What is the CQC?

What does the Care Quality Commission do?

The CQC is short for the Care Quality Commission. CQC is “an executive non-departmental public body of the department of health and social care of the UK.” It was founded in 2009. The organisation’s responsibility is to monitor and inspect the UK health care services such as local care homes, GP practices and hospitals to ensure that these care services are providing high-quality care.

The report about inspected care services is published publicly on the CQC website including an overall rating and recommendation.

The four-rating levels are:

• Outstanding:

  The service is performing exceptionally well.

• Good:

  The service is performing well and meeting our expectations.

• Requires improvement:

  The service is not performing as well as it should, and we have told the service how it must improve.

• Inadequate:

  The service is performing badly, and we have taken action against the person or organisation that runs it

Currently, in the UK, 78% of inspected care homes are rated as Good.

The requirements that care providers need to meet

All NHS and social care providers must be registered with the CQC and a UK care provider must meet a minimum set of standards required by law. The fundamental standards set by CQC suggests that a care provider organization should deliver the following standards as a minimum:

• Person centred care:

  Care or treatment must be tailored to the care receiver’s needs and preferences.

• Dignity and respect:

  Care receivers must be treated with dignity and respect all the time to ensure that they have privacy when they need and want it; everybody is treated as equals; and they are given any support they need to help them remain independent and involved in local community.

• Consent:

  Care receivers (or anybody legally acting on their behalf) must give their consent before receiving any care or treatment.

• Safety:

  Care receivers must not be given unsafe care or treatment or to be put at risk of harm that could be avoided. Care providers must assess the risks to care receiver’s health and safety while any care or treatment. The care giver must have the qualifications, competence, skills, and experience.

• Safeguarding from abuse:

  Care receivers must not suffer any form of abuse or improper treatment while receiving care, which includes neglect, degrading treatment, unnecessary restraint, and inappropriate limits on their freedom.

• Food and drink:

  Care receivers must be ensured to eat and drink enough to stay in good health during their care and treatment.

• Premises and equipment:

  Premises must be clean, suitable and look after properly. The equipment used in care and treatment must also be secure and used properly.

• Complaints:

  Care receivers must be able to complain about their care and treatment and care providers must be able to handle and respond to the complaint.

• Good governance:

  Care providers must have plans that ensure they can meet these standards. They must have effective governance and systems to check on the quality and safety of care. These must help the service improve and reduce any risks to care receiver health, safety, and welfare.

• Staffing:

  Care providers must have enough suitably qualified, competent and experienced staff to make sure they can meet required standards. Staff must be given the support, training, and supervision they need to help them do their job.

• Fit and proper staff:

  Care providers must only employ people who can provide care and treatment appropriate to their role. They must have strong recruitment procedures in place and carry out relevant checks such as on applicants’ criminal records and work history.

• Duty of candour:

  Care providers must be open and transparent with you about care and treatment. When something goes wrong, they must tell care giver (or their behalf) what has happened, provide support and apologise.

• Display of ratings:

  Care provider must display their CQC rating in their visible area. They must also include this information on their website and make our latest report on their service available public.

What to expect from a good care home

The five standard criteria that CQC will assess against are:

• Safety
• Effectiveness
• Care
• Responsiveness to people’s needs
• Management

If the care home was rated as good in each of the five standards listed above, CQC suggested that care receivers can expect the following experience:

Safe

• The home and any equipment are well maintained, and managers look for ways to improve safety. Care receivers should feel confident that your belongings are safe and secure.
• There are always enough staff on duty with the skills needed to make sure care receivers are safe.
• Care receivers are protected from being bullied, harassed, harmed or abused. Abuse includes neglect and financial abuse.
• Staff deal with incidents and accidents quickly and openly (and investigate them if necessary) and they learn from mistakes.
• Care receivers have as much freedom as possible to do the things they want to do – regardless of their disability or other needs.
• Staff give care receivers their medicine safely and store it correctly. Where possible, the home involves them in reviewing their medicines and supports them to be as independent as possible.
• The home is kept clean and hygienic to prevent any risk of infection to care receiver or other residents.

Effective

• Care receiver are regularly asked for their opinions about the quality and choice of the food and other aspects of the home, and their feedback is consistently good.
• Staff make sure care receiver get the right food and drink they need, and that they have enough of it.
• Staff have the right knowledge, qualifications, and skills to carry out their role so that care receiver have a good quality of life.
• Care receivers are always asked to give your consent (permission) to their care, treatment and support in a way they can understand. Where appropriate, their family and friends are also involved in decisions about their care.
• Staff know about care receiver’s health needs and personal preferences and give them as much choice and control as possible.
• Staff speak with health and social care professionals, such as GPs, and take the right action at the right time to keep care receivers in good health.
• Care receivers are asked for your likes and needs when the home is adapted or decorated. Any changes to the home are made to help them to be as independent as possible.

Caring

• Staff know about care receiver’s background, likes, hopes and needs. This includes any needs they have because of their age, disability, sex (gender), gender identity, race, religion or belief, or sexuality (whether they are lesbian, gay, bisexual or heterosexual).
• Care receivers are encouraged to express their views, no matter how complex their needs are.
• They have access to advocates (people who can speak on their behalf).
• Staff also know care receiver’s wishes for their care at the end of their life, if this applies.
• Staff treat them with dignity and respect. Staff spend time with care receivers, develop trusting relationships and are concerned for their wellbeing.
• They have enough privacy.
• Your family and friends can visit them.

Responsive to people’s needs

• Care, treatment, and support for receivers are set out in a written plan that describes what staff need to do to make sure that they receive personalised care.
• Care receivers and their family and friends where appropriate, are actively involved in developing this plan. For example, they should be able to have a choice about who provides them with personal care, such as help with washing and dressing.
• As their needs and preferences change, their plan is changed, and all those who need to know, such as their care staff, are kept up to date.
• The plan includes information about the whole of their life, including their goals, their abilities and how they want to manage their health. They may also have a health action plan.
• Staff work hard to prevent care receivers from feeling lonely. Staff do this by helping them to keep in contact with their family and friends.
• Staff also help care receivers keep up with their hobbies and get involved in the community if they want to.
• If care receivers need to visit hospital, staff plan this well with them to make sure it goes as smoothly as possible.
• If care receivers have any concerns and complaints, staff always take them seriously, investigate them thoroughly and respond to them in good time.

Well led

• Care receivers know who the manager is, and anyone else in charge.
• Managers know what their responsibilities are and are always honest, including when things go wrong.
• Staff know what is expected of them and are happy in their work.
• Managers are available to support their staff.
• Staff have the confidence to report concerns about the care that colleagues, carers and other professionals give. When this happens, they are supported, and their concerns are thoroughly investigated.

What to do if you are experiencing bad care quality

If a care receiver is not happy with the quality of the care, he/she can complain to the care home operator or to the local council. If she/he is not happy with the response, they can contact the Local Government Ombudsman for further investigation.

Care receivers can also inform the CQC via the CQC website. CQC’s role as a regulator means that they do not settle individual complaints, but they still want you to tell them about your experiences of care. The information is valuable to CQC as it helps them decide when, where and what to inspect. When CQC find that a service is not meeting required standards of quality and safety they will take action to ensure care improves.