The CQC signalled it intends to go ahead with reforms to the way it inspects care services this week
The Care Quality Commission is to move forward with planned changes to the way it inspects services after it’s ‘Better regulation, better care ‘ consultation showed “extremely positive” feedback for its proposals, it said in an announcement this week.
The watchdog is now seeking views on its four draft assessment frameworks setting out its separate approach to inspecting adult social care, mental health care, primary care and community services and secondary and specialist care (hospitals).
The draft frameworks have been developed by the chief inspectors for each area, based on ‘extensive feedback’ from ‘ internal and external engagement and consultation work over the last year, as well as the recommendations from the independent reviews carried out by Dr Penny Dash, Professor Sir Mike Richards and the Care Provider Alliance’ the Inspectorate said.
Here’s everything adult social care providers need to know about the reform of adult social care inspections so far:
What changes have been proposed?
Separate frameworks are being re-introduced following strong lobbying from across the sectors involved, including adult social care (the watchdog said the vast majority (95 per cent) of those who responded to its consultation backed the move.
The watchdog is also set to change its methods for inspection, assessing and awarding ratings to health and care providers’ services, including removing the use of scoring and re-introducing rating characteristics within each sector-specific framework, replacing quality statements with a ‘set of new supporting key lines of enquiry’ to ‘clearly indicate’ areas inspected during visits.
It also said Its new approach aims to strengthen equality and human rights, improve the timeliness and reliability of its work, enhance data systems, support more consistent inspector judgements, and boost collaboration with providers, based on consultation feedback.
What will happen next?
The watchdog will now ask adult social care providers for feedback on their proposed framework for the sector, through feedback tools, meetings, events and other engagement activities – leading to its ‘development and refinement.’
It also said it plans to pilot its new approach later in the year.
How has the sector reacted to the proposed changes?
There is strong support for the reintroduction of the separate framework and changes to the way ratings are applied, although a slightly smaller proportion backed the latter, according to the consultation summary.
However, it added that there are several risks to the reforms’ success, such as a ‘pervasive and deeply felt’ lack of trust in the CQC among providers, the authors of the consultation summary report said.
This means that ‘several strategic risks could undermine the reforms regardless of how well individual elements are designed,’ the report added.
It concluded that the response shows the sector ‘wants CQC to succeed’ but warned it will fail if reforms are not adequately piloted, it doesn’t fix technological barriers, it ignores systemic constraints on providers out of their control such as underfunding and workforce challenges, and does not ultimately bring ‘substantive improvement.’
Care England chief executive Professor Martin Green OBE said he welcomed “sensible steps” such as the reintroduction of separate frameworks and “clearer lines of inquiry’”but added the replacement of scoring “is a concern.”
“It risks creating a system where ratings are less stable and harder to compare, with greater reliance on individual judgement. That makes it more difficult for providers to understand what sits behind a rating and how decisions are being made.
“If CQC is placing greater weight on professional judgement, it must be clear how that judgement is applied in practice. Providers need confidence that ratings are consistent, that thresholds between ratings are understood, and that similar services will receive similar outcomes”, he added.
