The Care Quality Commission (CQC) carries out frequent site inspections. These inspections give the CQC the chance to engage face to with those employed in a health or social care environment as well as those who are cared for. The needs and requirements, as well as demands of those working in the care environment, are noted, and records looked at to get an idea of conditions.
What types of CQC inspections are there?
There are essentially two types of CQC inspection. Regular checks are called comprehensive inspections and these are used to ensure the service being inspected is providing care that is safe, caring, effective, responsive to the needs of patients and well-led. How frequent the inspections and visits depend on the type of service being provided.
The second type of inspection is a focused inspection. These are smaller and more comprehensive inspections undertake for one of two main reasons:
There has been a notification that there is something that should be concerned about that may have been raised in a comprehensive inspection or through ongoing monitoring.
There is a change in the operations of the service provider such as a takeover, merger or acquisition.
Different services different inspections
When inspecting the various types of services, different things are always looked into and considered. NHS Trusts, for example, have eight core services that are inspected and when inspecting a local doctor’s surgery how the practice serves its local population group is looked into. The five key questions the CQC needs to be answered are asked with every type of service supplier regardless.
What are the eight core services inspected in an NHS Trust?
The core services inspected in an NHS Trust are:
- Urgent and emergency services (A&E)
- Medical care (including older people's care)
- Critical care
- Maternity and gynaecology
- Services for children and young people
- End of life care
- Outpatient services and diagnostic imaging (such as x-rays and scans)
What the “population groups considered when inspecting a doctor’s surgery?
NHS GP practices the quality of care for the following six groups is always considered:
- Older people
- People with long-term conditions
- Families, children and young people
- Working-age people (including those recently retired and students)
- People whose circumstances may make them vulnerable
- People experiencing poor mental health (including people with dementia)
By considering each population group the overall levels of care can be understood, and those who are more vulnerable can be protected or assisted better. Using the population group systems it can also be ensured that the practice is providing the most appropriate services for the region it serves.
The of a CQC Visit
The start of the visit begins with introductions of senior members and key players from the CQC and the site being inspected. Role players will be identified, the scope and purpose of the investigation with outlined and the communication process with be established.
It should be noted that inspections doctors practices, GP out of hours services and acute hospitals begin with a presentation by the service that gives an overview of their performance.
The five key lines of enquiry are used as the foundation for the inspection along with information gathered in the planning stage. The inspection will be carefully structured, and focus will be given to critical or concern areas where service may not be as effective as hoped. Information for the final report from the inspection is gathered to meet the key lines of evidence as follows:
Gathering information from those people who use the services, speaking to people individually or in small groups. Sometimes comment cards may be placed in surgeries or reception areas. Information for general comments and complaints books are also used to gather information.
Information for the inspection is also gathered from staff members using a variety of methods and means. Very often information is gleaned by observing the care given, reviewing records, looking at documents and policies. Further to this, the actually facility is inspected to gather valuable information.
The objective of a CQC inspection is not to criticise or find fault but to improve service delivery in the health and social care environment. The final report of a CQC inspection is delivered at a meeting between the CQC inspectors and senior staff at the facility or service inspected. The feedback generally includes:
A summary of the overall visit
Highlights of any points of concern or interest
Identification of action that the service provider can immediately take
An indication of future or planned inspections
Explanation of judgements and how they will be published