Care inspection Archives - Altogether Care

Relax – this isn’t going to be a detailed explanation of how the Care Quality Commission conducts inspections or formulates a rating for a particular care provider. This is intended to be an overview that will help you put ratings into context. The best advice if you want to know about a particular care provider is often to go and look for yourself.

Inspections seek to answer five key questions:

Is the service safe?
Is it effective?
Is it caring?
Is it responsive to service user needs?
Is it well-led?

Each of these questions is rated according to a four-point scale: Outstanding, Good, Requires Improvement, Inadequate. There is no category for ‘satisfactory.’

The ratings for each of these questions are then aggregated to form an overall rating. Each question has an equal weighting. So, for example, a provider rated Good in four categories and Requires Improvement in one will normally have an overall rating of Good.

However, there are a few complications. For example, no provider can be rated better than Requires Improvement if there has been a breach of the regulations. It may also be worth bearing in mind that inspection findings are based to a large extent on the presentation of evidence, rather than direct observation of the care service users receive.

What Does ‘Good’ Mean?

The overall rating will normally be Good if there are no key question ratings of Inadequate and no more than one key question rating of Requires Improvement. There are actually many combinations that could result in an overall rating of Good, so it might help to look at the rating and judgement for each question individually. If the ratings for safe, effective and caring are all good this may cover your main concerns.

An overall rating of Requires Improvement may also need interpretation. There may well be three aspects of the service that are rated good and two that require improvement. The service could be safe, effective and caring but was unable to show inspectors sufficient evidence that it should be rated Good for being well led or responsive.

Likewise, if two or more of the key questions are rated as inadequate, then the overall rating will normally be Inadequate, even if some aspects of the service are good.

At the other end of the scale, an overall rating of Outstanding doesn’t mean that a provider is outstanding in all areas. It can be outstanding in two areas and good in three. So, a provider rated outstanding for being caring may have a lower overall rating than one that is rated as good for the same question (we did say it wasn’t straightforward). Choosing a care home or home care provider is a big decision. There are many factors to consider and the CQC rating is useful guidance. But it often helps to dig a bit deeper to see the real story behind the rating.

You can find more about our Care Homes and Care at Home service ratings here.

First of all, Care Quality Commission (CQC) inspections are a good thing. It is important that there is accountability so that people placing their trust in care services can have confidence that the system is properly regulated.

Accountability also helps providers with common performance benchmarks and guidance on where we can improve.

To make best use of CQC inspection reports when choosing a care home or home care provider, it can help to understand a bit of background and context. Inspectors report on whether services are safe, effective, caring, responsive and well led. There are four possible ratings: Outstanding, Good, Requires Improvement and Inadequate. There is no category for ‘satisfactory.’

Some of the inspection rating is based on documentation such as procedures and record keeping and some of it is essentially a snapshot of what inspectors saw and who they spoke to. So, there could be some subjectivity in the findings- there’s also potentially some randomness based on exactly when the inspection happened.

There’s no doubt too, that some providers are better at the process of preparing for inspections than others. Although you could argue that this is what you’d expect from a well-managed organisation.

What do Ratings Mean?

Don’t dismiss homes simply if they are not Outstanding or Good. Care providers, and more importantly, care users are highly individual and other factors should also be considered.

For example, a home with a lower rating may be a better choice for an individual if the location makes it easier for relatives to visit and for the resident to maintain links with the community they come from. It may be that the facilities and activities on offer are more in line with what a particular person wants.

Similarly, you shouldn’t necessarily be put off a care home because its CQC rating at its last inspection was ‘Requires Improvement.’ There may not be that much practical difference between a provider that just got over the threshold to be rated ‘Good’ and one that didn’t quite make it.

If a home or provider is said to require improvement, it’s important to understand what this means. It could be that they provide essentially safe and effective care but need to tighten up some of their management processes. Even a provider with an ‘Inadequate’ rating shouldn’t be discounted out of hand if the management is taking urgent and purposeful action to correct the shortcomings found in the inspection.

The best way to identify the most suitable care home is to arrange a visit during a normal day to see for yourself whether residents look happy and well cared for. By all means, take along a copy of the most recent inspection report and talk through any concerns with the manager. More importantly, go with an open mind and ask: ‘is this a place where I or my loved one could live the life they want to live. To arrange a visit at any of our ‘Good’ care homes, contact us today on 01305 300 161.

Tag: Care inspection

What Does a CQC Inspection Rating Really Mean?

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