A Simple Guide to CQC Inspections for Care and Nursing Homes

Estimated reading time: 10 minutes

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If you run or work in a care or nursing home in England, chances are you’ve heard of the CQC and CQC Inspections. This stands for the Care Quality Commission.

The CQC is the organisation that regulates and inspects care providers to make sure residents are safe and receiving good care.

CQC inspections can feel scary if you don’t know what to expect. But understanding the inspection process can help you be prepared and do your best.

In this article, we’ll explain CQC inspections in a simple way. We’ll look at:

• What CQC inspections check for
• The different types of inspections
• How often inspections happen
• Ways care and nursing homes can prepare
• What to do during and after an inspection

Let’s get started!

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What Are CQC Inspections?

First, CQC inspections are visits conducted by CQC inspectors to examine the quality and safety of care in nursing and care homes.

The inspectors check to see if standards are being met in areas like:

• Keeping residents safe from harm or abuse
• Having proper staff training and skill levels
• Storing medications correctly
• Maintaining dignity and independence
• Meeting health, personal and social needs
• Having good leadership and management

Basically CQC inspections are like a review to ensure homes are providing good care.

After inspecting, the CQC gives the home an overall rating. Homes want to earn a “Good” or “Outstanding” rating. That shows high quality.

Types of CQC Inspections

There are a few kinds of CQC inspections.

Routine Inspections

Routine inspections of care and nursing homes usually happen once every 2 years. Some key details:

• Inspectors visit without notifying the home in advance. It’s unannounced.
• The visit lasts 1-2 days depending on the home’s size.
• Inspectors tour facilities, observe staff, review records, and speak with residents, families and workers.
• Findings are used to assess standards and give a quality rating.

Focused Inspections

Focused inspections target specific concerns or problem areas reported about a home between routine inspections. For example:

• Complaints about poor care or safety risks
• Low staffing levels
• Medication errors
• Issues identified during a previous routine inspection

These focused visits are shorter but concentrate on investigating the risks or problems through records review, staff interviews and observations. They identify whether standards are breached in those limited areas.

Thematic inspections

Thematic inspections focus on one specific topic or area of care.

The CQC picks a theme they want to look at more closely across many different places. This is usually something they are worried about.

For example, they may be worried that many nursing homes have problems with infection control.

So CQC inspectors will visit lots of different nursing homes. At each one, they will only inspect the infection control practices.

They will look at things like:

• Do staff wash hands properly?
• Are surfaces cleaned enough?
• Are infections spreading?

By going to many places, they can see if infection control is a bigger problem everywhere.

Afterwards, the CQC will share what they learned about that theme.

Their report will say where things need to improve.

It can help many nursing homes get better at infection control.

Thematic inspections let the CQC focus on one specific problem area across all providers. This helps them spot bigger issues in healthcare.

Other types

Other types are targeted inspections which examines and addresses urgent concerns or risks regarding a service’s ability to provide safe and effective care. Provider Initiated-reviews allows a service to request a CQC review of a specific area or service they’ve identified for improvement.

How Often Do Inspections Happen?

Let’s look at the frequency of CQC inspections:

• Routine inspections happen about once every 2 years for each care and nursing home.
• Focused inspections happen as needed in between. There’s no fixed schedule.
• New care and nursing homes get a routine inspection within the first year after opening.
• Homes with poorer ratings get re-inspected more often until improvements are made.

So while every home has routine CQC visits every couple of years, additional focused inspections can occur at any time if concerns arise. It’s important to maintain standards daily.

CQC inspection frequency:

Generally, you want to look at the frequency of inspection happening based on these factors:

• High-risk services: Every 12-18 months.
• Lower-risk services: Every 2-5 years.
• Services rated Requires Improvement or Inadequate: Within 6-12 months.
• Services with significant changes or concerns: As needed, potentially unannounced.

Factors That Can Invite CQC Inspections on Facilities

The frequency of CQC inspections in England depends on several factors, such as:

1. Service Type which can be high risk services for hospital, GP practices, and services caring for vulnerable individuals. This takes between 12-18 months as explained above. Lower risk services such as dental clinics and private clinics are less frequently, 2-5 years.
2. Previous Ratings which require improvement on last inspection or are inadequate would require more frequent visits to monitor activities. It can be between 6 to 12 months. Outstanding and good rating may take up to 5 years.
3. Changes in Services or Concerns can contribute to frequent inspections by CQC regulators. Changes in leadership, staffing or reports on concerns can trigger an unannounced visit.
4. CQC continuously monitors services through data analysis and intelligence gathering. This information can also trigger inspections or targeted reviews.

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Related: How Quality health and social care training will benefit your care team [short read]

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How Can Homes Prepare for CQC Inspections?

Preparing ahead helps homes be ready for CQC inspections. Here are some tips:

• Review previous inspection reports and address any outstanding issues.
• Train all staff on the CQC standards so they understand expectations.
• Implement regular audits and checks to identify risks early.
• Have good record keeping with care plans, safety logs, training files, meeting minutes, etc.
• Gather feedback from residents, families and staff to improve weak spots.
• Make sure sufficient, skilled staff are always available.
• Provide person-centered care focused on choice, dignity and independence.

Preparing properly takes time but gives homes the best chance of a positive inspection experience.

What to Do During a CQC Inspection

When inspection day arrives, here are some pointers:

• Greet inspectors politely and respond to questions directly.
• Allow inspectors full access to all areas and information. Don’t hide problems.
• Be transparent about challenges and discuss improvements underway.
• Guide observational tours to highlight strengths while still permitting full review.
• Introduce inspectors to residents and explain how their needs are met.
• Have key records like care plans, incident reports, and policies organized for easy access.
• Reassure any anxious staff or residents and remind them to share openly.

Staying cooperative and improvement-focused sets the right tone.

After the CQC Inspection

Once inspectors leave, important next steps include:

• Review inspector notes and begin addressing deficiencies right away.
• Develop an improvement plan for any standards that require improvement or are unmet.
• Prioritize changes that impact safety and wellbeing the most.
• Allocate resources needed to drive changes, whether staff training, new equipment etc.
• Update families on how the home is responding to any inspection findings.
• Celebrate successes noted while aiming even higher.

The end of one inspection marks the start of the next cycle of continuous improvement!

Ongoing Readiness for Care and Nursing Homes

The best way for homes to be ready for the next CQC visit is maintaining standards daily. Here are some suggestions:

• Do regular self-audits against CQC standards.
• Schedule monthly care reviews for each resident to ensure needs are met.
• Monitor staff performance and conduct spot checks.
• Review incidents for any patterns and address risks.
• Check facilities, sanitation and equipment regularly.
• Survey residents, families and staff for regular feedback.
• Update policies, training and resources to stay current.

By self-monitoring, homes can identify and resolve small issues before they become big.

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PRACTICAL TIPS TO GET YOUR CARE HOME CQC INSPECTION-READY

1. Audit Across CQC Standards

A crucial first step is auditing your own practices against CQC standards. Key areas to review for cqc inspections include:

1. Safe – Are thorough risk assessments done? Are facilities and equipment well-maintained? Is training up-to-date?

2. Effective – Do care plans reflect current best practices? Are skills and training adequate? Is care reviewed and adjusted as needed?

3. Caring – Is staff communication respectful and warm? Are choices and privacy respected? Is dignity maintained?

4. Responsive – Are staffing levels sufficient? Is care person-centered? Are changing needs accommodated?

5. Well-led – Are vision and values clear? Is the environment inclusive? Are risks addressed proactively?

Be brutally honest. Identify any shortcomings so you can strengthen them well ahead of inspection.

2. Address Known Weak Spots

Revisit your most recent CQC report. Did they flag any standards as “Requires Improvement” or “Inadequate”? Place extra focus on improving these areas:

• Review why the issue occurred. Look for root causes.
• Set measurable markers for improvement targets.
• Develop action plans that provides necessary changes to policies, procedures, equipment, training etc.
• Allocate resources and assign staff to drive changes.
• Establish monitoring systems to track progress.

Don’t wait for the next cqc checks – start improving on these aspects now.

3. Deep Clean and Organise

First impressions matter.

Ensure your home looks and feels welcoming, clean and organised:

• Schedule deep cleaning tasks like carpets, walls, medic rooms, kitchens, bathrooms.
• Make repairs to any damaged furnishings or features.
• Organise drawers and storage cupboards for tidy appearance.

-Remove clutter from hallways, doorways and fire escapes.

• Refresh decor where needed for homelike environment.

A clean, organised home supports safety and dignity. CQC Inspectors will quickly notice this.

4. Update Policies and Procedures

Check that all care policies and procedures are current and reflect latest sector best practices and regulations. Key documents to review for CQC inspections include:

• Safeguarding and whistleblowing policies
• Mental capacity and consent procedures
• Infection control and clinical guidelines
• Medication management protocols
• Staffing and training policies
• Health and safety procedures

Outdated documents can create compliance issues.

5. Boost Infection Control

Infection prevention is always a priority. Give it extra attention:

• Re-train staff on hand hygiene, PPE use and cleaning protocols.
• Stock adequate PPE supplies and hand sanitizer.
• Post handwashing reminders in bathrooms and care areas.
• Sanitize high-touch surfaces like handles, railings, chairs daily.
• Promptly isolate residents with infections.

A visibly robust infection regime reassures inspectors.

6. Strengthen Medication Safety

Medication mistakes concern inspectors. Minimize risks:

• Validate staff competency in medication administration.
• Eliminate clutter and organide storage areas.
• Conduct regular medication audits and room checks.
• Remove expired, unneeded medications promptly.
• Ensure MAR charts and allergy labels are all updated.
• Identify residents needing support with medication compliance.

Following strong medication control procedures is key.

7. Review Equipment Needs

Ensure equipment availability enables high quality care:

• Check that patient handling equipment (hoists, stand aids etc) is adequate and functioning properly.
• Confirm suction machines, oxygen, BP monitors and other clinical equipment are in supply.
• Make sure call bells, personal alarms and sensor mats are working and within easy reach of residents.

Proper equipment maintains safety and care quality.

8. Conduct Staff Reviews

Your staff make the care home. Invest in their skills:

• Identify any training gaps and develop refreshers trainings targeting identified weaknesses.
• Ensure sufficient numbers of trained staff are available around the clock.
• Review personnel files to confirm qualifications meet requirements.
• Discuss CQC expectations and do practice walkthroughs.
• Recognise and thank teams for their dedication and hard work!

Supporting your staff supports CQC readiness.

9. Listen to Resident Feedback

Most importantly, listen to residents’ needs through:

• Your own quality assurance questionnaires
• Structured interviews with individual residents
• Focus group discussions on life in the home
• Anonymous comment boxes
• Monitoring complaints

Feedback identifies where care needs strengthening through a resident lens. Act on concerns raised to become truly resident-led.

10. Preparing Well Reduces Anxiety

Thorough preparation not only improves compliance but also reduces stress when inspectors arrive. Confidence comes through diligent readiness.

While CQC inspections only happen every couple of years, maintaining continual inspection vigilance enables your home to provide the highest quality care every single day.

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The Takeaway on Our CQC Inspection Tips

CQC inspections allow England’s care regulators to check that nursing and care homes meet quality standards. While inspections can feel intimidating, being prepared helps homes demonstrate their strengths.

The CQC process promotes continuous improvement over time. Use it as motivation to be your best every single day.

With the right readiness activities and a cooperative, transparent approach, CQC inspections can help your home provide even better care!