbeing, that could negatively affect your overall rating.

Focused Inspection

Focused inspections are often conducted as a follow up to a previous visit and are therefore more targeted. Inspectors do not look at all five Key Lines of Enquiry, but rather one well-led key question. That said, they can expand it to a comprehensive inspection if new concerns arise.

The best way to get through any CQC inspection is to make sure that you are well prepared. At CQC Compliance Ltd, we can help you conduct a mock CQC inspection to ensure that you are ready for your inspection and any issues are identified and dealt with beforehand. Contact us today for more information.

Advice
[ February 18, 2021 by Susan Newton 0 Comments ]

What to Do If Your Service Has Been Given an Enforcement Action

Every care service sets out striving to offer the best service possible. But, sometimes, standards can slip without anyone realising. This can be due to a number of factors. Whatever the cause, it is important those issues are rectified.

An enforcement action can be a daunting prospect, but CQC Compliance are on hand to help you navigate the process.

What Is an Enforcement Action?

An enforcement action is an official notice of required action, filed by the CQC (Care Quality Commission). This is generally as a result of a CQC inspection.

In a nutshell, it means deviations have been found from established care standards, and your service is on notice to rectify them before further action or penalties result.

The action the CQC takes will be proportionate to the impact that the breach has on the people who use the service and how serious it is.

It is important to note that you must not be complacent if you have received an enforcement action, as the CQC is using its powers to de-register “failing” organisations who do not adequately respond to their requirements.

What Should You Do About It?

At CQC Compliance Ltd, we can help you to better understand the nature of your enforcement notice, and then advise you on the best ways to rectify the highlighted issues.

We can help you through a series of practical steps to ensure your organisation is brought back up to a high standard.

Our support varies based on your needs as a business. We can help you with anything from giving you advice on best practice to deal with a specific issue, through to staging a mock CQC inspection to ensure you will be able to pass. Our service is designed to help you understand where standards have slipped, why it has happened, and exactly what you can do to rectify the issue.

Using the expertise and knowledge of our team, you can find your way back to providing truly outstanding service every day.


Representations


If the CQC decide to issue a warning notice, a registered person will have 10 working days to make a written representation to us.

The process for making representations regarding warning notices are different to that of other types of enforcement action. For instance, there is no right of appeal to the First-Tier Tribunal against a warning notice, you can only make representations to the CQC.

To find out more, visit the CQC’s website here.

Have You Been Served an Enforcement Notice?

If you have been served an enforcement notice, or you would like to make sure your organisation is going to pass an upcoming inspection, CQC Compliance Ltd can help you. Our dedicated team of professionals have an extensive understanding of CQC procedures and guidelines and can provide you with practical and effective advice.

Contact CQC Compliance Ltd today for more information.

Advice
[ February 9, 2021 by Susan Newton 0 Comments ]

Challenging Your CQC Inspection Draft Report

As the CQC is a public body, it must be able to show that its decisions and inspections are lawful and have followed the correct procedures. This is why the factual accuracy check was introduced for any provider to have a final say before inspection reports are released.

The factual accuracy check deals allow health and social care providers to challenge areas of a draft CQC report that they believe is wrong or incomplete. This is an important phase as it enables the providers to rectify the contentious points before the report goes public. It also means that it is very difficult for providers to subsequently challenge reports once they have been published.

The CQC state that: “the factual accuracy process gives inspectors and providers the opportunity to ensure that they see and consider all relevant information that will form the basis of CQC’s judgements.”


What Is the Timeline from Receiving the Factual Accuracy Draft Report?


When issuing a draft report, providers will receive an email from the CQC that states they have 10 working days from the date of the email to submit their challenge. This includes the points you wish to make and any extra supporting information that you think is essential “to influence the content the report and/or judgements.”



What Is the Problem?


Many providers have claimed that the email from the CQC has been dated one or more days before it is actually sent. This means that many providers have been advised that their deadline is actually a lot earlier than it really is.

It is assumed that the CQC are generating their letters and dating them with the presumption the email will be sent on the same day.

However, some inspectors have been asking providers for factual accuracy challenges before the 10 working days are up. This has meant many providers have felt they are out of time for their challenge submission and have had their reports published despite not being finalised through the process.


What Should You Do as a Provider?


As a provider, it is important that you calculate the correct deadline from the date you receive the draft report by email.

If your covering letter is a different date to your report, it is advisable that you contact the CQC for written confirmation of your deadline.

This ensures that you have enough time to challenge the draft report before it is published and can benefit from the full 10 working day period.


How Do I Challenge the Factual Accuracy Report?


If you are unhappy with your factual accuracy report and its ratings, is important that you utilise this process.

To challenge, you must ensure that you have solid grounds to do so. You must also ensure that your challenge is laid out clearly and concisely with robust evidence to support your claims.

If you have received a draft inspection and want to make a factual accuracy challenge, contact us today and our team of specialists can advise you of the next steps.

Advice
[ February 2, 2021 by Susan Newton 0 Comments ]

What Do CQC Inspectors Look For?

If you have a health and social care provider, it is highly likely that you will be inspected by the Care Quality Commission (CQC).

The purpose of CQC inspections is to ensure that service-users are cared for in an effective and dignified way, whilst also supporting those offering care.

During these visits, CQC inspectors ask five questions (Is your service Safe, Caring, Responsive, Effective and Well-Led?) that form the basis of your CQC rating.

Is your provider safe?

The safety of your service user should always be your top priority. CQC inspectors will want to know that you protect your service-users from abuse or any form of avoidable harm. They will therefore look at the cleanliness and hygiene of your provider and all the equipment. They will also enquire about how many trained staff members are on duty and their ability to cater to your service-users’ needs.

Is your provider effective?

Being an effective provider is of utmost importance within the health and social care sector. To prove that your support, care, and treatment have a good outcome, CQC inspectors will look at how service-users are treated.

For example, if you operate a care home, the CQC inspectors will look for factors such as:

•  How the patients are fed.
•  If family members are consulted on care decisions.
•  If the staff know every patient’s health needs and personal preferences.
•  If the staff has the knowledge and skills to offer these services.

Is your provider caring?

CQC inspectors expect private clinics and home care service providers to treat all their patients with compassion, dignity, kindness, and respect. During an inspection, the CQC inspectors will look into how you take care of your service users’ needs. These can be based on their differences, including disabilities, gender, age and religion.

Is your provider responsive to people’s needs?

Your services should be organised to ensure that all service user’s needs are met. This includes their physical, mental, and psychological needs.

CQC inspection reports are also made up of direct observation of people’s experience of the care being given, as well as conversations with caregiving teams and families of those living in a care environment. As this is the case, CQC inspectors may interview these service users to find out how well they are taken care of.

Is your provider well-led?

High quality leadership and governance are essential in the health and social care industry as it often translates into high quality care for service users. Therefore, it is essential for health and social care providers to have a Registered Manager who oversees all operations, which is something CQC inspectors will be looking for on their visits.

If you are unsure about the role of the Registered Manager within your provider, you can read the CQC guidelines to help Registered Managers and teams understand their responsibilities.

To ensure you are delivering high quality care, you must ensure that you are always prepared for your CQC inspection, particularly are they are unannounced. The best way to prepare for an actual CQC inspection is to organise a mock inspection with our team. Mock CQC inspections are a useful tool to help identify, analyse and record areas of good practices and non-complying practices within regulated care settings.

Get in touch with the CQC Compliance team to discuss your specific requirements and to arrange your mock CQC inspection.

Advice
[ January 26, 2021 by Susan Newton 0 Comments ]

How to Prepare for a CQC Inspection

The purpose of CQC inspections is to ensure that service-users are cared for in an effective and dignified way, whilst also supporting those offering care.

CQC inspections aren’t designed to catch people out, or to “name and shame” they’re designed to offer concrete suggestions for improvement, as well as to showcase what a provider has done well. The role of CQC is to help everyone have the best possible experience of care.

CQC inspection reports are made up of direct observation of people’s experience of the care being given, as well as conversations with caregiving teams and families of those living in a care environment.


How Can You Prepare for A CQC Inspection?


Although CQC visits are unannounced, there are various ways you can make sure you’re prepared for your inspection and be certain that you’re delivering care to the very best standard.

The best way to prepare for an actual CQC inspection is to organise a mock inspection with our team. Mock CQC inspections are a useful tool to help identify, analyse and record areas of good practices and non-complying practices within regulated care settings.


What Does a Mock CQC Inspection Involve?


Our Inspection Support includes:

  • A comprehensive series of audits, interviews and checks carried out by a compliance expert.
  • A full compliance audit covering the five SCREW questions (Is your service Safe, Caring, Responsive, Effective and Well-Led?) that form the basis of your CQC rating.
  • A report produced following the mock inspection which will identify any potential breaches, areas for improvement and an action plan.

By following the same guidelines and principles of the CQC, detailed feedback can be generated to outline key findings from the mock inspection. They can also help you to attain the rating you deserve.

The inspection will be carried out using a suite of five Key Lines of Enquiry (KLOE) principles which can be bespoke to your care service provider.


Other ways to help you prepare are:

• Read CQC guidelines to help Registered Managers and teams understand their responsibilities.
• Review any reports from previous inspections to be sure that areas for improvement have been actioned.
• Review the reports of similar service providers to understand what best practice looks like.
• Review your appraisal, training, and meeting programmes to be sure you’re offering the best support and development to every member of your team.
• Have the outcome for those needing care and support at the forefront of your reviews.
• Develop documentation, review and reporting systems that are easy to use and easy to action. All managers should be able to access these documents.
• Have regular conversations with your team about compliance and confidence.

A simple checklist and a solid understanding of the CQC inspections can help to provide consistent high-quality care.

We want to work with you to ensure you receive a personalised service that suits your needs. Get in touch to discuss your specific requirements and to arrange your mock CQC inspection.