What To Expect From The CQC In 2023

In April 2023, the CQC published an update in relation to what providers can expect for the rest of 2023 in terms of its new regulatory approach and new single assessment framework.

In its update, the CQC stated that it has been reorganising its internal operational teams and that whilst this is taking place, staff will continue to use the CQC’s current assessment frameworks whilst they spend time familiarising themselves with the new regulatory approach in order to prepare for implementation later in the year.

What Is The CQC’s New Approach And Single Assessment Framework?

Under the CQC’s new inspection approach, inspections will remain but a wider range of activities will be used to gather evidence to assess quality. The quality of a service will be reviewed more regularly and the CQC will do this by considering a series of quality statements which fall under the different domains of Safe, Caring, Effective, Responsive and Well-led. In total, there will be 34 topic areas across the five key questions.

The CQC describes quality statements as, “the commitments that providers, commissioners and system leaders should live up to. Expressed as ‘we statements’, they show what is needed to deliver high-quality, person-centered care.” All providers, no matter what type of service they provide will be assessed under the same single assessment framework which will link to the relevant regulations. An example of a quality statement which falls under the Safe domain and relates to a provider’s learning culture is, “We have a proactive and positive culture of safety based on openness and honesty, in which concerns about safety are listened to, safety events are investigated and reported thoroughly, and lessons are learned to continually identify and embed good practices.”

The CQC has also developed six categories of evidence to understand how the quality of care is being delivered against a quality statement. The six categories are as follows:

1. Peoples experiences;

2. Feedback from staff and leaders;

3. Observation of care;

4. Feedback from partners;

5. Processes; and

6. Outcomes of care.

The CQC’s current four ratings of Outstanding, Good, Requires Improvement or Inadequate will remain in place but the CQC will use a scoring framework to determine the quality of the service on an ongoing basis. The idea behind this being that ratings are more responsive to changes in risk and reflect the most up-to-date view of quality. Depending on what the CQC finds, it will provide a score for each required evidence category as follows:

4 = Evidence shows an exceptional standard of care

3 = Evidence shows a good standard of care

2 = Evidence shows shortfalls in the standard of care

1 = Evidence shows significant shortfalls in the standard of care

Initially the CQC will only publish ratings but in the future it intends to publish specific scores. The CQC is of the view that using a scoring system as part of its assessments will assist providers as it will indicate how close the service is to another rating. For example, for a rating of Good the score will demonstrate whether the rating is closer to achieving Requires Improvement or Outstanding. The scores will also help the CQC determine if quality is moving up or down within a rating.

What Happens Next?

The CQC has said that during the summer of 2023, it will start to roll out its new online Provider Portal and it will notify providers directly about when they are able to sign up to the portal. Providers will be able to submit statutory notifications via the portal as the CQC moves away from using email. The Provider Portal will be the only way for the CQC and providers to communicate electronically in the future and so it is advisable that provides familiarise themselves with the new system.

Later in the year, the CQC has said that when it rolls out its new assessment approach under its new assessment framework, providers will also be able to review the CQC’s draft judgements through what the CQC calls, “an improved process for checking the factual accuracy of draft reports”. It is unclear what this ‘improved process’ will look like in practice and we await further details. The CQC has also said that it will provide information on what ‘good’ looks like under its new assessment framework and will set out which evidence categories will be prioritised.

Conclusion

Over the coming months, the CQC will continue to provide updates in relation to the new assessment approach. This is good and necessary because at this stage providers still lack clarity in relation to how the new approach will work in practice.

If providers would like help with or advice in relation to the CQC’s inspection process, Ridouts can help. Please contact our specialist team of solicitors on 0207 317 0340 or ask for a call back via the website.