October 6, 2020

cqc standards and cqc kloe

The Care Quality Commission (CQC) is an independent body for regulating health and social care standards in England. To be successful, every practice or care home manager must understand the CQC standards and CQC KLOE (key lines of enquiry).

cqc standards and cqc kloe

This article provides a quick overview of these standards and KLOE. We’ll cover:

  • CQC roles and function
  • CQC standards
  • CQC KLOE for health and social care service

You can find more about quality improvement tools here.

CQC Roles and Function

Their purpose is to ensure that the health and social care services available will provide people with high-quality, compassionate, safe, and effective services, and to encourage improvements where it is deemed necessary.

They carry out inspections of individual establishments, rating their services and monitoring them for quality of care. Their views on major quality issues are published on their website.

They also protect those who are vulnerable, listen to their experiences and work with other organisations or public groups to make sure that the safety of those vulnerable people is never infringed. This list of vulnerable people includes those who have been restricted under the Mental Health Act.

The CQC outlines a set of fundamental standards that all health and social care providers should meet – commonly called CQC standards. It holds every individual establishment to these standards.

CQC Standards

1 – Person-Centred Care

Treatment must be tailored to each individual, meeting their unique needs and preferences.

2 – Dignity and Respect

Whilst being cared for, individuals must be treated with dignity and respect. This includes giving privacy when needed or wanted, giving support to help encourage independence, and all individuals being treated equally.

3 – Consent

Each individual, or those acting on their behalf, must give consent before any treatment or care is given.

4 – Safety

FOr obvisous reasons, this is an important CQC standard. No individual should receive unsafe treatment or care. Putting individuals at unnecessary risk of harm should always be avoided.

Risk assessments must be carried out on health and safety for any treatment or care, and the staff carrying out treatment or care must have the necessary qualifications and competence.

5 – Safeguarding From Abuse

No abuse or improper treatment should be suffered while individuals are under a health or social care establishment. This includes malpractice such as neglect, inappropriate or unnecessary restraint, degrading treatments, or any inappropriate limits being placed on an individual’s freedom.

6 – Food and Drink

Individuals must be kept in good health with regular food and drink whilst receiving treatment and care.

7 – Premises and Equipment

Establishments providing care and the treatment or equipment used should always be kept clean, and any equipment must be secured and used correctly.

8 – Complaints

A system must be in place to handle, respond to, and investigate complaints effectively.

9 – Good Governance

Care providers must have clear plans to meet the required standards of care. They need to have effective systems and governance to evaluate quality and safety, and identify where improvements need to be made.

10 – Staffing

Staff should be qualified, experienced, and competent. They must be given the correct support, supervision, and training.

11 – Fit and Proper Staff

Care providers should only employ those who can offer the correct treatment and care for their role. Recruitment procedures must carry out the relevant background checks.

12 – Duty of Candour

Care providers must be transparent and honest when discussing treatment and care. If mistakes are made, they have a duty to inform the individual involved and provide the necessary support.

13 – Display of Ratings

Care providers must always display their CQC rating in a visible place. This information should also be featured on their website, with their latest report available for viewing.

Overview of CQC KLOE

In this article, I’ve deliberately left out the long list of CQC KLOE for two reasons. First, KLOE do change. So, anything published based on the KLOEs will become obsolete the moment the KLOEs are updated. The second reason I’ve not included the detailed list of the KLOEs was to avoid making this book artificially bulky.

However, KLOE are available online (for healthcare services and for adult social care services). I update the download links regularly, so you can have only the latest versions irrespective of when you are reading this book. To download the latest versions of the KLOE, check out the resources section of this part.

CQC KLOE for Healthcare Services

KLOEs are the key lines of enquiry that the CQC will be asking and investigating during an inspection. There are 5 different KLOEs, all with their own prompting questions to ensure that they collect all of the necessary information for their inspection.

In 2017 and 2018, the KLOE were updated to remove any duplicated prompts and respond to feedback received from their Next Phase consultation. They are frequently re-evaluated to ensure that they are appropriate and easy to understand.

The 5 CQC KLOE for healthcare services

1. Safe

The CQC defines safe as being protected from any abuse or avoidable harm. This includes any physical, mental, sexual, financial, institutional, negligent, discriminatory, or psychological abuse.

When carrying out an assessment of an establishment, the CQC will ask questions in 6 different areas:

  • How systems safeguard people from abuse.
  • How risk assessments are carried out.
  • Whether staff have the necessary information to deliver safe treatment and care.
  • How the proper and safe use of medications is ensured.
  • What the establishment’s track record is on safety.
  • How lessons are learned when things do go wrong.

2. Effective

The CQC defines effective as providing treatment and care that results in good outcomes and good quality of life for each individual.

The 6 areas that will be approached during an inspection are:

  • Whether individual needs are assessed, and treatment and care are delivered in line with the current legislation.
  • How each individual’s outcomes are monitored.
  • How the establishment ensures staff are able to deliver effective treatment and care.
  • How services, teams and staff work together within and across different establishments.
  • How individuals are supported in living healthier lives.
  • Whether consent to treatment and care is always sought.

3. Caring

The CQC defines caring as ensuring that the service offers individuals kindness and compassion and treats them with dignity and respect.

When assessing an establishment, the CQC will ask questions in 3 main areas:

  • Whether the service makes sure that individuals are treated with kindness, compassion and respect and given the right emotional support.
  • Whether the service supports an individual’s expression of views and involvement in treatment and care decisions.
  • How the dignity and privacy of individuals are respected.

4. Responsive

The CQC defines responsive as meeting the needs of individuals.

The 4 areas that the CQC will investigate are:

  • Whether care is personalised and responsive to the needs of each individual.
  • Whether the service takes account of different individual choices.
  • Whether care is accessed at the right time.
  • Whether complaints are noted and responded to correctly.

5. Well-led

The CQC defines well-led as a service having the right governance, leadership, and management in order to deliver treatment and care of a high-quality, in a fair and open environment, with each individual’s needs kept at the centre of practice.

The CQC will ask questions covering the following 8 areas:

  • Whether the capacity and capability of leadership is enough to deliver high quality care.
  • Whether there is a key strategy to deliver a vision of high-quality care.
  • Whether there is a culture of sustainable, high quality care.
  • Whether there is good management driven by systems, roles, and accountability.
  • Whether there are effective processes in place to manage risks and performance.
  • Whether information is processed effectively and accurately, and acted on accordingly.
  • Whether service users, staff, the public, and partners are engaged in supporting high-quality care.
  • Whether there are systems in place to encourage learning and improvements.

CQC KLOE for Community and Adult Social Care Services

The CQC has the same 5 individual KLOE that are listed for evaluating health practices. However, they have adjusted some of the areas investigated within these key lines of enquiry to better suit social care services.

1. Safe

The 6 areas that will be investigated by the CQC are:

  • How systems safeguard people from abuse.
  • How risk assessments are carried out.
  • How the establishment ensures there are sufficient staff suitable for the safety and needs of individuals.
  • How the proper and safe use of medications are ensured.
  • How well individuals are protected by infection prevention and control.
  • How lessons are learned when mistakes are made.

2. Effective

The 7 areas that the CQC will ask questions about are:

  • Whether individual needs are assessed, and treatment and care are delivered in line with the current legislation.
  • How the establishment ensures staff are able to deliver effective treatment and care.
  • Whether people are supported to eat and drink enough for the maintenance of a balanced diet.
  • How services, teams, and staff work together within and across different establishments.
  • How individuals are supported in living healthier lives with access to the necessary ongoing healthcare they require.
  • Whether individual needs are met through the design and adaptation of the premises.
  • Whether consent to treatment and care is always sought.

3. Caring

There are 3 different areas the CQC will make enquiries about, following the same questions outlined for health care:

  • Whether the service makes sure that individuals are treated with kindness, compassion and respect and given the right emotional support.
  • Whether the service supports an individual’s expression of views and involvement in treatment and care decisions.
  • How the dignity and privacy of individuals is respected.

4. Responsive

There are 3 separate areas that the CQC will ask questions about regarding how responsive the establishment is:

  • Whether care is personalised and responsive to the needs of each individual.
  • Whether complaints are noted, investigated, and responded to correctly.
  • How individuals are supported and made to feel comfortable and dignified during end of life care, and how pain is kept to a minimum.

5. Well-led

The CQC will ask questions in 5 main areas:

  • Whether there is a clear strategy to deliver a vision of high-quality care, a positive culture, openness, inclusivity, and empowerment in order to achieve the best possible outcome for each individual.
  • Whether the governance framework in place ensures that each staff member knows their responsibilities, and makes sure that there is a clear understanding of risks and regulatory requirements.
  • Whether service users, staff, and the public are kept involved and engaged.
  • Whether the establishment continuously learns, improves, and innovates.
  • How the service works alongside and in partnership with other agencies.

In conclusion

Those were the CQC standards and KLOE that every practice and care home manager should be familiar with. You can also learn more about change management here.

About the author 

drmahey

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