Staying one step ahead : Grade yourself

CQC inspections have slowly moved from the initial learning process towards corporate governance and accountability.

Preparing for your next inspection

Review your last inspection and see where you are in the inspection map below.
Then look at the next stage, and you can prepare for that.
If the inspector repeats the same stage as last time, this might be that you haven't progressed enough and might face difficulties.

Map of inspection stages

Quick guide to colour coding: Green means the inspector spent less time on this because you are expected to have achieved this, and may perform random checks to ensure compliance

1st Stage: Fundamentals

Have you got basic rules for operating the organisation
Is everyone aware of the rules
Do you record activity

2nd Stage: Operations

Record of activity, and completeness
Basic staff competency, recruitment processes and appraisals

3rd Stage: Monitoring

Staff training and development, awareness of key safety areas, knowledge
Management competency, Good governance, oversight of operations

4th Stage: Care

Governance and accountability of officers
Standards of care, Involvement in care, Consent

5th Stage: Actual Performance

Engagement with stakeholders, joined up care
Outcomes achieved, comparisons and benchmarks

Final Stage: Maturity

The CQC is moving towards online self-declarations and targeted site visits. The old PIR (Provider Information Request) will be replaced with an annual online Provider Information Collection report (PIC).

CQC will target Providers based on their declarations and intelligence gathered from other sources. Whistleblowing will become more important in trigger inspections.

Future: CQC becomes part of the NHS

The CQC is likely to reinvent itself and may seek a change in legislation. The transformation has already started:-

Inspect all providers [done]
Extend to inspect owners of Groups [2018/2019]
Extend to inspect Complex Providers [2018/2019]
Invent NEW role: Inspect CCGs and Commissioning [In motion since 2014]

“….. we need to be able to look at how the system operates, not by being invited to do reviews but in it being part of the routine way we do our business. I think that requires legislative change.”

Sir David Bevan

May 2018

This process started in 2014

According to an interview given by Sir David Bevan on 20^th March 2015, the process started 12 to 18 months before that interview.

The CQC is looking to become an “embedded regulator” in the system and commissioning so that they inspect 24/7/365 from inside the system instead of being “invited to inspect”.

In essence, CQC will become internal auditors, and part of the NHS and yet independent from other employees, thus guaranteeing its survival for as long as the NHS exists.