David Finney tells you how to prepare for your CQC Inspection, ahead of the latest changes
I wonder if, every time the doorbell rings, you imagine that it might be the CQC inspector making their unannounced visit to inspect your service and, potentially, decide your future.
The latest news from CQC is that they have told all substance misuse treatment providers that the start of the inspections of all ‘independent standalone’ services will begin in July 2015. This basically refers to residential rehabilitation services.
Until then, CQC have said that they will be conducting a ‘survey of the provider landscape’. This means that you will probably receive a form in which you will be asked to give a range of factual information, such as how many beds you have, staffing numbers, and registration details. This does not mean that you will be inspected soon; it is merely an information-gathering exercise.
Meanwhile, there are two important changes to bear in mind when preparing for inspection:
- You are no longer considered to be care homes. I think this should be a relief, as for years you have been trying to convince CQC that you are specialist treatment services first and foremost. CQC now take this view as well.
- You are now within the specialist mental health section of the Hospitals Directorate at CQC. This will mean that inspections will look very different. The questions you will be asked will come from a treatment perspective, and the inspectors will probably have a mental health background. CQC say they are going to provide specific training for inspectors in substance misuse, although I am not sure that this has started yet.
So what will inspections look like; and how can you best prepare yourself for them?
There are two distinct stages outlined by CQC:
- Intelligent Monitoring: CQC will aim to gather information from a range of sources about the operation of your service.
- They will scan information provided by organisations such as Safeguarding Boards, Public Health England, Healthwatch, and Clinical Commissioning Groups.
- They will rely on you to supply information about your stakeholders – such as people who commission your services, local authorities, mental health teams, and any other professionals with whom you do business. You will be asked for this information in a ‘Provider Information Return’ (PIR). Normally you will only have a few days to supply this information.
Tip: Make a list of all your stakeholders so that you can supply this information quickly.
- In your PIR, you will be asked to answer the five questions: how is your service safe, effective, caring, responsive, and well-led? You will also be asked what improvements you are intending to make to your service.
Tip: Match your answers to the characteristics for ‘good’ services, published by CQC.
- Site visit: You will probably be visited by an inspection team, which will include an ‘expert by experience’ (ie a person who has used services), and possibly a specialist professional advisor.
The team will use the new methodology, which is yet to be published in its final form, but will follow the ‘Key Lines of Enquiry’. This will include new questions about treatment effectiveness, use of evidence-based outcomes, systems for keeping people safe, implementation of the Mental Capacity Act and governance structures, as well as all the standard issues such as premises, staffing, and safeguarding.
Tip: Look at the new Key Lines of Enquiry when they are published and ensure that you have covered every angle.
Finally, look out for any training that is specific to the substance misuse sector so that you have the right focus to your preparation.
David Finney is an independent social care consultant with a specialist interest in the regulation of substance misuse services.
A DDN/FDAP CQC compliance workshop will be taking place 7 July 2015. For more information and to book, visit www.drinkanddrugsnews.com/cqc-training