What is the role of the CQC?

In order to be fully-prepared for a CQC inspection, it is important to actually understand what the role of the CQC is

The role of the Care Quality Commission (CQC) as an independent regulator is to register health and adult social care service providers in England and to check that standards are being met.

What is the ‘duty of candour‘?

The ‘duty of candour’ for organisations aims to ensure that providers are open and honest with people when something goes wrong with their care and treatment. In order to meet the duty of candour patients should expect:

• a culture within the service that is open and honest at all levels;
• to be told in a timely manner when certain safety incidents have happened;
• to receive a written and truthful account of the incident, and an explanation of any enquiries and investigations that the service will make;
• to receive an apology in writing;
• to receive reasonable support if they were directly affected by the incident.

If the service fails to do any of these things, the CQC can take action.

What is the ‘fit and proper person’ requirement?

When a service provider is a health service body it must not appoint, or have in place, in the practice anyone who:

• is not of good character;
• does not have the qualifications, competence, skills and experience necessary for the office, position or work for which they are employed;
• is not able, by reason of their health, after reasonable adjustments are made, to properly perform tasks intrinsic to their office or position;
• has been responsible for, been privy to, contributed to, or facilitated, any serious misconduct or mismanagement (whether unlawful or not) in the course of a regulated activity.

What are the different types of inspection?

There are two different types of inspection, comprehensive and focused. A comprehensive inspection will review the provider in relation to the five key questions leading to a rating for each on a four-point scale, and an assessment of all six of the population groups. This type of inspection takes place at the same time as the CQC inspects a number of practices in a CCG area. Such an inspection will usually only involve one day on site, and will be announced. This type of inspection will happen at least once every three years.

A focused inspection follows up on a previous inspection, or responds to a particular issue or concern. It may not look at all five key questions and six population groups, and the team size and composition will depend on the focus of the inspection. Unlike a comprehensive inspection, it may be unannounced.

How are practices rated?

GP practices are rated as:

• outstanding
• good
• requires improvement, or
• inadequate.

For each practice, the CQC inspection will rate performance at four levels:

• level 1: rate every population group for every key question;
• level 2: an aggregated rating for each population group;
• level 3: an aggregated rating for each key question;
• level 4: an aggregated overall rating for the practice as a whole.

The rules for aggregating ratings are as follows:

• outstanding = two outstandings  and the rest good;
• good = one outstanding and rest good or one requires improvement and rest good;
• requires improvement = two requires improvement and rest good or one inadequate;
• inadequate = two or more inadequate.

The aggregated population group ratings (level 2) do not directly tie into the overall key question ratings (level 3), which can lead to some odd results.