Care Improvement Works

Free, reliable guides, learning tools and resources for providers of adult social care in England. These are mapped to the Care Quality Commission’s inspection questions and key lines of enquiries (KLOEs).

Find improvement and workforce development resources from Skills for Care and the Social Care Institute for Excellence to help improve your service – whatever your inspection rating.

Care Improvement Works

Display of ratings: a guide for care providers

 From 1st April, 2015 if you’ve been awarded a rating by the CQC under their new inspection regime, you will be required to publically display it. 

View guidance of rating

CQC to inspect health and social care systems across geographical areas

In the New Year, CQC will begin piloting an approach to inspection, which will examine services across whole health economies to determine the drivers of both good and poor quality care, and establish the extent to which different services are integrated. In an interview with the Health Service Journal in October, the Chief Inspector of General Practice, Professor Steve Field, who leads for CQC on integrated care, suggested how this might work. He noted that an integrated inspection could for instance look at urgent care, encompassing inspections of NHS 111 services which would be timed to coincide with CQC looking at GP out of hours services and A&E departments. Such inspections will seek to establish how joined up health and social care provision is, in local health economies and in the words of Professor Field, ‘will empower patients to seek care as appropriate’.

This move is part of a wider trend on the regulator’s behalf to inspect wider integrated care pathways and the experience that patients and service users have when they interact with a number of different care providers. Further evidence of this can be seen in CQC’s thematic inspection into dementia undertaken earlier this year, which attempted to gauge people’s experiences of dementia care – especially as they moved between care homes and hospitals. The subsequent report entitled Cracks in the Pathway, and the widespread coverage that this report received, demonstrates the importance that the media and most importantly, the public, place on joined-up care.

The direction of travel that this new model indicates means that CQC, in the future, could potentially provide analysis of medicines management between general practice and care homes, on how effective discharge is from acute hospital wards to care homes, or the level of access that care home residents have to GP services, amongst other areas where health and social care interact.

CQC have published a report on the 'Variation in the quality of care means people living with dementia risk receiving poor care'

A major review of dementia care by the Care Quality Commission (CQC) says the unacceptable gap in the quality of care means it is likely that someone living with dementia will experience poor care as they move between care homes and hospitals.

Click here to continue reading

A year of learning and improvement for CQC by Vivien Shepherd

The Care Quality Commission (CQC) made radical changes to how it regulates health and adult social care last year, in order to fulfil its purpose to make sure people receive safe, effective, compassionate and high-quality care in England.

In its Annual report and accounts out today (Thursday 10 July), the regulator looks back on the 2013/14 business year, which saw the appointments of its Chief Inspectors of Adult Social Care (Andrea Sutcliffe), of General Practice (Prof Steve Field), and of Hospitals (Prof Sir Mike Richards). They are leading specialist and expert teams for their sectors, with inspections and other actions based around what matters most to people who use services – whether they are they safe, caring, effective, well-led and responsive to people’s needs.

Also in 2013/14, CQC began to rate services on a four point scale of Outstanding, Good, Requires Improvement, and Inadequate. These will help people compare services and highlight where improvements need to be made. CQC rated 18 NHS trusts last year and has rated more since then. CQC will begin to do the same for adult social care and general practice services from this October.

Another highlight was when the regulator launched its “Intelligent Monitoring” model for acute NHS trusts, which analyses various sources of performance data about services, including people’s experiences and views of care, to help CQC decide what to inspect and when.

David Prior, Chair of the Care Quality Commission, said: "In 2013/14, we completely changed CQC’s leadership team, its organisation and governance, and began to develop a fundamentally different approach to risk monitoring, inspection and regulation.

"The next year is another significant moment for the organisation as we move from development to implementation of our new model. We are at the beginning of a long journey to excellence. We are heading in the right direction but it will take time to build and entrench an effective new approach to regulating health and adult social care.

"We are clear that our priority is the safety and quality of care that people receive and we believe that greater transparency will help to drive improvements in standards.

"We are making progress and we are confident that, increasingly, those who need health and care services will be able to rely on our judgements, be informed by our ratings, be protected from inadequate care and benefit from a health and social care service that is continuously improving."

David Behan, Chief Executive of the Care Quality Commission, said: "CQC’s role is to make sure people receive safe, effective, compassionate, and high-quality health and adult social care and to encourage services to improve. To achieve this, we have made radical changes to the way we inspect services. At the same time, we have carried out more inspections than in previous years.

"I would like to thank CQC staff for the immense hard work they have put into the last twelve months and for their commitment in delivering the changes needed."

Other highlights from 2013/14 include:

  • CQC inspected over 1,700 more locations than it did in 2012/13 – 30,334 locations, compared to 28,583. These total 39,567 planned, responsive and follow-up inspections. The 6% increase in inspected locations was mainly because CQC began to regulate general practices for the first time last year. Most of CQC’s inspections (68%) continued to be of care homes and other adult social care services, as this is the largest sector that CQC regulates.
  • CQC involved people who have experience of using care services (known as “Experts by Experience”) on over 3,000 more inspections than it did in 2012/13, showing CQC’s continued commitment to make sure the views of people who use services are at the heart of everything it does.
  • CQC issued a third more warning notices to providers for not meeting national standards of quality and safety: 1,456, compared to 910 in 2012/13. This reflects CQC’s commitment to take action when it identifies areas of concern and its closer scrutiny on providers to ensure they improve their services, as well as the higher number of inspections that it carried out.
  • CQC was contacted 9,473 times by health and adult social care professionals wishing to “blow the whistle”; a 10% increase from 8,634 in 2012/13. This could show greater awareness about CQC and the willingness of those who work in regulated services to be open about their concerns.

CQC’s Annual report and accounts 2012/13 has been presented to Parliament today and can be downloaded from CQC’s website.

To read CQC’s Annual report and accounts 2013/14, please visit: www.cqc.org.uk/content/publications
When looking at CQC’s enforcement actions generally, there was a 50% increase compared to last year: 1,523 enforcement actions in 2013/14, compared to 1,029 in 2012/13. As well as warning notices, enforcement actions can include issuing fixed penalty notices, cancelling, amending or suspending a provider’s registration with CQC and prosecution. To find out more about the range of enforcement actions that CQC can take against providers that do not meet the national standards of quality and safety, please visit: www.cqc.org.uk/content/how-we-enforce
The 2013/14 year saw the regulation of general practices in England added to CQC’s remit. CQC inspected 1,546 primary medical services in this period (around a fifth of registered providers).
CQC is committed to putting the views of people who services at the heart of everything it does. In 2013/14, CQC involved Experts by Experience and specialists 4,481 of its inspections, compared to 1,408 the year before. To find out more about CQC’s Experts by Experience, please visit: www.cqc.org.uk/content/involving-people-who-use-services
To find out more about CQC’s “Intelligent Monitoring” of acute NHS trusts, please visit: www.cqc.org.uk/public/hospital-intelligent-monitoring
To find out more about how people can raise concerns and share experiences of care, please visit: www.cqc.org.uk/contact-us

CQC update and NSA provider leadership survey 

Following the publication of our signposting document ‘A Fresh Start’ late last year, we are continuing to develop our new inspection model for adult social care providers and would like to thank all of you that have already contributed.

The feedback you have given us has been an enormous help, and we are well on our way to shaping the new model that we will pilot with providers in April and July of this year.

I wanted to take this opportunity to update you on next steps, and some key upcoming milestones, before we launch our new model in October.

In early April we are launching a formal consultation on a provider handbook which will outline the principles and approach behind our new methodology.

This will include information about how we will inspect and rate providers (we plan to award indicative ratings from July this year which we will publish in October). It will be followed by consultations on our regulations guidance and enforcement policy in June.

Final versions of the provider handbook, regulations guidance and enforcement policy will be published in September before the new approach is rolled out across the sector on 1 October.

One of the questions we will be focusing on in our new inspections is how well-led a provider is. We have been working closely with organisations such as the National Skills Academy for Social Care (NSA) on what that means and how we can all help services and managers to be better leaders.

The NSA has commissioned Morar Consulting, an independent research organisation, to carry out an online survey of registered providers looking at different aspects of leadership and what it means to you. 

You can find a link to that survey here, and I hope you will take part.

The survey is anonymous and should only take 10 minutes to complete. All the information provided will be kept confidential. If you have any queries about the survey, please contact Debbie Sorkin at the Skills Academy at debbie.sorkin@nsasocialcare.co.uk or on 0203 011 5271.