The words CQC and inspection can strike fear into the hearts of practices; what can your practice do to get through this daunting time? Charlotte Hudson investigates.

All general practices will be inspected by the CQC every two years, in most cases focusing on a minimum of five of the 16 essential standards. Preparation is key; if you regularly monitor your practice’s compliance with the CQC’s essential standards, there should be no need for last minute panic. Your practice can actually use the inspection as an opportunity to promote the standard of care that you provide to your patients.

"The CQC give practices 48 hours’ notice of an inspection, unless it is a responsive inspection"

There are three kinds of CQC inspections of general practices:

Scheduled inspections – a standard routine inspection to check that you are meeting the essential standards of quality and safety

Responsive inspections – these are usually unannounced and made when the CQC has concerns about the quality or safety of a service

Themed inspections – where the inspector will look at a specific area in health and social care.

The CQC give practices 48 hours’ notice of an inspection, unless it is a responsive inspection.

During the inspection the inspectors will talk to patients and staff, and they may also speak with members of your Patient Participation Group if your practice has one. The inspectors will cross-check what they see and hear against other evidence such as records, schedules and protocols. They will look for evidence that the regulations are not being met.

Vickie Wilkes, Regulatory Policy Manager at the CQC, has provided some tips for practices ahead of their inspection:

1. It is important to ensure that someone is there at the practice to meet with the inspectors. A key person to co-ordinate the day, introduce the inspectors to patients and staff, and provide the inspectors with somewhere they can sit and do their work, is essential. This is usually the practice manager.
2. All staff, from the receptionists to the GPs, should be made aware that we are coming and be prepared to talk to the team, answering questions about how they work, etc. It’s all well having a policy in place but that on its own is not enough; testing staff is far more important for us, to find out what staff would do personally in situations.
3. The practice needs to be honest and upfront with us. If they’re not fully compliant it is much better to acknowledge this and tell us. Don’t try to hide it because it could make it worse for your practice. As long as you show how you are planning on improving practices to be compliant you will be fine.
4. Don’t listen to the myths about the CQC inspections. Two common ones are if the reception desk is too high you will fail, and you’re not allowed toys in waiting rooms.
5. Focus on the CQC documents to help prepare your practice for an inspection.

What's new?

Over the past 12 months the CQC has been undertaking a full review of how effective its inspections are and how they need to change. David Behan, Chief Executive of the CQC, said that an assessment of how the leadership of an organisation can set the culture around quality and safety will be built into the inspections it carries out.

He continued: “Our objective is to make sure that the people who use health and social care services receive high-quality, compassionate care which is also safe and effective. We encourage services to improve so that they can be the best they can be.

“In order to do this we are changing quite radically the way we inspect care and health services. Each service is different – for example, how you inspect a large multi-site intern teaching hospital and how you inspect a three-bed care home for people with autism needs to be different.” 

"A key person to co-ordinate the day, introduce the inspectors to patients and staff, and provide the inspectors with somewhere they can sit and do their work, is essential. This is usually the practice manager"

As part of the new approach, the CQC will ask five questions about services that will be the basis of their inspections.

1. Are services safe?
2. Are services effective?
3. Are services caring? (Will I be treated with compassion and dignity?)
4. Are they well-led?
5. Are they responsive to people’s needs?

“Question 4 is an important one because the link between the leadership of an organisation and the quality of care is now well established, and Robert Francis highlighted this in his inquiry report in Mid Staffordshire,” explained Mr Behan. “How the leadership of an organisation sets the culture around quality and safety is something we want to assess as part of our inspection programme.”

The CQC has started rolling out the new approach to inspections in hospitals first (from September to December 2013), and 18 hospitals in total will be asked these five questions.

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