Help shape CQC’s assessments and ratings
From Chris Day, Director of Engagement at CQC
At the heart of how we work is a recognition that we can only deliver effective regulation by developing our approach in partnership with people who work in health and social care, people who use services, and our colleagues. When we introduced our new assessment framework, we didn’t always get that right.
To identify where we need to make rapid improvements we’ve looked at where we got things wrong, the things you’ve told us that aren’t working, and the findings in the reports from Dr Penny Dash and Sir Mike Richards. Following conversations with people who use services and providers, we will be reviewing how we assess, what we look for on assessment, and improving our methodology so it’s simpler and enables more regular assessment. We will also be developing better information and guidance for providers to use.
We know that we need to work with you to restore trust, and we need to give meaningful opportunities to influence, work with us, and co-design our improvements. We are working at pace and in consultation with our stakeholders to rebuild that trust and become the strong, credible, and effective regulator of health and care services that the public and providers need and deserve.
To do this well, we need to set out how you can influence our work, when we are co-designing, and be clear about how your feedback has shaped our decisions. In this blog I’ll talk about some of this work that has happened so far and what’s coming next. In future blogs I want to showcase how your involvement has shaped more effective regulation.
Recent engagement
We’ve started work on co-designing new ratings characteristics and exploring what other guidance is needed to explain the things we look for that contribute to giving ratings at the different levels.
This work is focused on clearly defining the characteristics that we would expect to see in a service to give a rating of either outstanding, good, requires improvement or inadequate under our assessment framework. We’ve had several engagement sessions on this, involving over 100 people to explore the first steps in developing this new guidance, and have launched a survey to test some of our initial drafts of guidance. We’ve heard some really important feedback so far, highlighting issues such as the need for us to:
- Consider what specific sectors and types of providers need.
- Be clearer and more detailed about what different levels of quality look like, developing ratings principles that people who use services can easily understand.
- Ensure there is consistency between the guidance our inspection teams use and what is available for providers.
We’ve also heard clearly that providers need better guidance on our new assessment approach, how it works and what to expect. You’ve told us you need a single document that covers these areas. To meet this need, we’ve started developing a new handbook for providers, which will explain clearly how we carry out our assessments and what to expect from us. Through workshops, one-to-one conversations and surveys, we’ve had feedback from over 1,200 people on how the handbook should look and what it needs to cover. Thank you to everyone who’s engaged with us on this so far.
We’re still completing some initial engagement before moving on to analysing the feedback received and putting together one or more handbook prototypes. We will then arrange further sessions to get your feedback on these. So far, the engagement sessions have highlighted the importance of using plain English so we’re clear on what we mean and making the document easier to navigate. We’ve also heard that it’s crucial to present examples of best practice and innovations that contribute to outstanding ratings, while also providing guidance for managers during inspections.
We’ll continue to co-design this handbook by working with providers to make sure it meets the needs of those who will use it and, ultimately, to help providers understand what they need to do to demonstrate how well their service provides care throughout the assessment process. If you’d like to get involved with this work, you can email us at experience.research@cqc.org.uk.
This is just the start of the process. We have more engagement sessions coming up to explore and test initial drafts of this new guidance.
Engagement coming soon
Between now and the end of the year, we’ll be engaging around proposed changes to our methodology — in particular, the proposed changes to our scoring approach to enable us to give an up-to-date view of quality.
We’ll be asking for your support to look at these areas:
- Moving away from applying default scores for a service’s previous assessment.
- The right number of quality statements to look at in an assessment.
- How we arrive at quality statement scores to deliver ratings.
This work will help us meet the recommendations in the reports from Sir Mike Richards and Penny Dash to help deliver more effective regulation. But we won’t make these changes before engaging with you and giving opportunities to influence.
We have had feedback that it can be hard to keep on top of the different ways of engaging with us, so in response, we will be developing a dedicated webpage where you can see all the latest events, surveys and other opportunities to get involved in ongoing co-design work. You can also sign up to our regular bulletins where we will advertise upcoming opportunities.
Thank you again for your engagement and support. I know we all share a purpose to ensure people receive safe and effective care and encourage improvement. We’re committed to improving to deliver this purpose and working with you to get this right.
