Robyn Drury of Care4Quality talks CQC & the Transition Towards the new Single Assessment Framework

The journey towards transitioning to the new Single Assessment Framework has begun with the CQC releasing their latest progress webinar and updated guidance on their website.  Care home managers and providers are getting acquainted with the new framework guidance with the roll out in the South of the UK starting November 2023.  Care4Quality will continue to monitor and offer practical tips on how to understand CQC’s new processes stemming from the Single Assessment Framework.

Background to the CQC Single Assessment Framework

This framework is set to replace the existing individual KLOE and their characteristics and replace this with the 34 quality statements and new inspection methodology. This marks a significant shift in how the CQC evaluates and oversees health and social care services with the CQC aiming for greater consistency and transparency in their service rating methods, including collating real time data in addition to site inspection at the service provision.

The CQC new approach will involve moving to:

• A Single Assessment Framework
• Ongoing assessment of quality and risk
• Evidence gathered at multiple points in time in addition to site inspection
• Teams assigning scores to evidence
• Ratings updated more regularly with a shorter narrative

The care service will be a reflection of the provision in real time with policies and procedures, regular feedback impact and continuous improvement and staff upskilling and development key to a sustainable care business.

Recently, the CQC provided deeper insights into their strategy for evidence gathering within this framework, with the focus on quality statements and what evidence would be reviewed within this.

In this fresh approach, the CQC will deploy six distinctive methodologies to assess healthcare service quality:

• Patient and User Experiences
• Feedback from Staff and Leadership
• Collaborative Feedback from Partners
• Direct Observation
• Process Evaluation
• Outcome Assessment

Each category, as specified by the CQC, outlines the types of evidence they seek:

• The quality of care delivery
• Performance against each quality statement

In due course the CQC will use a scoring system to assess the quality of the care delivery:

• A score of 4 will show an exceptional standard of care
• A score of 3 will show a good standard of care
• A score of 2 will show shortfalls in the standard of care
• A score of 1 will show significant shortfalls in the standard of care

Notably, stakeholders' feedback, encompassing service users, leaders, partners, and staff via surveys and discussions plays a pivotal role and this heightened emphasis on the patient and user experience underscores the CQC's commitment to person-centred care.

The CQC confirms there will still be on-site inspections, and this will still be a vital part of the assessment however these observations can be provided by external organisations and not just CQC inspectors. At Care4Quality we deem this aspect as essential to ensure that Safe care is being carried out within a safe environment, something that is not always easy to determine remotely.

Another crucial facet of the assessment process revolves around scrutinising processes. This could encompass a blend of on-site and remote evaluations, with a focus on what processes the service has in place and how they are following them.  This will include reviews of internal governance systems, examining care records and learning from incidents and how these are used to continuously improve the service. The final element, outcome assessment, zeroes in on evaluating the impact of these processes on individuals utilising health and social care services, ensuring alignment with desired objectives.

The number of evidence categories considered and their sources will vary based on factors such as the service type or model, the level of assessment (service, provider, local authority, or integrated care system), and whether the assessment pertains to an existing service or registration.

While the CQC has introduced Quality Statements, the new framework is still reliant on the original regulations that underpin it. Onsite inspections will continue to provide observational evidence, and document reviews will remain an integral part of the process.

Health and social care services should still take every opportunity to ensure they remain up-to-date with these changes and to facilitate this, and we strongly urge all managers and providers to actively participate in the upcoming CQC webinars and subscribe to the Care 4 Quality newsletter where we provide updates on changes.

Together we can support each other with things to come and remind ourselves that Safe, Effective, Caring, Responsive and Well Led Care is what is at the heart of it all.

Stay informed about these developments by visiting the CQC website: Visit the CQC Website and sign up to the Care 4 Quality newsletter where we will digest and explain new information as it comes to light and begin to inspect under the new methodology once rolled out.