CQC assesses the quality and safety of regulated services in England. Its five key questions ask whether services are Safe, Effective, Caring, Responsive and Well-led. These questions are distinct from the supporting assessment prompts and the legal requirements that apply to providers.

Prepare by keeping care practice, governance and evidence consistent every day. Readiness work can help identify gaps and improvement priorities, but it cannot guarantee a CQC rating. Use CQC’s current assessment guidance for your service type.

When do CQC carry out inspections?

CQC’s assessment frequency is informed by the information it receives, the evidence it collects and its view of risk. Assessments may be planned or responsive to concerns. Do not rely on a fixed interval based only on the previous rating; check CQC’s current guidance on how often it assesses services.

Preparing for inspection

Inspections may be announced or unannounced. CQC says most care-home and nursing-home inspections are unannounced; announced visits are more common for some services supporting people in their own homes. Read CQC’s guidance on what to expect during an inspection rather than assuming a standard two-week notice period.

If CQC requests information, follow the requirements and deadline given for that request. The evidence needed depends on the service and assessment. The examples below are a preparation aid, not a universal statutory checklist or a promise of a particular response period.

The things that the CQC will ask for are:

• An action plan addressing findings from patient surveys.
• A summary of complaints received in the last 12 months.
• Evidence of the monitoring of service and treatment quality.
• Recruitment and training policies and procedures.
• The number of staff by role.
• A copy of the current statement of purpose.

This information will give the inspector a preliminary idea of the quality of care and level of management that is being conducted by the service provider.

The CQC may also request documentation from the provider. While the documentation that is requested may vary depending on the service that is being inspected, the documents that are likely to be requested are:

• A summary of significant events.
• Audits of infection control, cleanliness, and disabled access.
• Risk assessments with evidence of actions taken.
• Health and safety documentation.
• A business continuity plan.
• HR staff files including policies and procedures.
• Operational policies for the service such as safeguarding, complaints, patient management, etc.
• Calibration reports for any equipment that may be in use.
• PAT testing reports.
• Training schedule for staff.

Mock Inspection

A mock inspection can help identify gaps in care practice, governance and supporting evidence. For an independent review, explore Delphi’s mock CQC inspection support. The examples below can support a walkthrough and should be adapted to the service:

• Any clutter found in all areas.
• Health and safety logs – fridge temperatures, emergency medication, etc.
• Ensure accident/incident logs are kept in a designated area for staff.
• Emergency equipment, such as fire extinguishers, are kept in the right place and have not expired.
• A trained member of staff has been appointed as first aid lead.
• It is easy for patients and residents to complain and leave feedback.
• There are private areas that are accessible to patients and residents.
• Medical supply cupboards are appropriately secured.
• All out of date stock is removed and appropriately disposed of.
• Good stock control systems are in place throughout the service.

An internal readiness review can help a service identify gaps. An independent mock CQC inspection offers an external perspective on practice, evidence and improvement priorities. Read The Martlets mock inspection case study for a practical example, or discuss your inspection-readiness priorities with Delphi. A mock inspection does not guarantee a CQC rating.

Staff preparation

Ensuring that all staff are aware that an inspection will be happening and what will be expected of them is an essential part of the preparation process. Having a detailed document that includes policies and procedures, locations of emergency equipment, etc,  which staff can access easily will significantly aid preparation.

Presentation

On the day of inspection, present the service in the best light possible. This can be done by ensuring that senior staff are working on the day and welcome packs, which include important information such as the names of roles of staff, health and safety procedures, etc, are provided to the inspectors when they arrive.

Visual presentation of the service will also go a long way during the inspection. Make sure that the entire premises is clean, clear of clutter, and secure will present the service in the best light possible.

Patient Involvement

Involving patients and residents in this process can help identify any further areas of improvement, especially in areas such as person-care and well-being. Creating patient surveys can provide useful information that can be acted upon prior to the inspection.