At Bettal we talk to providers like you everyday both about our product range and also about the things that matter to them. One of the frequent topics of conversation currently is the CQC’s single assessment framework. Many providers and registered managers are worried about what it means for them and what is going to change. Many are uncertain about the change in terminology and what that requires from their service.
In this blog we will take a look at the evidence categories, starting with processes which appears to be the most misunderstood category. We will consider what it means for providers and how Bettal can help.
If you are unclear about the single assessment framework, take a look at this previous blog, which highlights its main features, as well as our blog about the quality statements.
What is staying the same?
The good news for providers is that much of what you are used to in the regulatory approach is staying in its new incarnation, for example the five key questions, i.e. is the service:
• Safe.
• Effective.
• Caring.
• Responsive.
• Well led.
As well as the rating regime:
• Outstanding.
• Good.
• Requires Improvement.
• Inadequate.
What is evidence in the new regime?
While the CQC have always looked into the quality of care when inspecting providers, what they have looked at has always been a bit nebulous. Within the single assessment framework the approach to collecting evidence is set to be more tangible with the defined evidence categories consisting of:
• People’s experiences.
• Feedback from staff and leaders.
• Observations of care.
• Feedback from partners.
• Processes.
• Outcomes of care.
We will explore each of these categories in future blogs, for now we’ll see what the CQC mean by processes.
Processes
Processes are in essence all of the things a provider needs to have in place to function as a safe, compliant care service, e.g.:
• Policies.
• Procedures.
• Staffing records.
• Recruitment.
• Training.
• Supervision.
• Care and support plans.
• Risk assessments.
• Audits.
• Incident and accident reports.
• Complaints and compliments.
Of course to be processes, it is important that providers do something with this evidence. It is not, for example, enough just to have policies and procedures, providers need to show how they share these with staff and ensure they are put into practice.
So instead of asking if a service has these things in place the CQC ask:
• How does the service identify and manage risks to people’s health and wellbeing?
• How does the service ensure staff have the right skills, knowledge and experience to provide care?
Accidents, incidents, complaints and compliments also enable the provider to demonstrate the processes they have in place for learning lessons and feeding these down to the team and into changing what they do. So the question which arises is:
• How does the service promote a culture of learning and constant improvement?
In this sense processes are the key element of good governance and have a direct impact on the ways in which care is delivered and experienced by people and the outcomes of care – both evidence categories in their own right. Processes are therefore arguably the most important of the evidence categories because they bring to life other evidential classifications and allow the provider to show they know what they are doing.
How is the judgement made?
We know that inspections will only form one part of the single assessment framework. This means the CQC will collect evidence in a variety of ways in order to understand if providers have meaningful processes in place, including:
• Feedback from Service Users.
• Listening to staff and managers.
• Direct monitoring activities (conversations between the provider and the CQC).
• Evidence submitted by the provider.
Each judgement will relate to how well processes work to support the quality statements. For example the quality statement which states:
We have systems and processes to keep people safe from abuse, neglect, avoidable harm and discrimination
Might be judged by looking at the process providers use to:
• Manage safeguarding concerns.
• Respond to and manage accidents and incidents.
• Protect Service Users dignity and human rights.
Once you, as a provider, understand this, you will see how straightforward the new single assessment framework could be.
Summary
Preparing for the single assessment framework is not as challenging as many of the people we speak to believe. It really is a matter of understanding the terminology and breaking it down into actions which the service can take to ensure the requirements are met, just as you have always done.
One way to prepare to meet the processes check is to source your policies and procedures etc. from a reputable consultancy, like Bettal. Of course it is then up to you as a provider to review the policies and procedures, adapt any that need adapting for local use and to roll out the documentation to the wider team and ensure they are implemented.
If you would like to know more, browse our website, or get in touch:
Email: info@bettal.co.uk
Telephone: 01697741411
Peter Ellis MA MSc BSc(Hons) RN
Consultant
Bettal Quality Consultancy