FAQs for care homes on new CQC inspections

I listened to a recent HSJ interactive webinar about CQC inspections in care homes, titled “Are you ready for the CQC?” on 31 Oct 13.

The speakers were:

  • Matt Tee, chief operating officer, NHS Confederation
  • Alex Baylis, head of better regulation, CQC
  • Jan Filochowski, chief executive, Great Ormond Street Hospital for Children Foundation Trust
  • Paul Ridout and Neil Grant, partners, Ridouts
  • Chaired by Nick Golding, HSJ news editor

8 hospitals have been visited so far. Here is a summary of how their discussion about the change in CQC approach applied to care home inspections ….. 

What is different about this CQC ?

  • Data-led, confidence in leadership to tackle their issues judged and affects ratings
  • The CQC owns the report and has the final say on its content
  • Essential Standards are going, new guidelines in December.
  • The inspection is about demonstrating improvement not just compliance.
  • CQC has greater enforcement powers.
  • A hospital cannot be an FT until it has had an inspection.
  • Larger inspections will provide more confidence in judgements. The teams will use evidence and data better.
  • CQC is advancing holding hands with Monitor and NTDA. Monitor will be a close partner if a hospital review demonstrates failings. CQC will use Monitor’s discretionary powers.

 Is the CQC learning from history ?

  • There is a learning workshop due before Xmas for 8 inspected trusts to reflect and review
  • The CQC expects a steady state from April 2014
  • The CQC is being more transparent in how inspectors are trained and how they are being told to write reports.
  • There is a stronger emphasis on standardisation across inspection teams – there will be an increase in the inspection team’s training to ensure quality and standardisation.
  • CQC is working with Kings Fund, Monitor and NTDA to give leaders guidelines on inspections. These include guidelines around measurement and judgements.
  • The CQC wants to be better at using data to inform judgements

But Care homes are different to the hospitals being visited in the pilot phase ?

  • CQC recognises that care homes are different environments to acute hospitals. It has a signposting document for care homes to engage them in applying the new standards. Guidance will be ready in October 2014 for care homes.
  • Outside hospitals data is poorer therefore it is important to engage care homes leaders in developing standards

Will our care home have time to prepare ?

  • Preparation is very important 
  • Staff need to be proud of their achievements from good preparation. Many improvements come about through preparation. A Care Home should feel comfortable in having an honest conversation with CQC about their strengths and weaknesses.
  • The CQCV does not want preparation to be bureaucratic
  • NHS Litigation Authority is a good model.

How much does this cost ?

What does regulation cost, is it value for money ? To be seen but it needs to demonstrate to the public that it is value for money.

How can our care home challenge the CQC

  • Care homes need to be engaged in compiling the report as it will stand as fact when signed off.
  • Care homes can now challenge judgements as well as evidence
  • There will be an appeal process. Applying learning from CSCI and Ofsted.
  • Large teams will add to credibility of judgements, rather than relying on a few individuals to form an opinion. Large teams can challenge each other before forming a view.

 How will other regulators be involved ?

Looking to improve co-ordinating with Healthwatch and Overview and Scrutiny Committees.

 Will the metrics be published

  • First set now published. Different to quality and risk profiles that were used in acute hospitals and which was not public information. CQC will make data public which means it needs to be communicated alongside judgements to give a balanced view. CQC hopes this is not viewed as a league table but improvement work in progress.
  • We are in an era of transparency, the public tends to find data less interesting when it is published eg surgeons performance data. Secrecy brings anxiety to the public

 Will patients and carers be able to give their opinions ?

  • The voice of the public is very important
  • However the CQC intends to tap into people who have had both good and bad care to get a balanced view. Testing a variety of methods to get a rounded input from patients and carers.
  • Wants to give a credible depth of analysis, for example evidence from a couple of disgruntled patients is not credible evidence of the public voice.

 What happens after an inspection ?

A Quality Summit will be held to apply next steps with stakeholders from around the community. First one for an acute trusts is due shortly in Croydon

 Final thoughts from panel

“NHS is unprepared for this regulation”.

“Encouraged”

“Need to demonstrate value for money”

“Feel positive in the hope for standardisation”

“Key is credibility in judgements”

 

Ref:  HSJ interactive webinar “Are you ready for the CQC?” on 31 Oct 13.