Last reviewed 22 June 2018
It is increasingly important for social care providers to prepare for a Care Quality Commission (CQC) inspection. Performing a mock inspection helps greatly, preferably carried out on a continuous basis using a schedule to cover all areas of the KLOEs. Chris Payne takes you through the process step by step.
When do I start?
Now. That is if you already have not started — the aim is always to be continuously learning, developing and improving from what is happening in the service. The answer is always now even if you:
Remember that if you have a Good or Outstanding rating you can expect formal inspections less often than a Requires Improvement or Inadequate. But you still might receive focused inspections and if the CQC has information suggesting a drop of standards, it could bring a scheduled inspection forward.
Where do I start?
That depends on your position, eg as a registered person/manager, how long you have been in that position, eg as a recently appointed manager or someone who has been there for a long time, but you might like to locate your starting point along the following “road map” depending on the progress of your journey along it to date.
Point of departure
Do you understand or need to refresh your understanding of the regulations and standards that you are expected to achieve through an inspection?
Do you understand the current inspection model used by CQC, which can be found in its most recent publication How CQC Monitors, Inspects and Regulates Adult Social Care Services (May 2018), available on the CQC website. See also Croner-i Inspection Procedures topic.
Do you understand how inspectors go about their inspections using what they call the Key Lines of Enquiry (KLOE) to address the five key questions (Is it safe?, etc). Each self-audit tool includes the corresponding KLOE.
Inspections are carried out in just one or two days, but your “internal inspecting” is continuous and you cannot do everything at once, so you will need a schedule of activities to cover all key areas described in the KLOE systematically. There are several audit planning tools to help you do this.
Having planned your auditing schedules, you can use the different auditing tools to carry out different auditing activities. Auditing can be delegated to the most suitable manager/staff team members — one person cannot do everything.
For example, a care co-ordinator might be responsible for auditing risk assessments concerning service users.
The results of your audits can also be fed into the more in-depth self-assessments that are enabled by the self-audit tools which might be scheduled so that each of the five key questions is thoroughly assessed at least annually — but more often if there are weaknesses to be addressed through improvement planning, particularly if you are required to make improvements following an inspection.
Each self-audit includes an improvement planning section, but there is a separate Goal-setting and Evaluation Form. The Annual Development Plans: Reviewing and Improving Annual Performance Form provides another tool for improvement planning.
The standards and inspections, as any form of “customer care”, require you to be constantly listening to, valuing and acting on what your service users are telling you. So, you need feedback forms to provide you with this information.
You also need to check your actions in relation to any complaints using, for example, Self-audit Responsive 2: Concerns and Complaints.
You will also need to audit that you are compliant with all health and safety regulations, for example, using the Audit: Premises — General Risk Assessment Form, medication compliance using, for example, Audit: Care Home Medication Checklist and Monitoring Form and other safety issues. Audit tools for a variety of such purposes can be found in the Croner-i Forms section.
Reaching your destination
You never actually reach your destination because it is continually changing, and, in any case, you can expect an inspection to take place at any time — how often depends on the results of your last inspection and the monitoring information collected by the CQC under the title of CQC Insight.
From 2018 the CQC also requires you to open an online account to contribute to its Provider Information Collection (PIC), which it recommends you should update quarterly and at least annually, otherwise you will be penalised.
The PIC asks you to answer from your self-assessments how you are addressing the five key questions.
Is (the service):
If you have completed the Croner-i self-audits systematically and thoroughly, you should have no problems in keeping your CQC PIC up to date as you can regularly feed in your information.
On the other hand, if from your last inspection you have been required to make a number of improvements or have been rated as inadequate you will need to have a clear strategy. You might get some help from the two-part Croner-i feature article, Using adverse inspection reports as opportunities for improvement parts one and two.
If you have experienced a lot of changes particularly of registered manager you might need to return to the point of departure.