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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

  1. Review your last inspection and see where you are in the inspection map below.
  2. Then look at the next stage, and you can prepare for that.
  3. 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
cqc inspections future trends key

1st Stage: Fundamentals

  • Have you got basic rules for operating the organisation
  • Is everyone aware of the rules
  • Do you record activity
 cqc inspection trends 1

2nd Stage: Operations

  • Record of activity, and completeness
  • Basic staff competency, recruitment processes and appraisals
 cqc inspection trends 2

3rd Stage: Monitoring

  • Staff training and development, awareness of key safety areas, knowledge
  • Management competency, Good governance, oversight of operations
 cqc inspection trends 3

cqc inspection trends old new

4th Stage: Care

  • Governance and accountability of officers
  • Standards of care, Involvement in care, Consent
 cqc inspection trends 4

5th Stage: Actual Performance

  • Engagement with stakeholders, joined up care
  • Outcomes achieved, comparisons and benchmarks
 cqc inspection trends 5

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.

cqc inspection trends 6

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:-

  1. Inspect all providers [done]
  2. Extend to inspect owners of Groups [2018/2019]
  3. Extend to inspect Complex Providers [2018/2019]
  4. 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 20th 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.