Good, But for How Long? CQC’s New Focus on Aged Ratings
Care Quality Commission (CQC) has published new guidance setting out how it will revisit certain adult social care services that are already rated Good. The initiative is designed to confirm whether older Good ratings remain accurate, while enabling the regulator to assess a greater number of services.
The programme will apply to selected services with aged Good ratings, including care homes, domiciliary care agencies and supported living services, provided they meet specific eligibility criteria:
are rated Good overall and Good in all five key questions,
have a rating that is at least six or seven years old,
have a registered manager,
present no indication of a change in rating,
do not provide care or treatment to children,
have not added the service user band of ‘people with a learning disability and autistic people’ since they were last rated good,
have no ongoing enforcement activity.
Rather than carrying out a full assessment, CQC intends to use a more streamlined approach, focusing on a reduced number of quality statements and placing particular emphasis on the experiences and outcomes of people receiving care.
For providers, the most important message is that inspectors will be looking closely at what life is actually like for people using the service. CQC has stated that it will spend more time gathering feedback from people who use services, relatives, visiting professionals, staff and leaders, alongside observing care and support in practice. Positive findings will then be supported by targeted reviews of records and documentation.
This reinforces a theme that has run through CQC’s assessment framework for some time: good paperwork alone is not enough. Providers should ensure they can demonstrate how governance systems, audits and quality assurance processes translate into positive lived experiences and outcomes for the people they support.
While I am sure that many of the providers that fall within this remit will welcome the opportunity to demonstrate that their services remain Good or are now Outstanding, you cannot escape the concern that such ratings may be harder to achieve under this system. CQC will assess fewer quality statements and assessment reports will be more concise. Some providers may feel that opportunities to demonstrate exceptional practice could be more limited within a shorter and more focused assessment.
The guidance states that inspectors will only expand the assessment and revert to the usual assessment methodology if they identify concerns or evidence of outstanding practice during planning or the assessment process.
Key takeaways
As the programme rolls out, providers should take the opportunity to prepare by asking some key questions:
What would people using our service say about their experience today?
Can we clearly evidence positive outcomes?
Are our records consistent with what people, staff and professionals would tell an inspector?
Can we demonstrate continuous improvement rather than simply maintaining compliance?
Ultimately, the new programme reflects CQC’s desire to ensure that historic Good ratings continue to reflect current performance. Providers with older ratings should expect greater scrutiny and should focus on ensuring that the quality of care experienced by people every day matches the rating displayed on the front door.
While any uptick in inspection activity is welcome, the cynical among us may wonder whether this is a ‘get rich quick’ scheme to get some inspection numbers on the books.