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Forewarned is forearmed
Joanna Shah gives an essential guide to navigating the CQC inspection process
Inspections are at the core of CQC ’ s regulatory model in assessing the quality of care provided by health and social care services in England . CQC now has powers to rate independent standalone substance misuse services and has started its wave of comprehensive inspections to enable it to establish an initial baseline rating for these providers .
Preparation before an inspection is a key element to ensuring your organisation does itself justice through the inspection process . One of the starting points in ensuring your service is ready for an inspection is to be mindful of the following :
• Ensure that the information CQC holds about your service ( contained in CQC ’ s Insight model ), is accurate and fair .
• CQC will normally ask for you to submit a Provider Information Request ( PIR ) before they come to inspect your service . It is likely that an inspection
will take place within three months of completing and returning the PIR . The PIR is your chance to get your case across to CQC by highlighting any evidence of innovation , improvement and sustainability .
• As part of your own quality assurance checks , challenge your own systems to check for weaknesses against CQC ’ s Key Lines of Enquiry and Core
Service Guidance .
• You could invite an external consultant to assess your service ’ s compliance with the Fundamental Standards . At Ridouts we have access to experienced
consultants who could support you through the planning phase .
• Audit documentation across your service : care plans , risk assessments and daily records should be ‘ joined up ’ and demonstrate the delivery of safe and
effective care and treatment .
• It is worthwhile briefing your staff on what to expect in a written summary of the CQC inspection process . Reassure your staff that
inspections are not something to fear but an opportunity to demonstrate how your service works .
No matter how well prepared you are , the inspection can be a stressful experience for staff , and surprises can occur . It is worthwhile to prepare staff for all contingencies on inspection day :
• Assist CQC to ensure a smooth inspection by asking questions and offering assistance where it is appropriate . Request feedback throughout the
inspection to avoid surprises .
• Address any immediate compliance issues that arise during the inspection and confirm that you have taken any necessary action .
• CQC may require additional information ; ensure there is clarity about the documents CQC requires and provide those documents promptly to CQC .
• CQC will conduct a feedback session at the end of its inspection . This session is an opportunity to head off any issues that have arisen during the
inspection or identify matters to take up with CQC after the inspection . Ensure that you take notes , ask questions and request evidence to support allegations where it has not been provided already , and if possible , present evidence to counter any findings .
The inspection process does not end on inspection day . It is important to respond to any further queries from CQC promptly and comprehensively :
• If you have concerns about the manner in which CQC has gathered its evidence , or other aspects of the inspection , consider requesting copies of
CQC ’ s inspection notes .
‘ Preparation is the key element ’
• Consider lodging a complaint to CQC if there are issues about the professionalism and conduct of particular inspectors .
• You have ten days to submit a factual accuracy response to CQC ’ S draft report . Be prepared for the draft report and respond in detail when it
arrives . If you do not submit factual accuracy comments , the report will become a record of fact .
• When you prepare your factual accuracy comments , bear in mind that you can challenge findings ( opinions ) and judgements as part of the process .
In particular , consider the following : – challenge negative or imprecise wording and any connotations in the draft report ; – assess whether CQC has provided evidence to support any allegations of breaches of regulations ; and – assess whether CQC has taken a measured and proportionate approach to rating your service .
• Remember to display your ratings in your service and on your website – it is an offence not to do so .
While it is important to cooperate with CQC and address compliance issues effectively , it is also important to ensure that CQC is held to account where it gets things wrong . Like any organisation , CQC is not above reproach . Timely legal advice should be sought during the inspection process on areas in dispute , particularly where enforcement action is threatened or inadequate ratings might arise .
Joanna Shah is a solicitor at Ridouts , a specialist law firm that has a core expertise in health and social care law , www . ridout-law . com
24 | drinkanddrugsnews | October 2018 www . drinkanddrugsnews . com