Webinar Overview from Care 4 Quality: Spotlight on the Single Assessment Framework

On the 20 August 2024, Care Management Matters (CMM) hosted a spotlight on the Single Assessment Framework addressing the recent changes with the CQC (Care Quality Commission) and the widely publicised issues surrounding them.

National Care Forum (NCF) conducted the webinar with participation from CQC colleagues Mary Cridge, Director of Adult Social Care, and David James, Deputy Director of Policy and Strategy, addressing key issues raised from the health and social care sector and providing insights into current activities at the CQC.

Challenges at the CQC and Implications for the Sector

Liz Jones from the NCF began by discussing the recent challenges faced by the CQC and their implications. She emphasised that the new framework was developed collaboratively to be more holistic, ensuring that the perspectives of individuals were more deeply integrated than in the previous KLOE inspection framework. This approach allows for the consideration of new categories of evidence, including people’s experiences, feedback from staff and leaders, and input from partners, areas that had been somewhat neglected previously.

Liz reviewed the significant public attention the CQC has garnered, particularly following Health Secretary Wes Streeting's remarks on 26 July 2024 where he stated that the current operations of the CQC were "not fit for purpose."

Addressing the introduction of the Single Assessment Framework (SAF) these are the key issues highlighted:

• Complicated and inconsistent scoring across inspections
• Inadequate review of the number of quality statements
• Reliance on outdated inspection reports for scoring
• Overall lack of inspections across the sector
• Challenges related to registering new services and the provider portal.

These issues have added significant difficulties for care providers, complicating an already challenging process.

The CQC had previously indicated its intention to inspect all quality statements associated with key questions rated as inadequate or requiring improvement; however, it has been observed that this practice has not been applied consistently.

Overall, it was noted that the CQC has lost credibility as a regulator, and there are numerous problems throughout the organisation that need resolving.

CQC's Response: Streamlining and Addressing Key Issues

The webinar then welcomed two CQC representatives, Mary Cridge and David James. One of the first questions posed was whether the Single Assessment Framework, given its well-known issues, would be paused to allow the CQC to address them:

The answer was a definite “no”.

Emphasised by Kate Terroni’s statement on 15 July 2024, the CQC are attempting to do more, but they acknowledged that inspections have not been as meaningful or valuable as intended. They do not see an underlying issue with the Single Assessment Framework itself but rather with internal IT systems and the cumbersome nature of the framework, which has impacted CQC inspectors. The CQC recognised the necessity to address issues and clarify processes within the framework while increasing the frequency of inspections.

Enhancing Inspection Processes and Provider Support

The CQC emphasised their commitment to streamlining their approach and collaborating with others to ensure effective implementation. They acknowledged the importance of inspecting all previously non-compliant areas, particularly those rated inadequate or requiring improvement. However, they recognised that the current method of scoring individual evidence categories for each quality statement might be too extensive and cumbersome.

A more pared-back regulatory approach with greater consistency is needed.

While resourcing continues to be a challenge for the CQC, their goal is to increase the number of inspections by adopting a more efficient process, addressing the backlog, and prioritising services that are non-compliant or have not been visited in many years.

Supporting Providers: New Initiatives and Collaborations

The CQC also addressed the need to further supporting providers, potentially through the development of a provider handbook that would clearly outline expectations for both on-site and remote inspections, along with benchmarking scoring.

Another area of support discussed was enhancing relationships. The CQC aims to bridge the current gap and provide supportive resources for providers with enquiries. They also intend to involve people within the sector in the forthcoming changes. Mary Cridge mentioned plans for regional roadshows, engagement sessions, and trade association meetings to gather feedback. These initiatives are expected to commence in September 2024, along with a way to establish more local contacts, ensuring that providers have a dedicated point of contact rather than relying solely on the call centre. Mary Cridge emphasised that "regulation is relational," and CQC wants to work with people to ensure the framework is a supportive regulatory tool.

Addressing Registration Delays

The issue of registration delays was also addressed, as the sector is experiencing significant delays, often exceeding eight months. The NCF offered assistance by proposing various approaches, including fast-tracking current trusted providers and those seeking to expand, as well as prioritising services that are in high demand by local authorities. The CQC acknowledged that this could be a beneficial approach and committed to collaborating on the matter.

Conclusion: Looking Ahead

The webinar provided valuable insights, and Care 4 Quality encourages providers to watch the recording once it becomes available. The CQC has reassured us that significant efforts are being made behind the scenes. They are looking to address the backlog of inspections, increase the frequency of visits, foster stronger relationships, engage more thoughtfully with the sector, and enhance the provider portal through co-design and collaboration. The CQC advises that it is comprised of dedicated individuals committed to improvement, and they are diligently pursuing these goals.

The next update is anticipated in late August 2024, with the CQC advising in a recent newsletter: "We will publish an interim statement in August about how frequently we plan to assess each type of service. We will then publish more information on this in September."

How Care 4 Quality Can Help 

As we await further updates, if you require assistance with your care service or want to ensure you are prepared for the upcoming increase in inspections under the new framework, please contact us at Care 4 Quality.  We offer mock inspections, bespoke support, and training based on your specific needs. 

For further information about this insight and further support contact Robyn Drury at Care 4 Quality.