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Advice on achieving CQC Standards
The health and social care sector is one of the most regulated industries to work within. This is in part due to the significant effect it can have on the people that use the service coupled with the vulnerability of the client group.
The regulation of care homes since 2000 have been evolving year on year, following the implantation of the Care Standards Act and latterly the Health and Social Care Act.
CQC use many sources of information to build a picture of the health and social care settings they regulate. This includes inspection reports from other agencies such as local authorities, fire officers, environmental health inspectors, GP’s, Social Workers and District Nurses as well as members of the public. All this information is used along with notifications from care homes as required by the health and social care act, as well as the annual return required to be submitted by Care Homes known in England as the PIR. Other sources available are also logged such as information on company websites and social media. All this information builds a picture of a health care setting prior to an inspection taking place and helps to decide on the regularity and types of inspection required.
Despite how excellent a service is; if there is no evidence to prove it the service risks getting grades less than they deserve. CQC rate homes in five categories these are: Safe, Responsive, Caring, Effective and Well led. They use the KLOE’s to measure this. KLOE stands for Key Lines of Enquiry, and each of the five categories above have several KLOE’s attached to them. Many have a cross over from one category to another. This means a care home manager needs to understand the KLOE’s and have all the evidence to hand demonstrate compliance.
How can a Health and Social Care Consultancy such as Swift Management assist in this process?
Many care home operators choose to use a care consultancy only when there is a problem to resolve but this could be a very short sighted view and whilst a care consultant is more than able to crisis manage, it is far better to engage their services to ensure their service is meeting standards, showcasing good practice and prevent the need for fire-fighting.
When looking at achieving CQC standards, increasing grades and demonstrating sustainable evidence Health and Social Care Consultants have a lot to offer. When we do visit a care home which has been rated inadequate, often staff, relatives and residents feel that the rating is unjust and is not reflective of the care home they know.
Building the evidence is singularly one of the most important things any care operator can do, some of it is simple but time-consuming, other elements need skill and understanding.
Care providers can encourage residents and relatives to complete online surveys such has completing a response card to Carehome.co.uk or directly to CQC. Keep pictures of events in and around the service as evidence of what has been taking place. Keep thank you cards and letters, along with letters of complaint. It is always about balancing the view. Every inspector knows that no service is perfect.
Many of our customers have taken advantage of our staff and resident and relative surveys; they are objective as they are independently undertaken, they are anonymous and as such seen to be a far more reliable form of survey than one undertaken internally. The team at Swift Management are also able to benchmark the results against other providers. Lesson learned are something CQC like to see and a simple response to the overall survey with a “you said” “we did” report to go with the results can go a long way in demonstrating that a provider takes what they hear seriously.
When a complaint is received, we can assist a provider in writing a response, which is meaningful appropriate and gives a clear indication of lessons learned. If the complainant is not satisfied again Swift Management can undertake an independent review. This is an option that shows transparency. We can assist care home managers with our KLOE inspections as these allow the home to showcase the evidence they have and make it easy for a manager to produce it at the time of an inspection. As we have previously said no service is perfect therefore a high-quality service improvement plan is vital to showcase your service. We have a tried and tested formula for this, and our support can keep you on track. It helps providers complete their PIR and again shows how the service is well led.
Regulatory Notifications are a legal requirement, but when our consultants visit a service the registered manager is often not reporting everything they should, this is sometimes because they do not see an incident as reportable or they do not want to bring the services reputation down, due to making the notification. This could not be further from the truth. Transparency and openness are something that CQC find reassuring, it shows the service has nothing to hide, and that improvements are consistent and ongoing. Our team helps registered managers overcome this and assist where necessary in tying back the issue to the action plan, thus making the action plan a live document. This again demonstrates transparency.
Providing a great service should be the principle aim of every provider within the health and social care sector, achieving CQC standards is not difficult, it is proving how you do so that is the challenge. Swift Management Services can provide you with support that allows you to do both.
One comment often seen in inspection reports relates to care documentation and care plans. The report usually highlights that they are not person centred or they do not reflect the care that is being given. Our consultants can provide training and support around writing person centred care plans but also audit care plans and other care documentation to show that they all link together. Many providers see the risk assessments, care plans and daily records as three distinct records but they are not and need to work hand in hand.
We also see examples of care plans that are documents which are neatly maintained and kept up to date for reviews or inspections but, the staff on the frontline do not have any knowledge of the contents. Again, our team help by implementing systems to ensure documentation is not only correct and detailed but also in use.
Achieving CQC standards and improving your ratings is usually about transparency, lesson learned and knowing your business and addressing issues. Our team of consultants at Swift Management are highly experienced in all these areas and can really make a difference which is why this year we are launching a package to support health and social care establishments meet the standards without breaking the bank.
When a care home, receives an inadequate rating they usually receive a local authority embargo meaning resident numbers fall with no new admissions, the private market falls away as people read your report and staff leave because they feel they do not want to be associated with an inadequate home, there is also usually an element of bad press. In an average 60 bed care home, receiving an inadequate rating can cost as much as £250k in lost revenue, increased training and agency costs etc therefore prevention must be better than cure especially for those people using our service.