Care Quality Commission Inspections Research Articles

Does outsourcing enable the survival of good care homes? A longitudinal analysis of all care homes in England, 2011–2023

BackgroundIt is unclear whether outsourcing has enabled the growth and survival of the best care homes, as intended. We aimed to test whether ownership (for-profit, public and third sector (non-profit))...

Facilitators of, and barriers to, personalisation in care homes in England: evidence from Care Quality Commission inspection reports

The personalisation of residential care services is based on three broad principles of valuing personal identity, empowering resident decision-making and fostering care relationships. We analysed 50 Care Quality Commission care home inspection reports to identify factors that the reports indicate facilitate or hinder the delivery of personalised residential care in England. Findings suggest that the provision of personalised services is affected by staff skills, attitudes and availability, as well as the quality of care home leadership. Future care policy should consider addressing external pressures facing the care home sector, including inadequate funding and too few staff, to mitigate barriers to delivering high-quality, personalised care.

Compliance problems in dental infection prevention and control in England: an analysis of Care Quality Commission inspections between 2016 and 2019.

Introduction All dental practices in England must be registered with the Care Quality Commission (CQC). The CQC inspects approximately 10% of practices each year to ensure premises are safe. Compliance with infection prevention and control is assessed during inspections.Aims The aim of this study was to identify common areas of non-compliance in infection prevention and control within general dental practice in England.Materials and methods The CQC inspection reports, for all practices found not safe following an inspection, were thematically analysed for non-compliance specifically in infection prevention and control.Results Between April 2016 and March 2019, 88 practices were deemed not safe. The most common areas of non-compliance were the management of risks associated with legionella, audit and the validation of decontamination equipment.Discussion Infection prevention and control compliance requires good management and leadership. Other factors are also thought to influence compliance including cost and morality.Conclusions Identification of recurrent infection prevention and control compliance issues highlights relevant areas to all CQC dental registrants that merit greater focus.

The new Care Quality Commission inspection procedures.

Emeritus Professor Alan Glasper, from the University of Southampton, discusses recent changes to the way in which the Care Quality Commission (CQC) conducts its health and social care inspections.

Implications of latest Care Quality Commission inspection procedures for support staff

The article focuses on Camilla Cavendish, a well-known journalist and former head of the Downing Street policy unit under prime minister David Cameron (and later baroness) published an independent review into healthcare assistants and support workers in the NHS and social care settings.

Changes to the Care Quality Commission's evolving inspection regime under COVID-19

Care Quality Commission inspections have rightly been reined back to enable providers to focus on the enormity of the COVID-19 task in hand. What has changed and when can you expect your next inspection? Amanda Halliwell explains

How can patient experience scores be used to predict quality inspection ratings? A retrospective cross-sectional study of national primary care datasets in the UK

ObjectivesThe relationship between patient feedback in the General Practice Patient Survey (GPPS) and Care Quality Commission (CQC) inspections of practices was investigated to understand whether there is an association between...

Inspection Regime Evolves Further Due to COVID-19

As Care Quality Commission inspections change again to support providers in coping with COVID-19, what has changed and when are you next likely to be inspected?

Care quality commission inspections of high-security hospitals

PurposePatients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC) monitors and regulates forensic healthcare provision. The purpose of this study is to identify key concerns highlighted in CQC inspection reports of the three high-secure hospitals in England between 2010 and 2018.Design/methodology/approachIn this qualitative study, 49 CQC inspection reports from three high-secure hospitals were subjected to thematic analysis.FindingsFive central themes emerged: staffing and management; restrictive practice; physical environment and ward atmosphere; patients’ needs and involvement in their care; and legal and statutory matters. There was some variation in the overall quality of care between the hospitals. Positive staff–patient interactions and good practice in assessing and delivering care were consistently observed. However, enduring staff shortages within each hospital were experienced negatively and sometimes co-occurred with concerns over restrictive practices, poor care-plan procedure and inadequate legal documentation. Over time, Rampton and Broadmoor Hospitals appeared to worsen with regard to staffing levels, staff morale and management involvement. While services progressed over time in providing patients with access to advocacy and information concerning their rights, in some recent inspections it remained unclear whether patients were adequately involved in the care-plan process.Practical implicationsThese findings provide preliminary indicators for areas requiring further attention from policymakers, clinicians and advocates.Originality/valueThis study appears to be the first systematic analysis of key concerns expressed in CQC reports of English high-security hospitals.

Relationship between general practice capitation funding and the quality of primary care in England: a cross-sectional, 3-year study

ObjectiveTo explore the relationship between general practice capitation funding and quality ratings based on general practice inspections.DesignCross-sectional study pooling 3 years of primary care administrative data.SettingUK primary care.Participants7310 practices (95%...

National Asthma and COPD Audit Programme and the NHS Long Term Plan

National Asthma and COPD Audit Programme and the NHS Long Term Plan

The perioperative Team Brief: A patient safety initiative or another tick-box exercise?

The World Health Organization Surgical Safety Checklist has been the subject of many professional discussions following its introduction in 2008. Since the addition of the Team Brief and Debrief in 2010 and the acceptance of the Five Steps to Safer Surgery as the gold standard, compliance has steadily improved (as audited by Care Quality Commission Inspections). This review of the literature therefore examined the perioperative Team Brief and identified gaps in knowledge. Evidence appears to suggest that whilst compliance is good in quantitative terms, there may be inconsistencies within the quality of Team Briefs from organisation to organisation and surgeon to surgeon. Concluding further research is required to establish what an effective Team Brief looks, sounds and feels like to all involved.

The effect of external inspections on safety in acute hospitals in the National Health Service in England: A controlled interrupted time-series analysis

Objectives To evaluate the effect of Care Quality Commission external inspections of acute trusts on adverse event rates in the English National Health Service. Methods Interrupted time-series analysis including all acute NHS trusts in England ( n = 155) using two control groups (new versus historical inspection regime and trusts not inspected). Multilevel random-coefficient modelling of (1) rates of falls with harm and (2) pressure ulcers, from April 2012 to June 2016, was undertaken using the new, resource-intensive regime of Care Quality Commission inspections as an intervention. Data used in the model included dates and type of inspection, patient safety indicators, demographic characteristics and financial risk of hospitals. Results In one year, Care Quality Commission inspected 66 acute trusts (42% of all English trusts) using their new regime and 46 (30%) using their previous one. Prior to inspections being announced, rates of falls with harm and pressure ulcers were improving in both intervention and control hospitals. The announcement of an inspection did not affect either indicator. After inspections, rates of falls with harm improved more slowly, and pressure ulcer rates no longer improved for trusts inspected using both regimes. Conclusions Neither form of external inspection was associated with positive, clinically significant effects on adverse event rates. Any improvement happening before the announced Care Quality Commission inspections slowed after the inspection.

Online-only primary care services – learning from CQC inspection

Remote consultation through online-only channels, for example video or text (web forms), is a rapidly growing healthcare sector. The Care Quality Commission (CQC) has seen year-on-year growth in applications for such services in England since 2010 (40 such services are registered). While these providers are mainly in the independent sector, there are collaborations with the …

Contemporary dental practice in the UK. Part 1: demography and practising arrangements in 2015.

To determine, by means of an anonymous, self-reported questionnaire, the demographic profile and practising details of general dental practitioners in the UK in 2015. A previously-piloted and validated 121-question questionnaire was distributed during 2015 to 500 dentists at UK dental meetings with a request that they complete the questionnaire and return it by post in the reply-paid envelope to the corresponding author. Three hundred and eighty-eight useable questionnaires were returned, giving aresponse rate of 77.6%. Of the respondents, 60.2% were male and 39.8% female. Theirmean age since graduation was 19.7 years. Just over half of the respondents (50.9%) replied that they were practice principals, 35.8% were associates and 10.6% were foundation dentists. A quarter of the respondents were in single-handed practices, the remainder being in a partnership or group practice. There was a mean of 4.2 dentists per practice, while the mean number of dental therapists in each practice was 0.3 and 1.2 hygienists. Regarding the first available NHS appointment in the respondents' practices for non-urgent care, 23.4% could provide this on the same day, the equivalent figure for private care being 40.1%. The mean percentage of patients receiving NHS treatment was 50%, with 33.8% receiving private treatment. Just over half of respondents considered that Care Quality Commission inspections were 'valuable for fostering patient trust and confidence in dental care.' The collected data indicated that 55.4% of respondents had an intra-oral camera, while, with regard to recently-introduced concepts and techniques, 80.4% used nickel-titanium files, 47.4% used zirconia-based bridgework and 24.9% used tricalcium silicate. Of great interest, perhaps, is the response to digital radiography/digital imaging, with the results indicating that 74.1% of respondents used this form of radiography. Regarding checking the light output of the light curing units, 53.1% stated that they did check the output, but in some cases this might be at a six-monthly interval. Results from this survey indicated that NHS service provision has dropped toapproximately 50% amongst the respondents. Regarding the staffing of dentalpractices, just over half the respondents were practice principals and there was a mean of 4.2 dentists per practice. The results also indicated that UK dentists continue to be innovative in the techniques that they employ.

User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England

BackgroundHigh profile failures of care in the NHS have raised concerns about regulatory systems for health‐care professionals and organizations. In response, the Care Quality Commission (CQC), the regulator of health and social care in England overhauled its regulatory regime. It moved to inspections which made much greater use of expert knowledge, data and views from a range of stakeholders, including service users.ObjectiveWe explore the role of service users and citizens in health and social care regulation, including how CQC involved people in inspecting and rating health and social care providers.DesignWe analyse CQC reports and documents, and 61 interviews with CQC staff and representatives of groups of service users and citizens and voluntary sector organizations to explore the place of service user voice in regulatory processes.ResultsCare Quality Commission invited comments and facilitated the sharing of existing service user experiences and engaged with representatives of groups of service users and voluntary sector organizations. CQC involved service users in their inspections as “experts by experience.” Information from service users informed both the inspection regime and individual inspections, but CQC was less focused on giving feedback to service users who contributed to these activities.Discussion and conclusionsService users can make an important contribution to regulation by sharing their experiences and having their voices heard, but their involvement was somewhat transactional, and largely on terms set by CQC. There may be scope for CQC to build more enduring relationships with service user groups and to engage them more effectively in the regulatory regime.

Report shows qualitative impact of CQC inspections

Inspections carried out by the Care Quality Commission (CQC) and the subsequent ratings are important factors for care institutions, but do they lead to quality improvement? Helena Frankova evaluates a recent report on this.

Understanding the latest CQC Assessment Framework

What are the new Care Quality Commission (CQC) assessment frameworks and how can a home prepare for them? Solicitor Laura Hannah, an expert in health and social care regulation and the CQC inspection regime, looks at how they could affect care homes

A review of Care Quality Commission criticisms of English community substance misuse treatment

The Care Quality Commission (CQC) monitors, inspects and regulates health and social care services in England to ensure they meet fundamental quality and safety standards. This article describes a review of 60 CQC inspection reports of community substance misuse services in England, to identify the topics that were evaluated negatively and were most frequently made the subject of requirement notices. Each report contains four types of statements: descriptive, evaluative, advisory and requirement notices. The evaluative and advisory statements, as well as the requirement notices, were recorded and categorised by topic, and frequency charts were constructed to show how often different topics were rated positively or negatively. The article highlights overall shortcomings of the English substance misuse treatment system and discusses possible causes, aspects of the inspection process and the potential effect of these reports on practice.

CQC's state of hospice services in England 2014–2017 report

The Care Quality Commission's inspections of hospice services found performance outstripping providers in other sectors, with a remarkable 25% rated Outstanding. In this article, Helena Frankova investigates what other care providers can learn from these services