Care Provider Alliance review of CQC's single assessment framework published

The CQC have published the results of a survey of care providers reviewing the single assessment framework. The Care Provider Alliance (which the Homecare Association is a constituent member of) surveyed 1200 provider organisations and follow up interviews were conducted with over 100 providers. 

You can find the full report here: Review of CQC's single assessment framework by the Care Provider Alliance - Care Quality Commission

The most prevalent issues identified were:

Several issues were made clear across both stages of this work, the most prevalent of which were:

• The quality statements are too numerous and overlapping, and the guidance to support them is unclear and not specific enough to the type of service inspected. This makes preparation for assessment and self-assessment within services a significant administrative burden and relies on individual interpretation of the quality statements. This in turn means that providers often spend a disproportionate amount of time in preparation for assessment and remain unsure of the inspectors’ interpretation of what ‘good’ looks like.
• The ‘flexible’ application of a sample of quality statements in each assessment creates opportunity for inspections to miss key information. For example, the selected sample may not encompass work that providers are proud of, or areas previously rated Requires Improvement which should be re-assessed and updated.
• Providers who have been assessed under the SAF have found it disorientating and upsetting. They describe staff feeling “devastated” and “distressed”, with registered managers leaving their jobs, and organisations considering closing their services. These experiences were consistent between those who received both good ratings and requires improvement ratings.
• Challenging assessment processes and outcomes is a very difficult, lengthy and frustrating administrative process and often yields little to no satisfactory outcomes for providers. Stage 1 data showed that smaller providers were less likely to challenge their outcomes, despite stage 2 indicating that they did not feel they had had a better experience or outcome. This may suggest that SME’s lower rate of challenge is due to a lack of resource and a need for support during these processes.
• Inspectors do not always have sufficient knowledge of a wide diversity of service types within social care, and the changing context in which they operate, meaning they do not always understand how to apply the quality statements appropriately in all cases and can draw inappropriate and inaccurate conclusions about services.
• Reports are often unclear, inaccurate and not timely, meaning ratings are not meaningful to the public, and the inspection process and report do not drive quality improvement for providers. Unclear reports make it challenging for providers to know where to improve, particularly when decisions are not explained clearly and the evidence influencing decisions may not be corroborated, meaning it disproportionately contributes to providers’ ratings.
• Communicating with the CQC has become very difficult for providers, with no reliable route through online systems and often no acknowledgement or feedback from CQC on receipt of information from providers.
• Communications within the CQC do not appear to reach all inspectors, meaning that they are not always aware of recent changes in the currently shifting landscape.