Single Assessment Framework

Quality Statements replace KLOEs

This is a ground up redesign starting from the bare bone Domain Headings of Safe, Caring, Responsive, Effective, and Well-Led.

1. The Key Domains have new definitions
2. Each Domain has 5-8 Quality Statements (34 in total)
3. Evidence will be gathered in 6 pre-defined categories

[Note that KLOEs are scrapped in their entirety]

A structured approach to ratings

Each Quality Statement will be assessed based on 6 predefined evidence categories

1. People's experience of health and care services
2. Feedback from staff and leaders
3. Feedback from partners
4. Observation
5. Processes
6. Outcomes

This is intended to provide structure and transparency to the way inspectors arrive at ratings. Previously, ratings were entirely dependent on individual inspector's judgement.

Efficiencies for inspectors

• Shift of main focus to external evidence and feedback
• Points based scoring system, so each judgement is scored/graded
• Resource efficiencies through remote assessments
• On-site inspections when triggered by information

Flexibility at inspections

• Allows subject by subject reviews instead of whole inspection
• Continuous reviews and compliance (Assess anything at anytime using video; telephone; or site-visits)
• Improved inspection targets and reduce backlog
• More frequent reviews and assessments
• Data driven targeting

Assessing Quality Statements

• Each Domain has number of Quality Statements
• Each Quality Statement is scored against 6 evidence categories
• The score is added up to arrive at a rating for each Quality Statement

Each Quality Statement has 6 Evidence Categories

Initial Phase

The CQC has adopted a phased approach, with limited checks at the early stages, focused on priority evidence targets. Roughly 100 out of the total 204 evidence categories have been marked as “Key Evidence Categories”. Inspections will focus only on these priority items, but can be expanded during the inspection, if deemed necessary.

Providers were initially broken down into 9 distinct Sectors, now expanded to 15, with variations created for each, resulting in 15 “Single Assessment Sub-Frameworks” until that inspection transitions to a Full Inspection status.

A hybrid system is in place with the following characteristics:-

1. 15 frameworks for partial inspections
2. Each Sector has different Key Evidence Categories

Without fundamental shift in inspection methods and available resources, past performance suggests it could take up to 8 years for all Providers to be on the new assessment system. We are unlikely to have meaningful comparable data until 2030 at the earliest

Estimation based on 54,000 live Providers and average of 7,000 inspections per year

Roll out - Types of assessment

Providers can expect 4 distinct types of inspections:-

PARTIAL:          Individual Evidence Category only
BASIC:             Key Evidence Categories (up to 100 checks)
ENHANCED:   Inspection expanded to other categories
FULL:              Comprehensive all 204 Evidence Categories

 If you are a New Registration or never been inspected before, you can expect a Full Inspection

If you have been inspected before, even under the old regime, you can expect any type of inspection although a Full Inspection is less likely