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Leading an inspection team: the onsite process Adult Social Care

Dr Linda Patterson, CQC Inspection Team Chair & PAST Clinical Vice President, Royal College of Physicians discussed leading an inspection team and the onsite process at today’s conference. In her presentation Linda looked in depth at:

  • how the onsite process works for announced and unannounced visits
  • what the inspection teams are looking for and what information they may ask for onsite
  • the role of experts by experience
  • my experience as a lead inspector
  • preparing the data, information and improving local monitoring information
  • how can you prepare for inspection?

Dr Linda Patterson’s full presentation is available for download at the end of this page.

“The inspection team includes: Chair, CQC Inspector, Data Support, Peer experts – Managers, nurses, doctors etc, experts by experience and admin support”

“Experts by experience look at peoples experience in terms of environment, noise, staff interactions, signage, cleanliness…etc…put yourself in the person’s shoes”

“Person centred coordinates care (integration) will cover my goals/outcomes, care planning, communication, information, decisions making including budgets and transitions”

“The process of inspection includes pre visit briefing (by phone), data packs sent out, on-site (review of data), allocation of teams and review of KLOE”

“Key lines of enquiry would be under the domains of safety, effectiveness, responsiveness, caring and well led, standards KLOEs.. BUT data may suggest particular lines of enquiry”

“Trust presentation should include a background to the organisation, its approach to ensuring good quality care, what is working well or is outstanding and the areas of concern or risk”

“On site evidence includes – observations of care, what people, carers and staff tell us, care environment and facilities and review of documents and records”

“The voice of users and the public is very important – there are ways to get this information and use it towards the inspection process.”

“Ratings are based on: rate every core service for every key question, An aggregated rating for each core service, an aggregated rating for each key question and an aggregated overall rating for the location as a whole”

“If you get 2 inadequate across the domains you will come out as Inadequate”

“The Particular issues the CQC are looking at are: safeguarding, DoLs and MCA, dementia care, recod keeping, medicines management and relationships with other providers eg. Health and social care – well led”

“At the end of the visit you may get preliminary feedback, any immediate issues and no rating are discussed”

“If any issues that need to be address and actioned they will be discussed”

“Post visit the report will be written on services and the organisations, a quality check will take place, factual accuracy check with the provider, the report in finalised and a quality summit will take place with the services and organisation”

Linda’s personal observation of the process include:

  • Team get the hang of it quickly
  • Most difficult thing is the judgements – what does it mean??
  • Importance of using data
  • Chair leads on leadership domain
  • Important to use and listen to experts by experience
  • Need to keep an eye on how the visit is going, timing priorities
  • You are the trouble-shooter
  • Judgement re escalation
  • Simple things can give a good/poor impression – clutter, empty hand gels, etc
  • Confidential personal information – should only be looked at “need to know”
  • Excellent learning opportunity 

Dr Linda Patterson’s Biography:

Linda is a clinical practitioner (consultant physician) with a track record of creativity, strategic implementation, delivery and clinical excellence. Her experience covers collaborative working with stakeholders from public, private and voluntary sectors.  She is committed to quality improvement for services to patients and the public. She has worked in both hospitals and community services, developing integrated care.

At present, Linda is a Non-Executive Director at Calderdale and Huddersfield NHS Foundation Trust, as well as Chair of NHS England Patient Safety Medical Expert Group. 

Future events of interest:

Implementing the national objective to end Prone/Face Down Restraint:

Examining Restraint Positions in Practice
Tuesday 22 September 2015
ICO Conference Centre, London

Self Neglect & Adult Safeguarding
Monday 5 October 2015
Hallam Conference Centre, London

Caldicott Guardian Training Course
Monday 12 October 2015
Hallam Conference Centre, London

Adult Safeguarding Enquiries & Safeguarding Adults Reviews
Monday 12 October 2015
Hallam Conference Centre, London

Improving Mental Health Crisis Care
Thursday 15 October 2015
Hallam Conference Centre, London

Deprivation of Liberty Safeguards: Ensuring Compliance in Practice
Tuesday 17 November 2015
Hallam Conference Centre, London

Download: Dr Linda Patterson"s full presentation

7 July 2015


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