How to get the most out of an inspection

What does a good inspection look and feel like?

CQC have published this document on the 23rd July 2020 after working alongside many trade association and stakeholders.

The document lays out some common themes around inspections from both the CQC and providers perspective.

https://www.cqc.org.uk/sites/default/files/20200708_how_to_get_the_most_out_of_inspection.pdf

Everyone involved in this process agreed that they are all working towards the same goal of providing great quality care for people.

The main themes are that everyone involved in an inspection should act professionally and with respect for each other. 

Good clear communication from the start.

What does that mean for a provider and home manager? It means understanding the CQC regulations, methodology and what CQC are looking for in their key lines of enquiry. It means being prepared at all times for an inspection. Having your evidence ready and preparing your staff through training and discussion to not be worried by an inspection. Being open with inspectors. In my experience, if you can pre-emptively tell the inspection team about your challenges and difficulties at the start and what action you are taking to improve the inspection team should respect that and see you are being open and transparent. This means that when they see any negative evidence this should match with what you told them and they will understand you are doing something about this. 

Both parties should put people first. So, if something is happening in the service which means the inspection team should avoid speaking to a person or entering their room make them aware. Inspection teams should avoid disrupting people’s day and activity as much as possible. On one inspection in small home, sadly a person passed away. The staff were both busy and distressed so we immediately discussed with the manager that we would leave and postpone the inspection and make an arrangement to return on another day. Inspectors should ask you when it is convenient to speak to staff for any length of time and they should avoid asking staff lots of questions when they are busy caring for people. They can and do ask staff a few questions during the day but this should not look like an impromptu interview. 

If for any reason you don’t agree with any feedback at inspection please always explain why you disagree and try to show evidence to explain your point of view. Always ask questions and seek clarification. If an inspector gives you some negative evidence, for instance they give an example of something not right in a care plan ask which care plan this relates to so you can go back and review. I have noted the most proactive providers and managers always ask questions and also take notes through the inspection. Those who listen to feedback without taking notes sometimes come back to CQC with disagreements or misunderstandings about what was said. 

At the end of an inspection the inspector should ask for your view of how the inspection went. This is definitely your opportunity to be honest even if it has been difficult. It is very difficult for inspectors if they give you the chance to speak up and you choose not to and then later you go back to CQC and challenge what was said during the inspection or make a complaint. Often this comes down to who said what and can be hard to prove or provide evidence for. It is always better to clear up misunderstandings straight away and come to a common understanding. 

Most inspectors and inspection teams are friendly, supportive and professional. If, however you do have any concerns about the way inspectors speak to you, your staff  or people please do raise it straight away  in a respectful way so the inspector has a chance to change the way they are interacting. Misunderstandings happen but they can usually be cleared up by talking it through. After all we are all human and none of us get all interactions right every time!