The CQC (Care Quality Commission) is the independent regulator of health and social care in England. They ensure that health and social care services such as care homes are providing their service users with effective, compassionate, safe and excellent care and they encourage service improvement. They register care providers, monitor, rate and inspect services, and take protective action for service users through advocating for change on major quality issues. The CQC protect vulnerable people’s rights and their values include teamwork, integrity, caring and excellence.
The CQC undertakes two types of inspections:
COMPREHENSIVE INSPECTIONS which are held regularly to ensure services are providing care that is responsive to people’s needs, effective, caring and safe. They are typically unannounced, although there are circumstances where the provider will be notified beforehand e.g. a small residential service may be contacted 48 hours prior to inspection to check that people are at home or up to a week’s notice may be given to very complicated community services where careful planning is needed.
They are held at the following intervals:
Services Rated as Good And Outstanding – normally within 30 months of the last comprehensive inspection report being published.
Services Rated as Requires Improvement – normally within 12 months of the last comprehensive inspection report being published.
Services Rated as Inadequate – normally within 6 months of the last comprehensive inspection report being published.
Services That Are No Longer Dormant – the first comprehensive inspection will normally be scheduled between 6 to 12 months from the date the service starts operating again.
Newly Registered Services – for brand new services, the first comprehensive inspection will normally be scheduled between 6 to 12 months from the date of registration. If a service was previously operated by another provider, or at a different address, the inspection will be normally be scheduled based on the location’s last inspection report publication date and rating or within 12 months of registration, whichever is the later date. For more information on why and when we continue the regulatory history (report and rating) of a service, see the guidance on our website.
FOCUSED INSPECTIONS are smaller in scale than comprehensive inspections, although they follow a similar process. Focused inspections are carried out either to investigate concerns which have been raised at a comprehensive inspection or if there is a change in a care provider’s circumstances such as a merger, acquisition or takeover.
The CQC will focus their inspection on their five key questions based around the welfare of the service user:
Each of these five questions above is broken down into more in-depth questions that the CQC refers to as their ‘key lines of enquiry’. This ensures consistency in inspections and ensures that all the key areas are covered.
Here are our top tips to prepare for your CQC inspection:
The inspector or inspection team will meet senior staff and explain who they are, the purpose and scope of the inspection, and how findings will be communicated. If acute hospitals or GP services are being inspected, the inspection will begin with a presentation by the care provider in which they will give their own views of their performance.
The key lines of enquiry are explored through:
A feedback meeting will be held with senior staff and the inspection team will:
Areas where the service is excelling or could be improved will be focused on particularly. Please note that inspections vary from service to service however the inspection above is based on a typical visit.
After the inspection, a report is produced by the lead inspector to include ratings which reflect the CQC’s findings and overall judgement of the quality of the care. The report will include what the findings from the key lines of enquiry mean for service users. Pertinent findings, whether positive or negative, will be detailed along with any regulation breaches found. Recommendations will be made to assist the provider in improving their rating.
The service provider will be rated as either Outstanding, Good, Requires Improvement or Inadequate, with each of the five key questions having a separate rating.
By law, you have to display the ratings from the CQC in the places you provide the care somewhere that is easily seen. If you have a website, you must display your rating on the website. When you receive your report after the inspection, you must respond to any areas of concern identified during the inspection and create an action plan to improve and address the issues.
The CQC will follow up on action that the service provider has been advised to take. This can be in the form of contact or re-visiting the service to undertake a focused inspection.
If your ratings require improvement, the CQC can:
If you fail an inspection, you should comply immediately with any recommendations for change that have been made. You should follow the advice and guidance set out above and you can seek further guidance here: