- The staff team's performance during a Care Quality Commission (CQC) inspection will have a big impact on the evidence that your service complies with the fundamental standards.
- Brief staff on the importance of the inspection process and the significance of the rating that CQC will award following the inspection.
- Tell staff what to expect during a CQC inspection, and what to do and what not to do. This will reduce anxiety and mistakes on the day.
- Care providers should reflect on inspections so they can learn from the experience and identify where they need to make improvements.
The social care sector depends heavily on the people who work within it. Without them, we would not have a social care sector. When CQC inspects a care service, the performance of the staff team on the day will have a big impact on whether the service is judged to comply with the fundamental standards. Yet many providers leave it to chance that their staff will perform to the best of their ability when put in a stressful high-pressure situation where they feel under the spotlight.
A review of CQC inspection reports for services rated as 'requires improvement' or 'inadequate' reveals that often the staff member spoken to by the CQC inspector failed to provide evidence that they understood requirements and how to implement them in practice. In reality they most probably do understand them and are good at their job; they just got flustered and confused when under pressure.
Also, it is possible that disgruntled staff may use the presence of a visitor, such as a Qualifications and Curriculum Framework (QCF) assessor, senior manager or CQC inspector, to air their feelings of dissatisfaction with the organisation or their manager. Preparing your staff for a CQC site visit is vital to being able to evidence how your service complies with the fundamental standards and KLOEs. This article looks at some key aspects of this preparation.
Sell the inspection to them
If the managers in the care service do not show that they recognise CQC inspections as a vital part of upholding public trust and confidence in the care sector then the staff team will view the inspection as a negative experience to be feared. Leaders and managers must make sure that their staff understand the importance of the inspection and the significance of the rating that CQC will award afterwards. This is best done via a combination of commitments, i.e. the inspection policy and procedure, and more importantly by leading by example. A key message is that the service has one chance every one-to-two years to gain a rating (which they are required to display by law) and everybody has a role to play in ensuring that the inspectors see the great work that the service does.
Tell them what to expect
When people do not know what to expect, this leads to unease which, if not alleviated, leads to fear. This can cause people to act out of character and become flustered, which can lead to them making mistakes or making ill-judged comments to the CQC inspector. Care services should tell staff what to expect during a CQC inspection and what to do and what not to do. This will reduce the chance of them feeling nervous and making simple mistakes when the service is inspected.
Develop an inspection procedure
Few organisations have a policy and procedure for managing a CQC inspection. Developing such a document enables the service to think about how they would manage the process, identify key things to be addressed and plan how they will address these. The policy and procedure should be developed with the staff team and should be disseminated to all staff, not just care staff. It should cover aspects such as: checking ID, allocating staff for the inspectors to speak to, access to records and documents and advising the inspectors of specific risks.
Practice makes perfect
Conducting mock inspections will get the staff team used to the experience and enable them to hone their skills. Mock inspections should be as realistic as possible and conducted by someone the staff team do not know. If the staff team make mistakes then these should be discussed after the mock inspection to enable them to recognise how these happened and how they can be prevented.
Engage with your staff now
A review of CQC inspection reports reveals that CQC's inspection methodology always includes a discussion with a sample of the staff team. In many cases, the staff members spoken to by CQC inspectors have used this discussion as an opportunity to unburden themselves about their dissatisfaction with the service. To avoid this, providers should engage with their staff team as soon as possible and on an ongoing basis. This can be through team meetings, supervisions and day-to-day contact.
If the team members know that the organisation and the registered manager is willing to engage with them and listen, then they will be more receptive to the reasons why things cannot be actioned immediately. They may even have some great suggestions about how some of the issues can be addressed. This process will create a more cohesive team that is less likely to make ill-judged comments to a third party such as the CQC inspection team.
Learn from the experience
Care providers should reflect on inspections to learn from the experience and identify future improvements. If a record of the inspection process is made, the care provider can reflect on how well the service managed the CQC inspection. Reviewing the inspection report, and in particular the way the CQC inspection team obtained the evidence used to award the ratings, can help the service identify where it can provide better evidence of the great work it does. Care providers should remember that they can access the inspection reports for any care service. Regularly reviewing inspection reports for similar services should form part of their continuous improvement agenda.
Don't let your greatest asset become a liability
The staff team are the greatest asset a care service has – without them, there is no care service provision. But if they are not ade-quately prepared for the CQC inspection process they can quickly turn into the greatest liability. A few simple actions, such as those described in this article, can reduce the risk of this occurring. Many organisations have a business continuity plan that identifies the risks to their operation. Staff performance during a CQC inspection is a very real risk to the business. To mitigate that risk, providers should consider using the control measures suggested in this article.
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