As the inevitable date for the CQC applying the single assessment framework approaches, we know that many providers are worried about what it means for them. There is of course another group of providers who are busy ignoring it while a further group are grabbing the bull by the horns and getting on with their preparations for it.
At Bettal, we would really like you to be in the latter group of providers who are prepared for the new regime because you understand what it will mean for you. In a previous blog we considered the evidence category process, in this blog we will consider what CQC mean by the evidence category outcomes.
If you are not up to speed with the single assessment framework and therefore do not understand the context of the evidence categories, please read what the CQC have to say about it.
Why is evidence important?
Previous inspection regimes have used evidence to determine the rating for providers, but the CQC have not always been clear as to where they will look for the evidence. Under the new single assessment framework, they have identified six distinct areas of evidence which they are interested in:
• People’s experiences.
• Feedback from staff and leaders.
• Observations of care.
• Feedback from partners.
• Outcomes of care.
With any and all elements of evidence-based practice, including inspection, the benefit of gathering information from more than one place is that the different forms of evidence can be checked off against each other. By checking different forms of evidence against each other, sometimes called triangulation, the CQC get a better picture of what the reality of any situation actually is.
So if one element of evidence appears to indicate good practice and another poor practice, then the inspector may look at a third form of evidence to work out what is really going on. Notably, the gathering of evidence is not a one-off event, with inspections no longer being the primary means by which providers are judged.
If you are not clear about what outcomes are, the CQC define them as:
Outcomes are focused on the impact of care processes on individuals. They cover how care has affected people’s physical, functional or psychological status.
Although this is a little ambiguous, the examples they also provide are not and include:
• Mortality rates.
• Emergency admission rates.
• Infection rates.
The CQC identify how they will collect data on outcomes of care remotely which may mean from Service Users, staff or other local agencies, like Healthwatch.
Why are outcomes important?
Outcomes are important because they provide a good measure of how effective a provider is being. Outcomes are in essence what providers work to achieve with their Service Users and so measuring them is an important way to measure the effectiveness of care provision.
Setting and achieving outcomes are fundamental to good care and support planning. Assessments identify what care needs a Service User has and the care and support plan provides the blueprint for how these will be met, the outcomes of care.
How is the judgement made?
The judgement which the CQC will come to about outcomes of care will be measured against the quality statements. So for example, if we take the quality statement from caring that says:
We promote people’s independence, so they know their rights and have choice and control over their own care, treatment and wellbeing.
An outcome measure of this is that when questioned, Service Users do indeed know their rights. Also the CQC would expect that Service Users, the people important to them and other professionals who work with a provider will state that people are given choice and control over their care.
Similarly if we take the quality statement from effective which says:
We routinely monitor people’s care and treatment to continuously improve it. We ensure that outcomes are positive and consistent, and that they meet both clinical expectations and the expectations of people themselves.
The CQC would expect to see that care and support plans identify measurable and person-centred outcomes. The CQC would also expect to see that these outcomes are reviewed regularly with the Service User and those important to them and that they are being met or that progress towards meeting them is being made.
Making sure you are prepared for the single assessment framework as a social care provider is a matter of ensuring you have read and understood what it requires from you – which is in essence what being a provider has always required of you.
One way to prepare to meet the outcomes 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:
Peter Ellis MA MSc BSc(Hons) RN
Bettal Quality Consultancy