Helen Fuller, Managing Director at Care 4 Quality
In the wake of the pandemic, Care Providers are finding themselves experiencing a new level of scrutiny from the regulator. The new methodology that has been laid out and is currently being adopted by the Care Quality Commission (CQC ), is slowly but surely becoming a key element of a provider’s care journey from registration to inspection ongoing monitoring not to mention enforcement actions. This means that the expectations for Providers to be evidencing their level of engagement and input around the governance of their services is more crucial than ever before.
Care 4 Quality provide consultancy and support to over 650 care services across the UK. In the past few months, we have observed a tangible increase in the focus around how providers have true operational oversight and a watertight knowledge of the regulatory framework that underpins their business and the care provision with them. Sadly, this is normally as a result of a difficult inspection, a significant safeguarding, or the increase in service monitoring by CQC.
From the registration ‘fit persons interview’ to the evidence of provider oversight that is requested consistently during inspection, and now during monthly monitoring, there is now an expectation to be able to evidence true governance of the service with a visible leadership and vision from the Provider.
What steps should a Providers take to ensure that they can evidence what is required of them?
Knowledge and Competence – Providers and Nominated Individuals must ensure that they have the necessary knowledge and practical understanding of the Health and Social Care Act and other relevant pieces of legislation, so that they can make informed judgements and decisions around the information that they are receiving from the home as part of regular management updates. There must be a clear understanding of the roles and responsibilities of a nominated individual. Providers must also be able to demonstrate that they have carried out sufficient checks and assessment of the service prior to taking ownership, and have a clear plan in place to support continuous improvement and development of the service. Reading CQC inspection reports to develop a wider knowledge of the regulatory framework and operational expectations is helpful.
Governance Structure – The system of auditing, reporting and clinical governance within the service needs to be such that it is subject to as much scrutiny as possible so that it maximises opportunity for isolated and organisational learnings and prompts conversations around best practice. So what does this look like in practice? Regular meetings and visits between the provider and management team to keep abreast of the day-to-day operations, stresses, and requirements of the business. This can mean spot checking audits, walking around the home with the management team, carrying out provider visits (and recording these) and maintaining open and transparent relationships with service users and stakeholders.
Interactions with the CQC – Try wherever possible to maintain a positive dialogue between the service, Provider and the CQC. This will help to build a relationship that demonstrates candour, responsiveness, commitment to quality of care and best practice.
Interactions with the Registered Manager – Carry out regular and meaningful supervision with your manager. This will strengthen the leadership dynamic and foster positive communication channels between manager and provider.
In conclusion, Providers need to be able to demonstrate a good working knowledge of their service. This will in turn enhance the relationship between the Provider, the Registered Manager, key stakeholders, and the regulator.