If you are reading this, chances are you are looking into home care services for yourself or a loved one. Deciding on a home care provider is one of the most important decisions you can take, with far-reaching implications for you and your loved ones.
This guide explains the role of the Care Quality Commission in assessing and regulating the home care industry in England, including what and how the CQC assesses home care providers, and why it matters when choosing home care.
What does the CQC do?
The Care Quality Commission (CQC) is the independent regulator of health and social care in England and is sponsored by the Department of Health and Social Care. The CQC makes sure health and social care services, such as home care providers, deliver safe, effective, compassionate, high-quality services.
They do this through:
- Registering care providers
- Monitoring, inspecting and rating services
- Taking action to protect individuals who use services
- Publishing their views on major quality issues in health & social care
If you are thinking of receiving home care, it’s important to understand the role of the CQC in the home care sector and learn how you can use their inspection ratings to assess potential home care providers.
What types of home care services do the CQC regulate?
Home care is a broad sector that encompasses home care providers, carer introductory agencies and private carers. Not all of these providers are regulated by the CQC.
The CQC assesses and regulates full-service home care providers only. A full-service home care provider describes a home care service that is fully managed by the provider, such as Trinity Homecare. This means they recruit and manage all their care staff and are wholly responsible and accountable for the home care that they provide.
The CQC does not regulate private carers and introductory home care agencies. Introductory home care agencies are client and carer introductory services. This means that the agency matches clients with professional carers who are self-employed. In this scenario, the carer is employed directly by the client and is the same as employing a private carer directly.
What does being CQC registered mean?
Any individual, partnership or organisation that provides regulated home care services in England must be registered with the CQC otherwise they commit a criminal offence.
When a home care provider registers with the CQC their application will be assessed for their ‘fitness and compliance’ to the requirements of the relevant regulations, otherwise, the application will be refused. The term ‘fitness and compliance’, the regulated activities, and the wider registration requirements are set out in the Health and Social Care Act 2008.
CQC inspections of home care providers
When the CQC carries out an inspection they consider 5 key elements of the service and rate them accordingly. The 5 standards are:
- Is it safe?
- Is it effective?
- Is it caring?
- Is it responsive?
- Is it well-led?
Each standard is given a rating.
The 4 possible ratings are:
- Outstanding – The service is performing exceptionally well.
- Good – The service is performing well and meeting the CQC’s expectations.
- Requires Improvement – The service is not performing as well as it should and the CQC has told the service how it must improve.
- Inadequate – The service is performing badly and the CQC has taken action against the person or organisation who runs it.
There are several different types of inspections that the CQC carries out in order to assess and rate a home care provider:
Comprehensive inspections take an in-depth and holistic view of the whole service. Inspectors look at the five key standards to consider if the service is safe, effective, caring, responsive and well-led. They give a rating of Outstanding, Good, Requires Improvement, or Inadequate for each key question, as well as an overall rating for the service.
Focused inspections are more targeted than comprehensive inspections: they are a response to specific issues or to follow-up findings from a previous inspection. They do not look at all five key questions.
These have a narrower focus than focused inspections and are intended to assess a particular risk or concern, for example, whether a warning notice has been met or to look at tangible concerns about specific risks to people’s safety.
Typically a CQC inspection will begin with a meeting with the care provider’s Senior Team to introduce the inspection team, the scope and purposes of the inspection and how they will communicate their findings.
Next, the inspectors will gather evidence using the five key standards. They will gather views of clients and staff members and will observe the care provided, review records, inspect the surroundings and look at documents & policies.
Once inspectors have gathered all the information needed they will hold a feedback meeting with the home care provider’s senior team. In the feedback meeting, they will cover key findings, highlight any issues, identify any immediate actions that are needed, and explain how they will make their judgments and publish them.
The 5 CQC standards in detail
Let’s take a look at the 5 key standards and the types of evidence that the CQC is looking for in each comprehensive inspection of home care providers:
1) Is it safe?
- How can you safeguard people from abuse?
- How are risks and safety monitored to ensure people’s freedom is respected?
- How do you ensure the proper and safe use of medicines?
- How well are people protected by the prevention and control of infection?
- Are lessons learned and improvements made when something goes wrong?
2) Is it effective?
- Is care delivered in line with legislation and evidence-based guidance?
- How do you ensure staff have the knowledge to deliver effective care?
- How well does your organisation as a whole work together to deliver effective care?
- Are carers aware of individual client’s likes, dislikes and preferences, and aware of their individual care requirements?
3) Is it caring?
- How do you ensure people are treated kindly and provided with emotional support?
- How do you support people to be actively involved in making decisions about their care?
- Do you treat clients with dignity and respect?
- Is a client’s privacy respected?
4) Is it responsive?
- How are concerns and complaints handled to improve the quality of care?
- Are clients and their families involved in creating care plans and how detailed are they?
- How quickly can you adapt to a client’s changing needs?
- How quickly can you implement change?
5) Is it well-led?
- Is a positive culture promoted?
- Are responsibilities clear and quality performance, risks and regulatory requirements managed?
- How are people engaged and involved with the service?
- How does your organisation continuously learn, improve and innovate?
- Are the management team accountable, honest and transparent?
- Are there clear and open lines of communication between management and care staff?
- Are care staff able to easily report concerns about the care provided by other carers/professionals?
To learn the in-depth rating criteria for each of the 5 inspection areas you can read more here.
Using CQC ratings to choose a home care provider
Now you understand the role of the CQC, the key standards for inspection, and how home care providers are rated you can use the CQC ratings to assess home care providers that are of interest to you.
You can find the CQC ratings for full-service home care providers, like Trinity Homecare, on the CQC website. Simply go to their homepage and type in the name of the home care provider you want to learn more about.
Alternatively, you can usually find the CQC ratings on the home care provider’s website. If a provider is happy to highlight their CQC rating on their website, it is a good sign that they have been rated highly and provide a good quality service. The opposite is also true if you cannot easily find the CQC rating on the home care provider’s website. Check the CQC website for the full report.
At Trinity Homecare, we are very proud to have been awarded ‘Outstanding’ by the CQC for the home care services we provide. That puts us in the top 3% of home care providers in England.
If you or your loved one are looking for high-quality, well-managed home care, look no further than Trinity. With over 30 years of experience, our CQC rating and customer reviews say it all. Call us today to find out how we can help you on 0207 183 4884, lines are open 7 days a week. Alternatively, complete our online enquiry form and one of our team will be in touch soon.