Quality of Care Homes and Care received at Home

The Care Quality Commission (CQC) is the independent inspector and regulator of health and social care services in England.

They make sure health and social care services, such as Care Homes and Care and Support in peoples’ own homes are safe, effective and high-quality. The CQC monitor, inspect and regulate services to make sure that they meet fundamental standards of quality and safety and they publish what they find to help people make informed decisions about their choice of care.

The CQC changed their monitoring regime in October 2014 to focus on 5 key questions:

Are they safe?

Are they effective?

Are they caring?

Are they responsive to people’s needs?

Are they well-led?

In order to answer these questions CQC Inspectors will gather information and intelligence from a range of sources including: Local Authorities, NHS and the Care Provider, and then carry out an on-site inspection. Once the inspector has considered all of the evidence related to each question a judgement is made on the compliance rating for each question and an overall rating for the care provider.

There are four ratings which the CQC give to health and social care services: outstanding, good, requires improvement and inadequate.T

Outstanding - The service is performing exceptionally well.

Good - The service is performing well and meeting our expectations.

Requires improvement - The service isn't performing as well as it should and we have told the service how it must improve.

Inadequate - The service is performing badly and we've taken action against the person or organisation that runs it.

Quarter 3 - December 2017

The Percentage of Care at Home Providers rated as Good or Outstanding by the Care Quality Commission(CQC) during 2017 followed an upward trend beyond the target. This is partly due to the prioritisation ofi nspections focusing on those Providers whom were rated non-compliant under the new inspection regime and also, partly due to West Sussex County Council and other commissioners of services increasing the support and coaching offered to care markets to promote the sustaining of enhanced quality of care for residents of the County.

During 2017 CQC commenced a public consultation process to seek views on their proposals to;

“regulate primary medical services and adult social care services, improve the structure of registration,and clarify their definition of registered providers, monitor, inspect and rate new models of care and large or complex providers, use their unique knowledge to encourage improvements in the quality of care in local areas, carry out their role in relation to the fit and proper persons requirement”

The consultations proposed a number of changes to the way that care services are registered and inspected by the CQC:

  • Key Lines of Enquiry (KLOEs), including the combination of the separate KLOEs currently used for community and residential based services into one new framework. There are 3 additional adult social care Key Lines Of Enquiry (that support the five key questions) with new prompts included in the sub-criteria under each KLOE.

  • Changes to frequency of inspections, including increasing the maximum interval between ratings for services rating Good or Outstanding from 24-months to 30-months.

  • Changes to response where services are repeatedly rated as Requires Improvement

  • Publication of refreshed guidance for ‘fit and proper’ persons requirements in relation to registration to for Providers and improved information sharing.

  • Introduction of an online Provider Information Collection which will allow care providers to submit up-to-date information about the quality of the service they provide directly to the CQC.

Adult Social Care Services were not planned to be inspected under the new revised framework until November 2017 and the maximum interval between inspections for services rated Good and Outstanding is due to be increased from 24 months to 30 months from April 2018, therefore; it may be some time before the impact of this is realised but as CQC implement the new inspection framework this will be a change for providers, consequently we anticipate there being a slight decrease in the quality ratings in the last 2 quarters of the year (services rated Good and Outstanding) compared to those during the last 12-months stabilise.

Quarter 2 - September 2017

The Percentage of Care at Home Providers rated as Good or Outstanding by the Care Quality Commission(CQC) during 2016/17 followed an upward trend beyond the target. This is partly due to the prioritisation of inspections focusing on those Providers whom were rated non-compliant under the new inspection regime and also, partly due to West Sussex County Council and other commissioners of services increasing the support and coaching offered to care markets to promote the sustaining of enhanced quality of care for residents of the County.

At the start of 2017 CQC commenced a public consultation process to seek views on their proposals to;

 “regulate primary medical services and adult social care services, improve the structure of registration,and clarify their definition of registered providers, monitor, inspect and rate new models of care and large or complex providers, use their unique knowledge to encourage improvements in the quality of care in local areas, carry out their role in relation to the fit and proper persons requirement”

The first phase of the consultation proposed a number of changes to the Key Lines of Enquiry (KLOEs), including the combination of the separate KLOEs currently used for community and residential based services into one new framework. There are 3 additional adult social care Key Lines Of Enquiry (that support the five key questions) with new prompts included in thesub-criteria under each KLOE. Adult Social Care Services will not be inspected under the new revised framework until November 2017. CQC are currently developing their next phase of regulation with consultation 2 due to close in August 2017. Consultation 3 is due to take place later in the year (2017/18). As CQC implement the new inspection framework this will be a change for providers, consequently we anticipate there being a slight decrease in the quality ratings in the last 2 quarters of the year (services rated Good and Outstanding) compared to those during the last 12-months stabilise. the increases seen during the last 12-months stabilise.

Quarter 1 - June 2017

The Percentage of Care at Home Providers rated as Good or Outstanding by the CQC during 2016/17 followed an upward trend beyond the target. This is partly due to the prioritisation of inspections focusing on those Providers whom were rated non-compliant under the new inspection regime and also, partly due to West Sussex County Council and other commissioners of services increasing the support and coaching offered to care markets to promote the sustaining of enhanced quality of care for residents of the County.

At the start of 2017 the CQC commenced a public consultation process to seek views on their proposals to;

“regulate primary medical services and adult social care services, improve the structure of registration,and clarify their definition of registered providers, monitor, inspect and rate new models of care and large or complex providers, use their unique knowledge to encourage improvements in the quality of care in local areas, carry out their role in relation to the fit and proper persons requirement”

The first phase of the consultation proposed a number of changes to the Key Lines of Enquiry (KLOEs), including the combination of the separate KLOEs currently used for community and residential based services into one new framework. There are 3 additional adult social care KLOEs (that support the five key questions) with new prompts included in the sub-criteria under each KLOE. Adult Social Care Services will not be inspected under the new revised framework until November 2017. The CQC are currently developing their next phase of regulation with consultation 2 due to close in August 2017. Consultation 3 is due to take place later in the year (2017/18). As CQC implement the new inspection framework this will be a change for providers, consequently we anticipate there being a slight decrease in the quality ratings in the last 2 quarters of the year (services rated Good and Outstanding) compared to those during the last 12-months.

Quarter 4 - March 2017

Latest figure continues on an upward trend showing quality in care homes is increasing. This increase may be due to the prioritisation of inspections by the CQC, as they implemented the new inspection regime, i.e. implementation of the new inspection regime focused initially on those providers whom were rated non-compliant under the previous inspection regime. Additionally, during the past year West Sussex County Council and other commissioners of services have increased support offered to the care markets and offered advice and guidance to care providers to promote the sustaining of high quality care for residents of the County. As we move into the next year, and the Care Quality Commission complete their implementation of the inspection regime moving to focused inspections, we expect to see the increases seen during the last 12-months stabilise.