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Principles and protocols of CQC Inspection

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Since the introduction of the fundamental Standards in the 2014 regulations, the Care Quality Commission has continued to build on the 5 key principles upon which the 2014 regulations are structured.

All services are asked the same questions during the inspection, based on the principles

Are they safe?

Are they effective?

Are they caring?
Are they responsive?

Are they well-led?

These questions are then broken down into further sets of questions, the key lines of enquiry, (KLOES) which are then used in different sectors.

On narrowing the focus to these 5 principles they have lost the holistic view and vision of care, except through the prism of the tick box. As the only regulator in social care, their history is littered with what might have been.

Proportionality used to be a mantra, now it is applied less and less, putting small and medium homes at a disadvantage in terms of costs and workload. These small, family-owned homes are being lost to a bureaucracy that seems unable or unwilling to make proportionality work. Now we have a Regulator, who seems to want to take us back to institutions, not homes, 65 bed, 85 beds, 112 beds, these are not homes and the irony is they have taken steps to avert such institutional buildings in Learning Disability Services. Are we really saying that older people with dementia are not vulnerable?

We are not talking of care villages, which by their facilities and ethos need to be, to service a large residential community. As most organisations funded by taxes from the general public, CQC have various working agreements with other publicly funded organisations which are simply working documents that provide a framework to their working relationships. These include the General Medical Council (GMC), Health and Safety Executive (HSE), General Dental Council (GDC) to name a few, plus they have information-sharing agreements with a wide range of partners such as the police, Ministry of Justice, and local authorities. They also have Memorandum of Understanding statements with other organisations.

This system of written protocols allows the free flow of data to move seamlessly between CQC and its partners, formally and legally. During Covid, we saw a massive increase in regulatory intrusion and invasion of personal and business freedoms.

It is time for CQC to answer questions about the nature, scope and outcomes of its role and listen to the individuals in care homes, their families and the misery and distress they have been through. There are 5 principal questions that they have structured around inspection, but they are perfectly placed to add the 6th.

Does what they have seen during inspection represent good value for money?

Margaret Ross-SandsĀ  W&P.

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