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All Change for the CQC!

Wednesday 19th Mar 2014 - Kate Hodkinson

Thoughts of CQC have been constantly in the mind of many practice managers over the last 18 months – and even those who have successfully been through the inspection process can’t ignore it now.

A consultation launched in January by CQC is aiming to clarify how the current 28 Outcomes in the Essential Standards of Quality and Safety will be replaced by the new 11 Fundamental Standards and supporting conditions.

Professor Steve Field, the Chief Inspector of general Practice, has given several interviews outlining the changes expected from April this year. Some of them, I believe, demonstrate an improvement in the process – especially the make up of the inspection team that will include:

  • CQC  inspector
  • A GP
  • A Practice Nurse or Practice Manager
  • A Trainee GP
  • And possibly, a member of the public with “particular experience of using GP services”

I am hoping that this last point does not necessarily mean some of the daily visitors that GP practices get!

Five Key Questions From the CQC

The outcomes areas that are  currently in use will be replaced and the focus will shift to five key areas for providers to demonstrate:

Is it safe?

  • People are protected from physical, psychological or emotional harm and this area will focus on cleanliness, medicines management, safeguarding and incident monitoring

Is it effective?

  • People’s needs are met and their care is in line with nationally recognised guidelines and relevant NICE standards. The focus will be on people receiving the right diagnosis, care of people with long term conditions, effective referral processes and involvement in decision making

Is it caring?

  • People are treated with compassion, respect and dignity and that care is tailored to their needs in line with RCN 6Cs approach

Is it responsive?

  • Care and treatment is delivered at the right time, without excessive delay and that people are listened to in a way that responds to their needs and concerns. This area will focus on access, responding to the needs of your local population, record keeping and patient engagement and feedback

Is it well led?

  • There is effective leadership, governance and clinical involvement at all levels and an open and fair culture that listens to people’s views. This area takes into account training and supervisions and coordination with other providers

Eleven Fundamental Standards of Care from the CQC

  1. Person-centred care. The care and treatment of service users must reflect their needs and preferences.
  2. Dignity and respect. Service users must be treated with dignity and respect.
  3. Need for consent.
  4. Safe and appropriate care and treatment. All care and treatment provided to service users must be appropriate and safe.
  5. Safeguarding service users from abuse. Service users must not be subject to abuse.
  6. Meeting nutritional needs. The nutritional needs of service users must be met.
  7. Cleanliness, safety and suitability of premises and equipment
  8. Receiving and acting upon complaints
  9. Good governance
  10. Staffing
  11. Fit and proper persons employed

Download the 11 fundamentals standards of care with full supporting conditions CQC Fundamental Standard of Care 2014.

The Impact?

CQC will begin testing the new approach in April and will evaluate their findings in the summer before the new process and regulations are formally adopted in October. Every practice should have been inspected and rated by April 2016 – a challenging target for them to meet.

The 11 Fundamental standards don’t really change the basic principles that have been in the previous essential standards but the challenge for practices will be to provide evidence across the 5 Key questions  and not just in relation to each individual  supporting condition.

I will keep repeating the message to practice, that they should have confidence in the fact that their care is safe, effective, based on patient needs, well managed, compassionate and see the CQC inspection as an opportunity to demonstrate this.  Practice managers will need to continue the work started on getting the whole team involved and committed as the emphasis of the visit will continue to be on what actually happens to the patients and how they are dealt with by the team. The areas that every practice needs to look at will continue to be in ensuring that they  have sufficient, relevant and up to date evidence to support their registration.

Thornfields can provide a range of courses to meet mandatory training requirements such as Chaperone Training and Information Governance. For more information and details of the courses Thornfields provide


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