24 June 2024

Navigating the single assessment framework

CQC have sought to significantly change the inspection regime of all CQC regulated services in the last year, with the introduction of the new single assessment framework.

The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 underpin the delivery of care and the new assessment process but it is important to recognise that these have not changed in substance since their introduction.

So whilst those Regulations – the Fundamental Standards of Care – have not changed, the methodology and approach of observation, assessment and scoring by CQC is all new.

Providers will need to engage with the 34 new Quality Statements and showcase your service to CQC to demonstrate compliance and score maximum points.

Head of social care, Philippa Doyle, explains how to navigate the new inspection regime in the most cost-effective way, outlining the essential steps your business needs to take in preparation, in her latest article, first published in Care England’s Savings, Solutions, and Sustainability publication.

The shift from key lines of enquiry to quality statements

One of the most notable changes brought about by CQC’s new single assessment framework has been the transition from the previous 303 key lines of enquiry to 34 quality statements. On the surface, this reduction in the number of statements might suggest a simplification of the inspection process.

However, the reality is more nuanced. While fewer in number, the quality statements encompass a broader range of elements, requiring a more comprehensive understanding and demonstration of compliance from social care providers.

For providers, adapting to this shift involves a two fold approach:

keep doing what you’re doing
start reviewing each quality statement and look at what evidence you have within your service to demonstrate your compliance

Delivering the care is the easy part. The vast majority of providers are going to score ‘good ‘ in ‘caring’, because caring is what you and your staff do. The harder elements of the inspection regime are producing evidence to demonstrate your service is ‘safe’ and ‘well led’. Those two key domains are the ones to focus on. Get these right, and ‘effective’ and ‘responsive’ should follow.

The important of evidence based compliance

At the heart of effective compliance with CQC’s single assessment framework lies the concept of evidence. The adage ‘if it’s not written down, it didn’t happen’ encapsulates the essence of this principle. Providers are required to document their policies, procedures, and training protocols meticulously.

This documentation serves as tangible evidence of their commitment to delivering safe, high-quality care.

Moreover, compliance extends beyond mere documentation. Providers must also demonstrate a proactive approach to risk management and continuous improvement. This involves not only identifying potential risks but also implementing measures to mitigate them effectively. Additionally, providers must ensure that their staff are adequately trained to respond to various scenarios and that these training initiatives are well documented.

Key areas of focus

Within the framework of the CQC’s new single assessment, two key domains emerge as focal points for providers – safety and effective leadership. While delivering compassionate care may come naturally to many social care professionals, effectively demonstrating safety and leadership poses unique challenges.

Safety encompasses various dimensions, including physical safety, infection control, and medication management. Providers must ensure that their facilities are safe environments for both patients and staff. This involves conducting regular risk assessments, implementing robust infection control measures, and maintaining accurate records of medication administration.

Effective leadership, on the other hand, involves fostering a culture of accountability, transparency, and continuous improvement within the organisation. Leaders must lead by example, prioritising patient safety and staff wellbeing at all times. This entails promoting open communication channels, soliciting feedback from both staff and service users, and implementing mechanisms for learning and improvement.

Unpacking the quality statements

To effectively navigate the CQC’s new single assessment framework, providers must delve into the specifics of each quality statement. Providers should also keep in mind how the quality statements frame questions in a different way. As an example, let’s examine the first ‘Safe’ quality statement on learning culture.

Quality statement one – learning culture

‘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 learned to continually identify and embed good practices.’

This statement emphasises the importance of fostering a proactive and positive culture of safety within the organisation. Key elements include:

Openness and honesty – encouraging staff to report safety concerns openly and honestly.
Thorough investigation – conducting comprehensive investigations into safety events and incidents.
Continuous learning – extracting lessons from safety events to identify and embed best practices.

Providers are expected to provide evidence across various categories, including feedback from partners, organisational processes, duty of candour records, and evidence of learning and improvement. Compliance with this quality statement requires a multifaceted approach, involving organisational learning, continuous improvement, and adherence to regulatory standards such as duty of candour (Regulation 20).

Aligning with the fundamental standards

In addition to the quality statements, providers must also ensure compliance with the fundamental standards outlined by the CQC. These standards serve as the baseline for assessing the quality of care provided by social care organisations.

Let’s explore some of the key regulations relevant to safety and effective leadership:

Regulation 20: Duty of candour – providers must be transparent and honest in their dealings with patients and their families, particularly in cases of safety incidents.
Regulation 17: Good governance – providers must demonstrate effective governance structures and processes to ensure the delivery of safe, high-quality care.
Regulation 12: Safe care and treatment – providers must assess and mitigate risks effectively, ensuring the safety of patients under their care.

Practical tips and strategies

Compliance with the CQC’s new single assessment framework requires a comprehensive understanding of the regulatory landscape and a proactive approach to risk management.

Here are some practical tips and strategies for providers:

Stay updated – keep abreast of changes to regulations and guidance issued by the CQC.
Document everything – maintain thorough records of policies, procedures, and training initiatives, ensuring compliance with regulatory standards. You should also consider that you might need to present evidence in a different way to get the best marks.
Proactive risk management – conduct regular risk assessments and implement measures to mitigate identified risks effectively.
Foster a culture of learning – encourage staff to engage in continuous learning and improvement initiatives, fostering a culture of accountability and transparency.
Seek expert advice – don’t hesitate to seek guidance from legal or compliance experts

Navigating the path ahead

In conclusion, navigating the CQC’s new single assessment framework requires a proactive and systematic approach to compliance. By prioritising safety, effective leadership, and evidence-based practice, social care providers can demonstrate their commitment to delivering high-quality care. In addition, by unpacking the quality statements, aligning with fundamental standards, and implementing practical strategies, providers can navigate this new inspection regime in the most cost-effective manner possible.

Resources for health and social care providers

Providers can find out more on this topic from the recording of the first of four Care England webinars, run by Philippa, titled, ‘CQC single assessment framework: Quality statements analysis and how they link with the fundamental standards of care’. You can also register for the upcoming second webinar, titled, ‘CQC Well Led Quality Statements: An analysis’.

Hempsons offers training to assist providers with the CQC’s new single assessment framework and also to ensure you are operating in accordance with the fundamental standards of care.

If you need any help, you can also contact our free social care advice line for up to 30 minutes’ free advice. Call 01423 724056 or email socialcare@hempsons.co.uk.