Changes to single assessment framework

CHANGES TO SINGLE ASSESSMENT FRAMEWORK

The Care Quality Commission (CQC) have announced they will be implementing a new Single Assessment Framework to regulate health and adult social care as part of its new strategy to provide consistency across services.

The new strategy will strive to reduce health inequalities and to drive improvements for people who use services, and aim to deliver a more dynamic, data-led method of assessment with a focus on people’s experiences, safety cultures and care integration.

This will apply to care providers, local authorities, and integrated care systems across England. The new regime is currently being piloted with a small number of providers and a subsequent rollout across the board is expected in Autumn 2023.

WHY ARE THEY CHANGING THE ASSESSMENT FRAMEWORK?

The CQC have recognised they need to make changes for these 3 reasons:

• They want to make things simpler which will enable them to focus on what matters to people.
• The changes enable them to reflect on how care is delivered by different types of service as well as across a local area.
• The need to create one framework that connects the registration activity to the assessments of quality.

WHAT IS CHANGING?

The CQC have always had three assessment frameworks for hospitals, adult social care and primary medical services. Now, the Single Assessment Framework has been developed to streamline and simplify the assessment process.

The framework will include new Quality Statements which will be used to gather evidence when assessing providers. The Quality Statements will replace the Key Lines of Enquiry (KLOEs) which have previously been used to assess care providers and services.

The Quality Statements will be focusing on the following six evidence categories:

1. People’s Experiences.
2. Feedback from staff and leaders.
3. Observations of care.
4. Feedback from partners.
5. Processes
6. Outcomes of care.

Care providers must be aware of these categories and collate evidence to prove their compliance with the Quality Statements. Methods of collating this evidence may include:

• Provider submissions.
• Contact with people using the service.
• Structured conversations with managers and other leaders.
• Providers Information Returns.

The current timetable of on-site inspections will be replaced by frequent monitoring and engagement calls (DMA calls) to asses risk. CQC will inform providers on the outcome of the call and if a service is identified as ‘high risk’, further engagement calls are to be expected alongside on-site inspections.

WHAT CAN PROVIDERS DO TO PREPARE?

Inspections can be a stressful time for care staff, so keeping your team informed and sharing relevant information will enable them to understand the changes as they emerge.

Here are 10 things care providers can do to prepare in advance:

• Work with your care team and staff. Share information about the strategy with them as it becomes available. Add it to your team meeting agendas, share the CQC resources with them and make quality and compliance a cultural value in your care facility.
• Join CQC’s Citizen Lab. This gives you the opportunity to have early access to what CQC is thinking, as well as share your opinion on the upcoming changes.
• Keep your CQC presentation/Personal Information Record up to date. This will save you time in the long run as it will be requested.
• Look at the Direct Monitoring Activity (DMA) questions for care providers. Start to gather evidence and write your answers before the call.
• Reach out to other services. Are you part of leadership forums and healthcare groups in your area? Networking and sharing information and best practices helps to drive innovation and improvement across services.
• Make sure your audits are up to date and clearly reflect any changes made/actions taken in response to audit findings.
• Survey people who use your service, including friends, family and visiting professionals. Involve these people as much as possible in your service’s development and consider asking them to join interview panels – how do you utilise this feedback?
• Treat external stakeholders and the local authority in the same way as you do the CQC – they will be asked for feedback.
• Ensure your evidence is well organised. Think about the new evidence categories and how you will present this to CQC.
• Consider implementing a compliance software system. Electronic systems and processes can save a significant amount of time.

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