Having previously been inspected myself as a director of adult social services, I understand just how daunting regulatory inspection can feel. For providers, this can be heightened by the reality of unannounced or short notice visits and the pressure of preparing at pace. Yet when approached effectively, inspection offers an important opportunity to reflect on practice, demonstrate excellence and strengthen outcomes for people who use services.
Adult social care is distinctive in both the breadth and complexity of the needs it supports, often touching every aspect of a person’s life. For inspectors, the focus is not simply on compliance, but on understanding what services do well, how they learn and improve and most importantly, the difference they make to people’s lives.
In recent months, I have led conferences across the country with our adult social care inspection workforce, setting a clear expectation that inspectors should spend a large majority of their time observing practice and understanding the impact on people’s lives, supported by a more targeted review of records. We must also be proportionate in our actions and true to our commitments to both the public and providers, encouraging innovation and improvement by building strong, trusted relationships and making intelligent use of data and insight. This approach reflects the expectations set out in our published commitments. It was clear to me that this is what our inspectors want to do.
Communication is key
There are a number of ways providers can prepare well for inspection, but the consistent theme for success is effective communication – at the outset, throughout the process and at its conclusion. Inspection should be approached as a partnership, with inspection teams being transparent about their approach, clear about their expectations and attentive to the perspectives of staff, the people using the services, and those important to them.
Preparing staff well
One of the most effective ways providers can prepare for inspection is by ensuring staff feel confident and supported to speak openly with inspectors about their work. When we have met with care workers to discuss inspection their messages were clear: they want to be involved and informed in preparing for inspection, and they want leadership cultures that actively encourage sharing what they do well. Where fear of inspection persists, it can negatively affect both care provision and what inspectors observe.
Care workers should feel able to describe the impact their support has on people’s lives and how this enables positive outcomes. Inspectors are seeking an authentic understanding of day-to-day practice, including how well staff know the people they support, how services learn and adapt and how learning from experience leads to improved outcomes. It is within these reflective, open environments that ‘outstanding’ care cultures are most often recognised.
This approach was demonstrated particularly well by GoodOaks Homecare, a homecare agency in Surrey supporting younger and older adults, as well as people with mental health conditions, physical disabilities and sensory impairments. At its first inspection, the service achieved outstanding ratings in the key questions looking at how caring and well-led services are. Inspectors observed a culture shaped by visible, approachable leadership, where staff felt valued and confident, and where genuinely knowing people and putting them first led to compassionate, responsive care and strong partnership working.
Strengthening relationships
Looking ahead, I am committed to continuing the conversation about how we, as a regulator, can improve the inspection process for providers. This means working in partnership to identify and share best practice seen through inspection, and supporting services to respond proactively when issues arise, in a way that is proportionate and focused on improvement.
By maintaining an open dialogue and learning together, inspection can be a powerful driver of better experiences and outcomes for people who rely on adult social care. I would encourage providers to explore our guidance on getting the most out of inspection, as a practical starting point for engaging positively with the inspection process.
How does your organisation prepare for inspection? Visit the CMM website and comment on this column or join the conversation to share your thoughts.
Chris Badger is Chief Inspector of Adult Social Care and Integrated Care at CQC.
Email: [email protected] LinkedIn: @Care-Quality-Commission