WHAT TO EXPECT FROM A CQC INSPECTION
HOW TO PREPARE BY ROBERT PETTIFORD
Meeting and Greeting………
- Don’t panic! Remember that inspectors are human too and you can create a good first impression by remaining calm, professional and in control.
- Do ask to see inspectors ID/warrant if they do not offer it or it is not clearly displayed. Demonstrating that you take security seriously.
- Similarly, direct inspectors to alcohol hand gel and ask them to use it.
- Inspectors are entitled to commence their inspection immediately and via the most senior staff member on duty at that time. However, you are free to contact your manager to let them know that the inspection is underway.
- If there are any residents who could be upset by the presence of the inspectors or who exhibit behaviour that challenges, you should tell the inspectors before they start the inspection.
- Think in advance about where you could offer inspectors to sit and work. Direct inspectors to toilet facilities and offer to accompany them on a tour of your service. However, inspectors may wish to look round unaccompanied, in which case you should allow them to do so and give them the space to get on with the inspection.
What to expect
- The focus of the inspections is the experiences residents have when they receive care and the impact the care has on their health and wellbeing. CQC make judgements against the Health and Social Care Act 2008 and associated regulations and the judgements are informed by these experiences. Therefore inspectors spend a lot of their time on an inspection directly observing care and talking to resident’s who receive care, their family and carers. They will check their findings in several ways, perhaps by looking at records, or speaking with staff, to reach their judgements.
- During the inspection, CQC will observe care and talk to resident’s who use the service, and staff. They will cross-check what they see and hear against other evidence such as care records, care plans or other information. They will look for evidence that their regulations are not being met, but where they see, hear or find evidence to show that the care being provided is what they expect residents to experience, they will include this in their report.
- CQC will be sensitive when observing care. For example, they won’t normally observe the types of care that people have a right to receive in private.
- Inspectors won’t normally spend a great deal of time reading policy or procedure documents unless they need to look at them to substantiate other evidence or what staff or residents have told us about their experiences. For example, they may ask a member of staff what training they had completed, how they use it in their role, and they may verify their responses by checking the training records.
- They will speak with managers and members of staff of all levels. They don’t expect all staff to have the same knowledge, but they do expect them to understand their role in providing good outcomes for people and know what to do if they have concerns.
- They may spend time carrying out ‘pathway tracking’. This is when they follow a resident’s route through the hospital and get their views on it. It is an important part of the inspection, as it allows CQC to capture information about a sample of resident’s receiving care or treatment.
- They might ask to look at specific areas of your home (e.g. how you store medicine) and may ask you to show information such as training records. They will expect records to be sufficiently detailed and accurate to ensure residents receive safe care and good outcomes.
Speaking with Staff
- Inspectors will not wish to disrupt resident’s care and routines. They understand that ‘care comes first’, so don’t be afraid to say if there is something pressing that you need to do and offer to come back to the inspector immediately afterwards.
- Be honest: if you don’t know the answer to a question then it’s far better to say so. If you don’t understand what the inspector is asking you, then do ask them to rephrase their question until you do.
- Practice with peers in advance of inspections, describing how you carry out certain tasks, e.g. administer medicines/seek verbal consent/give resident’s choice; to get used to providing clear and concise explanations. Question your understanding of the Mental Capacity Act, DOL’s and Whistleblowing. How confident do you feel to answer questions?
- Think about your role and how to describe it and your day to day responsibilities. Also remind yourself of the chain of command on shifts and your route for escalating any concerns.
- Ensure that you have thoroughly read and understood care plans and can tell inspectors about the individual needs and preferences of the people in your care.
For Managers and senior care staff to consider: Can you demonstrate that you have an awareness of the fundamental standards and do you “own” them for Your service?
- What are you most proud of within service? Inspectors will be pleased to hear about this.
- Are there any known issues of concern within your service? Be honest and up-front about these but also be prepared to evidence what has been done to address them, e.g. action plans, orders for equipment, training course bookings etc.
- How is learning from incidents disseminated to your staff? (And would staff be able to tell inspectors too?) Can you evidence your home has learnt from any incidents and put measures in place to reduce the likelihood of them occurring again?
- Does medicines management comply with Royal Pharmaceutical guidelines?
- Are you confident that risks to residents with regard to cleanliness and infection control been considered? How have risks been minimised?
- How do you regularly assess the quality of the service you are providing? Do you carry out routine audits to give you confidence that your home meets with the fundamental standards?
- Does the home conduct staff and resident surveys and publish the results? Can you provide evidence of where you have acted on feedback about your home?
- Are the care plans and resident documentation regularly reviewed and updated as necessary?
- Are the policies and protocols dated, regularly reviewed and relevant to your home?
- Can you evidence that you are able to promptly identify risk, carry out assessments and manage risk appropriately in order to keep people safe from avoidable harm?
- Has the Mental Capacity Act 2005 and Depravation of Liberty Safeguards been considered and appropriately acted upon?
- Have staff completed all their mandatory training?
- What are the goals and vision of the service? Do you know and understand these?
- How do you regularly review the culture within your service? Consider how you make yourself available to junior staff in the event that they have any concerns.
- How do you cultivate an open and honest culture?
- Do you have relevant policies in place or know where to find them such as anti-bullying and harassment/whistle blowing etc.
- Is the issue of safeguarding and Mental capacity prominently displayed on the staff notice board? Do your staff feel confident in reporting safeguarding concerns or question where a person’s mental capacity has not been considered?
Contact Robert for an informal chat about his services and how he might be of assistance.
Robert Pettiford BA(Hons) DMS ACIM