The rollout of the Care Quality Commission’s (CQC) new single assessment framework is underway, but many social care providers are concerned the new approach places too much reliance on past performance and could distort new assessment ratings.
How are social care providers assessed?
Under the new framework, the performance of social care providers is assessed on five key questions and a selection of 34 ‘quality statements’, based on perceived risk. Whilst the core questions have not changed (safe, effective, caring, responsive and well-led), ratings are dependent on how well providers meet the supporting quality statements.
In the initial assessment carried out, the CQC has not considered all 34 statements; instead, it is considering an average of 9 to 10 quality statements. The following five quality statements have been appeared in all assessments carried out to date and they should therefore be treated as priority areas:
- Safeguarding
- Equity in experience and outcomes
- Involving people to manage risks
- Safe and effective staffing
- Independence, choice and control
New framework, poor reception
With many social care providers under pressure currently, the new assessment regime has not been well received. As the CQC has only been assessing providers against a small number of the 34 quality statements, many are concerned that their assessment could be inaccurate. For example, if a provider scored poorly in a specific area previously, this would be carried forward into their new assessment, regardless of any improvements they might have made in the meantime.
Those concerns have been shared with the CQC, who has since indicated that it will ensure that areas of poor performance from previous inspections will be revisited, although we are yet to see how this will be achieved in practice.
How can providers prepare for future assessment?
Any care providers concerned about the assessment process should ensure they have reviewed the quality statements thoroughly. They should prepare supporting evidence that will best demonstrate the provision of high-quality care. This preparation might include:
- Evidencing good performance for each of the five priority quality statements.
- Reviewing past problem areas, relating them to one of the new quality statements, and providing evidence of strong performance.
If there are areas that have scored negatively in the past, special attention should be given to demonstrating the steps taken to improve performance. This should be supported by feedback from service users, third-party professionals, and other stakeholders. While the CQC has indicated that future assessments will be wider than those seen to date, providers should be prepared to challenge the CQC to broaden its assessment to ensure performance improvements are included.
Under the new assessment regime, providers that are currently rated ‘good’ or ‘outstanding’ can’t afford to be complacent as just one negative score on a single quality statement could skew their overall rating. For example, a score of 1 for any quality statement would mean that their overall rating couldn’t be better than ‘requires improvement’. A score of 2 for any quality statement would mean that they couldn’t achieve an ‘outstanding’ rating.
Key takeaways
The CQC’s assessment framework is relatively new, and to some extent, the real challenge is yet to come. The pandemic has left a large backlog, and it is going to take time for the CQC to reassess all providers of care and support.
Social care service providers should consider doing the following:
- Prepare evidence of strong performance for each of the five priority quality statements.
- If the provider has been rated poorly in the past, identify which of the new quality statements is most relevant and provide robust evidence of strong performance.
- Prepare managers to challenge the CQC if the assessment’s findings are not a fair representation of current performance.
For more information
For more information, contact Tim Coolican or Freya Cassia.