What Evidence Do I Need for a CQC Inspection?
A huge thank you to everyone who visited us at this year's Care Show. It was an absolute pleasure meeting so many inspiring individuals, and we're thrilled that our talk was such a success! In fact, the theatre was so full that some attendees were turned away - so if you missed out, don’t worry! We’ve summarised the talk below and we’ll be breaking down everything you need to know about evidencing for your next CQC inspection.
Vikki Beckwith presenting at the Care Show Birmingham's Keynote Theatre.
Overview of the CQC Framework
On October 3rd of 2024, the Care Quality Commission (CQC) announced some major changes to the way they would be inspecting and reporting on health and social care services. As we know for now, the framework will retain the 34 Quality Statements alongside the 6 new Evidence Categories. However, key changes include the removal of individual scoring for evidence categories, with a shift toward scoring each Quality Statement as a whole. The goal is to speed up registrations and assessments, creating a more efficient inspection process.
The Six Evidence Categories
So the CQC has explained they will be keeping the six evidence categories at they are, so let’s take a closer look at them.
People’s Experience: Evidence such as phone calls, emails, and feedback forms.
Staff Feedback: Collected through staff surveys, interviews, and focus groups.
Partner Feedback: Feedback from partners via surveys, interviews, and focus groups.
Observation: Inspections conducted on-site to assess care delivery.
Processes: Includes audit results, access times for treatment, case note reviews, etc.
Outcomes: Includes data on mortality rates, emergency admissions, infection control rates, and other care outcomes.
Case Study: Sunrise Care Home
Whilst at the Care Show Birmingham, we included a mock case study to better explain the evidence collecting process. The care home in question is “Sunrise Care Home”, a small residential facility for older adults. The home has recently undergone major changes, including new management and the implementation of an electronic care records system.
As a CQC inspection approached, the team focused on gathering physical evidence to demonstrate compliance and high-quality care. Below are examples of evidence types across various Quality Statements:
Safe Quality Statement: Involving People to Manage Risks
Under the framework, there are only 3 evidence categories that are necessary to evidence this specific quality statement. These include People’s Experiences, Feedback from Staff and Leaders, and Observation. Here we will take a closer look at what physical evidence they can provide for each evidence category required for this quality statement.
People’s Experience:
Residents and families are involved in risk assessments during care planning. For example, one resident's feedback led to more personalised fall prevention measures. Evidence for this can include:
Care plan documents showing individualised risk assessments
Meeting notes from care planning sessions
Signed consent forms detailing agreed upon risk management strategies
2. Feedback from Staff and Leaders:
Staff are trained to identify and manage risks. A recent suggestion from a staff meeting led to a safer process for assisting residents with mobility challenges during group activities. Evidence for this can include:
Staff training records on risk management
Minutes from team meetings discussing risk strategies
Updated processes showing staff contributions to risk management
3. Observation:
Management monitors how staff help residents during high-risk activities, such as ensuring safe swallowing procedures during meals. Evidence for this can include:
Observation logs showing instances where staff followed risk management procedures
Daily care notes documenting actions taken to manage specific risks
Caring Quality Statement: Independence, Choice, and Control
Our next quality statement falls under the area of ‘Care’. For this specific statement there are 4 evidence categories that we will be zooming in on.
People’s Experience:
Residents participate in decisions about their daily lives, from meal choices to activities. A resident's request led to the creation of a weekly garden club. Evidence for this can include:
Meeting minutes from resident meetings
Feedback forms from residents on menu choices and activity preferences
Photographs of residents participating in the garden club.
2. Feedback from Staff and Leaders:
Staff reported that encouraging residents to make their own choices improves their wellbeing. For example, giving residents the freedom to set their daily routine has led to higher engagement. Evidence for this can include:
Staff training records on promoting independence and choice
Staff feedback forms
Care records showing where staff supported residents' choices
3. Observation:
Inspectors observe how staff promote independence by offering residents choices, such as selecting meals and leisure activities. Evidence for this can include:
Observation logs
Care notes documenting instances where residents were offered choices
Photos of residents engaging in chosen activities
4. Processes:
The home has policies supporting resident independence, and care plans are regularly reviewed to reflect changing preferences. Evidence for this can include:
Care plans demonstrating individualised preferences
Policies on promoting independence and choice
Records of care plan review meetings with residents
Documentation of decision making frameworks
Well Led Quality Statement: Leadership and Staff Involvement
The last quality statement we’ll be looking at falls under Well Led. For this particular quality statement, only 2 evidence categories need to be checked off which are Feedback from Staff and Leaders and Processes.
Feedback from Staff and Leaders:
Leadership involves staff in decision-making through regular meetings and open-door policies. A suggestion from staff resulted in more flexible working arrangements, improving morale and work-life balance. Evidence for this can include:
Meeting minutes documenting staff involvement in decision-making
Staff feedback forms showing positive perceptions of leadership
Records of policy changes that resulted from staff suggestions
2. Processes:
Processes to develop leadership skills include training on emotional intelligence, conflict resolution, and fostering an inclusive culture. These practices help create capable and compassionate leaders. Evidence for this can include:
Leadership development program curriculum
Training records for leadership training
Appraisal documents showing leadership competencies
Policies on inclusive leadership practices
The Importance of Getting Your Evidence Right
Why Evidence Matters
Demonstrates Quality of Care: Evidence provides a clear picture of how care services meet the CQC’s standards, ensuring that care is safe, effective, and compassionate.
Identifies Strengths and Areas for Improvement: Regularly compiling and reviewing evidence helps care providers improve by identifying both strong practices and areas needing enhancement.
Ensures Compliance: Proper documentation of practices helps prevent negative ratings and protects services from potential enforcement actions.
Promotes Person-Centred Care: By showing how people who use the service are involved in decision-making, evidence can highlight a provider’s commitment to person-centred care, which is a key focus for CQC inspections.
Final Thoughts
As the CQC moves forward with its updated framework, care providers must ensure they are collecting comprehensive, accurate evidence that showcases their commitment to high-quality care.
By following the framework and understanding how each evidence category applies, care homes can effectively prepare for inspections and demonstrate compliance.
