CQC has announced that, from 6 October 2020, it will roll out its Transitional Regulatory Approach (TRA) to Adult Social Care services.
The TRA is the way CQC will continue to inspect and regulate services through the next stage of the Covid-19 pandemic. It follows on from the Emergency Support Framework (ESF) initiated in response to the pandemic and will precede the CQC’s new strategy which is due in May 2021.
The TRA sees a return to CQC “crossing the threshold of services” but perhaps not in the manner, circumstances and timeframes Providers have been used to.
The new TRA is billed as being flexible and responsive to changes in the pandemic situation. The key components are:
- A strengthened approach to monitoring, with clear areas of focus based on existing Key Lines of Enquiry (KLOEs), to enable CQC to continually monitor risk in a service;
- Use of technology and CQC’s local relationships to have better direct contact with people who are using services, their families and staff in services;
- Inspection activity that is more targeted and focused on where CQC has concerns, without returning to a routine programme of planned inspections.
New guidance published on 1 October 2020, tells Providers what this approach looks like in practice.
In summary, CQC will review their information about services and follow it up with a call with the Provider. CQC state, “This is not an inspection and we do not rate services following a call”. Providers will have the opportunity to provide evidence within 24 hours of the call. The calls will be used by CQC to decide whether CQC need to take further regulatory action e.g. an inspection. As with the ESF, the CQC will produce a “monitoring summary record” following the call. Their guidance states “this record is not an inspection report, and there is no rating as a result. This means that usual steps such as the factual accuracy process do not apply.” This is concerning.
The clear focus on services of concern is a shift from CQC’s previous strategy which focused on risk as well as improvement. A focus on ‘risky services’ coupled with more focused and targeted inspection activity may leave other services without a mechanism to demonstrate improvement and achieve a better rating. CQC recognise that this will mean that they will only be able to re-rate services in a limited number of cases. This will be very frustrating for Providers, particularly those in the “Requires Improvement” category who have been waiting for an opportunity to demonstrate improvements at inspection. They are unlikely to be afforded that opportunity any time soon if they are not viewed a “risky” service.
Providers should continue to put forward evidence of best practice to CQC both in response to the TRA call and their draft report if they are a service that is inspected.
For those services that are inspected, the Factual Accuracy Process will be more important than ever for Providers to check and challenge the completeness of the information that CQC has used to reach its judgements and ratings. CQC’s own guidance is clear that this can include additional information such as exemplary practice to support a higher rating.