CQC inspections in domiciliary care

What are the aims of a CQC inspection?

An inspection is a check carried out by CQC (Care Quality Commission) on health and social care services. Inspectors come to visit your business to make sure that the care service provided is safe, effective, caring, responsive and well-led.

  • Safe – “you are protected from abuse and avoidable harm”’
  • Effective – “your care, treatment and support achieves good outcomes, helps you to maintain quality of life and is based on the best available evidence”
  • Caring – “staff involve and treat you with compassion, kindness, dignity and respect”
  • Responsive – “services are organised so that they meet your needs”
  • Well-led – “the leadership, management and governance of the organisation make sure it’s providing high-quality care that’s based around your individual needs, that it encourages learning and innovation, and that it promotes an open and fair culture”

As a care provider a CQC rating is critical to you reputation as it will be shown to everyone on the CQC’s website. When choosing a care provider the ratings are an easy and trustworthy source for comparison. To be rated as “Good” or “Outstanding” you should always be prepared for inspections.

You won’t be told when an inspection will take place but usually domiciliary care services are inspected at least once a year. An inspection can take place anytime – also during evenings and weekends.

There are three kinds of inspections:

Scheduled – normal inspections that are done regularly

Themed – an inspection on a set theme about a current issue or a concern.

Responsive – carried out when a concern has been identified


Inspections step by step

1. Before the inspection takes place CQC reviews the information they have on your business and assess the risks. This includes things like your last inspection report, the notifications they have received from you, concerns, complaints and safeguarding alerts, contract monitoring reports, information from stakeholders and members of the public. 

2. When the inspectors arrive they will prove their identity and ask for the registered person, the nominated individual or the senior person in charge. They will tell you if the inspection they are about to carry out is scheduled, themed or responsive. If there are no specific concerns you will usually be given some time to organise yourselves before the inspection starts.

3. A variety of different methods are used to find out if your service is safe, effective, caring, responsive and well-led. There is not a standard set of methods that are being used so they might differ case by case. The methods used usually include thing such as:

  • Interviewing managers and employees of all levels, service users, relatives of clients
  • Observing care: how carers do their job, how they interact and communicate with clients etc. You might be asked to provide a list of your visits over the next few weeks.
  • Asking you to call and ask how your clients and carers feel about the care that is given.
  • Comparing observations with the evidence provided including things like care records and care plans
  • Asking questions about your procedures: eg. what kind of systems are in use, how thing are recorded (sufficiently detailed, accurate, in a safe way). They might ask you to show them your records.
  • Looking at individual care pathways.


Inspection ratings

Judgements are based on a framework that helps inspectors to evaluate how the requirements are being met. Each of the five key dimensions will be rated separately. The rating scale has four levels:

Outstanding the service is performing exceptionally well”
Good  “the service is performing well and meeting our expectations.”
Requires improvement  “the service isn’t performing as well as it should and we have told the service how it must improve”
Inadequate  “the service is performing badly and we’ve taken enforcement action against the provider of the service”

To be rated Good or Outstanding a service has to able to show that it:

  • is compassionate, caring, open and transparent
  • learns from mistakes
  • aims to ensure there aren’t any barriers to accessing care
  • has adopted a person-centred approach to care

All the findings and ratings will be recorded to an inspection report that will be published on the CQC’s website. You will receive a copy of the draft version by email usually within two weeks of the inspection. You will have 10 working days to review the report and check its accuracy. This is also your chance to send comments on the content before the report will be published.

Check out also our practical tips on how to prepare for an inspection to receive the best rating.

Source: Care Quality Commission

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