How can providers prepare for CQC’s new assessment framework?
Key questions and quality statements
Under the CQC’s new assessment framework, the Key Lines of Enquiry (KLOEs) have been replaced by a set of key questions and subsequent quality statements. The new key questions will be centred around the familiar ‘Safe’, ‘Effective’, ‘Caring’, ‘Responsive’ and ‘Well-led’ criteria, while a host of new quality statements that relate to applicable legislation will sit under each key question. According to the CQC, the new quality statements are the commitments that providers should live up to. The CQC will define each quality statement using a ‘We statement’, which summarises for providers what is needed to deliver high-quality, person-centred care.
Informed decision-making
The CQC has developed its new quality statements using aspects of the Making It Real framework. This is an initiative that has been co-produced by Think Local Act Personal (TLAP), which worked with a range of partners and people with lived experience of using health and care services. Alongside the aforementioned ‘We statements’, which providers will be encouraged to align their practices with, a series of ‘I statements’ have also been created (and also linked to the new quality statements) as part of the regulator’s commitment to listening to and acting on what matters to the people who are experiencing services. A provider’s compliance with the ‘I statements’ will be measured using evidence provided in focus groups, interviews and case tracking, the regulator has expressed.
Evidence categories
The onus on providers to evidence quality care remains a fundamental aspect of the CQC’s new assessment framework. The regulator has outlined six categories of evidence that will be examined to make judgements and contribute to the determination of providers’ overall ratings. In addition, the CQC has stated that it will inform providers of the particular evidence categories that will be focused on when assessing a particular quality statement, including some examples of the types of evidence in question. The CQC’s new evidence categories are ‘people’s experience of health and care services’, ‘feedback from staff and leaders’, ‘feedback from partners’, ‘observation’, ‘processes’ and ‘outcomes’.
Other key differences
The regulator has summarised other key differences from its current model of assessment for the benefit of providers. Firstly, the CQC has highlighted how it will place less emphasis on using inspections as the primary way of gathering evidence. Instead, it will collect evidence at different times and through different channels, such as talking to the people who are receiving care services.
Secondly, the CQC has revealed that it will no longer use the rating of a service as the main determination of when it next needs to assess. Evidence the CQC collects or information it receives at any time may trigger an assessment. Lastly, the regulator has shared how it will make judgements about quality more regularly, instead of only after an inspection as it does currently. The CQC will use evidence from a variety of sources and look at any number of quality statements to determine this. Its assessments will be more structured and transparent, the regulator continues, using evidence categories and giving a score for what it finds.
As we prepare for the delayed implementation of the CQC’s new assessment framework, some may struggle to see how the jigsaw pieces we are being drip fed will fit together and question whether to wait for the picture to be completed or start preparing now. My advice is preparation is always key to avoidance of failure. In your preparation, it will be vital that you remain up to date with all publications presented by the CQC by subscribing to its newsletters and updates service. Remember that the CQC is the driving force behind all the changes and not the speculators or spectators. The new provider portal is being introduced in stages, with a pilot programme already underway and the rollout will continue until March 2024. You should ensure that the CQC has your up-to-date contact details to ensure receipt of your invitation to use the portal. Be sure to continue improving and maintaining the highest possible standards of care using the methodology and tools that you already have available to you. Remembering that ‘good’ quality care is just that, irrespective of any changes to evaluation processes and functions. Under the new regulatory approach, the five key lines of enquiry (KLOEs) will remain so, but it will be key to consider the published changes we know to expect, such as the new ‘quality statements’ which are aligned to the KLOEs. Take time now in your preparation to map and gap any potential shortfalls in your governance and audit systems and processes. Identify the areas of change to understand what evidence will fit where and where there may be more focus than previously. Whilst these changes may be overwhelming, taking small steps now to develop your understanding of the revisions to scoring and rating frequency etc. will be key to your ongoing success. Linkedin: www.linkedin.com/in/robbaillie Email: [email protected] It’s early October at the time of writing and we’re still not entirely sure on how the new CQC inspection regime is going to work. We’re being drip fed information on timings, quality statements and evidence categories and, whilst it’s helpful to see what sort of information CQC will need to see from providers to measure each quality statement, drilling down into the detail remains a bit challenging. There are six evidence categories: Evidence in one or more of these categories might be needed by CQC to answer a quality statement. Added to that, depending on which sector you operate in, slightly different evidence categories might come into play. Take, for example, the care home and supported living services sector. Under the ‘Safe’ domain, there is a quality statement on learning culture.The evidence categories that come into play here are: The provider is then scored on that evidence to answer the quality statement. The points system ranges from one to four (significant shortfalls, some shortfalls, a good standard and an exceptional standard). That score is then added to your scores in all the other quality statements in ‘Safe’, to give you an overall percentage for ‘Safe’, which dictates your rating. 25 to 38% = inadequate. 39 to 62% = requires improvement. 63 to 87% = good. Over 87% = outstanding. So, each quality statement is answered by way of evidence in different categories, which is scored, and then fed into an overall score. Points mean prizes so get your evidence sorted and you’re half way to a decent rating. X @PhilippaDoyle1 Email: [email protected] Rob Baillie, Founder and Managing Director, Care Quality Solutions
Philippa Doyle, Partner and Head of Social Care, Hempsons