A comprehensive guide to CQC inspections
What is a CQC inspection?
If you provide health care or adult social care services that are regulated activities under the Health and Social Care Act 2008, you must be registered with the Care Quality Commission (CQC).
CQC inspections are an important part of regulating health and social care providers in England. Visiting services, or carrying out remote inspections gives the CQC an opportunity to talk to staff and service users. This helps them observe how care is delivered and how the needs of clients are managed.
While the gathering of data, evidence and information plays a large part in the CQC’s inspection process, the observation of care, feedback from clients and families, and leadership are also scrutinised.
In August 2022, the CQC began to trial its new regulatory framework and inspection process with limited and targeted home care organisations. Based on feedback from stakeholders, in December 2023 the CQC said that it was important to give providers the time to prepare for changes and consider the pace at which it was proposing to implement complex changes.
From spring 2023, it will focus on:
– making sure the technology we need is in place and that we’re able to test it with providers
– being confident that the new regulatory approach is ready to launch
The new assessment process will gradually start to be carried out by 2023.
Who carries out CQC inspections?
Adult social care inspection teams are led by a CQC inspector and they will often include an Expert by Experience. An Expert by Experience is a person who has experienced care personally or has experience caring for someone. They provide feedback to the inspector, which helps the inspectors to make their judgements.
Sometimes the CQC conduct remote inspections with domiciliary care services and extra care housing services. During these inspections, the CQC will use telephone and digital methods to gather information. This means that the CQC may not always need to visit services in person.
Where do the CQC gather evidence for an inspection?
For adult social care services – such as care homes and home care companies, the CQC gather evidence to answer the key lines of enquiry from four sources:
- A range of data, including local information
- Information collected just before the inspection
- Information from speaking with people who use services, their families, carers, staff and other professionals
- The inspection
What are the types of CQC inspection
Comprehensive inspections
Comprehensive inspections take an in-depth look at a whole service. Inspectors look at all five key questions to consider if the service is safe, effective, caring, responsive and well-led. The CQC also provide a rating of outstanding, good, requires improvement or inadequate for each key question, as well as an overall rating for the service.
Comprehensive inspections:
- Are usually unannounced
- Are triggered by a substantial risk or a quality improvement (based on data gathering)
Focused inspections
Focused inspections are more targeted than comprehensive inspections and are a response to specific information the CQC have received or to follow-up finding from a previous inspection. The CQC does not look at all five key questions, however, the scope can be widened to a comprehensive inspection if concerns are brought to light.
Focused inspections:
- Are structured according to the reason why they need to be conducted, including the risks or concerns raised
- Always look at the well-led key question, plus any other key question that is relevant to the information that triggers it
- Are smaller in scale than a comprehensive inspection
- Broadly follow the same process as a comprehensive inspection
- Can change an overall rating at any time
- Are normally unannounced
- May expand to a comprehensive inspection in response to findings.
Targeted inspections
Targeted inspections have a narrower focus than focused inspections and are intended to assess a particular risk or concern, for example, whether a Warning Notice has been met or to look at tangible concerns about specific risks to people’s safety.
Targeted inspections:
- Do not look at an entire key question
- Are usually unannounced and can take place before a focused or comprehensive inspection
- Will not lead to a change of ratings or the timing of the next scheduled comprehensive inspection
Want to know more about technology and the CQC? Read our comprehensive blog series.
Want to know more about remote CQC inspections? Head over to our comprehensive remote inspection topic page.
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