Professional Comment

When An Inspector Calls…

By Kevin Groombridge, Chief executive, Independent Care Inspections (

Practice makes perfect and this philosophy is advisable to achieve a top performance when industry regulator inspectors scrutinise a care home.

To achieve an outstanding rating from the Care Quality Commission (CQC), a home’s leadership, planning, legal compliance, care and procedures need to be excellent not only in deed, but also backed up by meticulous documentation.

To overcome any doubts about its quality of care, a home should arrange regular mock audits of its operations and records.

Homes that don’t feel confident about identifying any deficiencies themselves can always seek help from independent external experts to point them in the right direction.

This will help identify, enact on and embed factors essential to providing successful and person-centric care and services.

The reputational and commercial damage to a home given a poor rating by the CQC can be devastating.

It can lead to a fall in demand for its care from potential new residents and current occupants and their families considering alternative accommodation, which will impact on its financial viability.

A good reputation is hard won, but can quickly and easily be lost, through sloppy practices and procedures, if a home’s owner or managers take their eye off the ball.

Care homes striving to retain an outstanding ranking or to improve on a below par performance should operate as if there is an inspector on the premises every day.

CQC inspections usually are unannounced. Therefore, those homes that continually concentrate on meeting the regulator’s criteria and conditions are less likely to be given a low rating.

There are three key aspects to the performance of a care home, these are:
• Quality care – The effective care of people that ensures that residents are living their best lives
• Financial performance – A care home must be sound financially and be able to attract and retain the highest calibre of staff
• Management of risk – Reducing risks in care, health and safety and financially are essential for the long-term well-being of residents and the care home.

The most successful care homes, in terms of high regulator ratings, take a positive approach to inspection with robust systems, a high degree of preparedness and staff being positive about the inspection process.

The preparation and availability of complete records, especially care plans is essential for an inspector to locate and see evidence of strong and effective practice.

Checklist for Inspection – Factors to consider
There are four main factors in preparing for, and achieving better inspection outcomes:

1. Clear understanding of standards, regulations, and best practice:
Communication is key. Staff should be aware of and apply all relevant standards, regulations, and best practice.
Regular and effective training and supervision is essential for employees, so they are confident and able to demonstrate competency.

2. Records and documentation:
It is not enough to be seen by residents and their families to be doing the right thing. Detailed, up to date and accurate documentation must be in place to prove this is happening and that the correct procedures, systems and methodologies are in place and being closely followed.

3. Staff are briefed and confident
When staff are more relaxed and natural then residents are also. Inspection can create pressure, but confident staff are better at explaining and demonstrating good care and in people interactions. This ensures that the inspector can observe a more normal process.
To improve practice, it is vital that staff are trained, properly briefed and their confidence is boosted to participate positively in inspections.

4. Quality assurance and continuous improvement
A care home that has confidence in its quality assurance system will be constantly reviewing practice to minimise weaknesses and build on strengths.

This process is very effective if there are internal and external elements in auditing the home.

The CQC inspector is independent of the home and is applying standards that are well known, but not just specifically what the care home company has contained within its policies. Inspectors will also be seeking evidence that a care home can act on deficiencies that are identified.

The most effective care homes and care home groups utilise fully independent inspection systems to ensure that they can achieve higher ratings.