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How adult social care is inspected

New inspection process for adult social care

The Care Quality Commission's (CQC) annual assurance process is expected to start in April 2023. Under the Health and Care Act 2022, the CQC will undertake a baseline inspection of all adults social care directorates over the next two years.

We don’t yet know at what point the CQC will be visiting Dorset, but it is likely to feel like the OFSTED system for Children’s services.

The assurance process will look at Dorset Council adult social care through four main themes. These themes replace the Key Lines of Enquiry (KLOE’s) that were previously used by CQC and will be used to inspect provider services, adults service and Integrated Care Systems. The four themes are:

Working with people

This theme covers assessing needs, care planning and review, direct payments, charging arrangements, supporting people to live healthier lives, prevention, wellbeing and information and advice.

There are 2 quality statements: 

  • assessing needs 
  • supporting people to live healthier lives

Assessing needs 

We maximise the effectiveness of people’s care and treatment by assessing and reviewing their health, care, wellbeing and communication needs with them.

The Care Quality Commission will look for evidence that:

  • people with care and support needs, unpaid carers, those who fund or arrange their own care and communities have the best possible wellbeing outcomes
  • care and support needs are assessed in a timely and consistent way
  • assessments and care and support plans are co-produced, up-to-date and regularly reviewed
  • support is coordinated across different agencies and services and decisions and outcomes are transparent
  • people's care and support reflects their right to choice, builds on their strengths and assets, and reflects what they want to achieve and how they wish to live their lives

Supporting people to live healthier lives 

We support people to manage their health and wellbeing so they can maximise their independence, choice and control, live healthier lives and where possible, reduce future needs for care and support. 

The Care Quality Commission will look for evidence that:

  • the local authority works with people, partners and the local community to make available a range of services, facilities and other measures to promote independence and support people to prevent, delay or reduce their needs for care and support 
  • people in the area have access to the information and advice they need to make informed decisions about how their care and/or support needs are met

Providing support

This theme covers safe pathways, fair provision of services and our work with partners and communities

There are 2 quality statements: 

  • care provision, integration and continuity 
  • partnerships and communities 

Care provision, integration and continuity 

We understand the diverse health and care needs of people and our local communities, so care is joined-up, flexible and supports choice and continuity. 

The Care Quality Commission will look for evidence that:

  • the care and support needs of people and communities are understood; there is a varied and strong provider market with enough space to meet demand now and in future 
  • local people, including those who fund or arrange their own care, have access to a range of safe, effective and high-quality support options to meet their care and support needs
  • services are sustainable, affordable and provide continuity for people

Partnerships and communities 

We understand our duty to collaborate and work in partnership, so our services work seamlessly for people. We share information and learning with partners and collaborate for improvement. 

The Care Quality Commission will look for evidence that:

  • the local authority works towards mixing care and support services with those provided by partner agencies to achieve better outcomes for people who need care and support and unpaid carers and to reduce inequalities
  • there is partnership working to help ensure that care and support meets the diverse needs of individuals and communities
  • people experience a seamless care and support journey, and their support is co-ordinated across different agencies and services

Ensuring safety

This theme looks at our safeguarding work and protecting people’s rights, so they are free from abuse, discrimination, avoidable harm and neglect.

There are 2 quality statements:  

  • safe systems, pathways and transitions  
  • safeguarding  

Safe systems, pathways and transitions 

We work with people and our partners to establish and maintain safe systems of care, in which safety is managed, monitored and assured. We ensure continuity of care, including when people move between different services. 

The Care Quality Commission will look for evidence that:

  • when people move between services, settings or areas, there is a plan for what happens next and who will do what, and all the practical arrangements are in place
  • people feel safe and are supported to understand and manage any risks

Safeguarding 

We work with people to understand what being safe means to them and work with our partners to develop the best way to achieve this. We concentrate on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect, we make sure we share concerns quickly and appropriately.

The Care Quality Commission will look for evidence that:

  • safeguarding enquiries are carried out sensitively and without delay, keeping the wishes and best interests of the person concerned at the centre
  • people can participate in the safeguarding process as much as they want to.
  • people are supported to make choices that balance risks with positive choice and control in their lives 
  • there is a clear understanding of the key safeguarding risks and issues in the area and a clear, resourced strategic plan to address them
  • lessons are learned when people have experienced serious abuse or neglect and action is taken to remove future risks and drive best practice

Leadership

This theme looks at how capable, compassionate and inclusive leaders deliver care, treatment and support and embody the culture and values of staff.

There are 2 quality statements: 

  • governance, management and sustainability 
  • learning, improvement and innovation 

Governance, management and sustainability 

We have clear responsibilities, roles, systems of accountability and good governance to manage and deliver good quality, sustainable care, treatment and support. We act on the best information about risk, performance and outcomes, and we share this securely with others when appropriate.

The Care Quality Commission will look for evidence that:

  • there are effective governance and performance management arrangements at all levels. These provide visibility and assurance on delivery of Care Act duties, risks to delivery, quality and sustainability, and people’s care and support experiences and outcomes. 
  • the local authority uses information about risks, performance and outcomes to inform strategy, allocate resources and to deliver the actions needed to improve care and support outcomes for people and local communities

Learning, improvement and innovation 

We focus on continuous learning, innovation and improvement across our organisation and the local system. We encourage creative ways of delivering equality of experience, outcome and quality of life for people. We actively contribute to safe, effective practice and research.

The Care Quality Commission will look for evidence that:

  • learning from people’s feedback about their experiences of care and support, and feedback from staff and partners is embedded throughout the local authority’s work and it informs strategy, improvement activity and decision making at all levels
  • coproduction is embedded throughout the local authority’s work. 
  • there is an inclusive and positive culture of continuous learning and improvement, and this is shared by all leaders and staff across the organisation and with their partners. 

How will the new CQC assessment of local authorities work? 

Each quality statement will be rated, the scores for each quality statement will then be added up and converted into a percentage. It is expected that the CQC will use the same 4 ratings as before: inadequate, requires improvement, good and outstanding.  

We are always looking for feedback, if you have a story or comments to share, please email us.

If you wish to learn more about the role of the CQC, the CQC website will provide more detail including the interim guidance.

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