The new framework will be rolled out starting in November 2023 in the South network and gradually extended to other geographical networks (including London and the rest of England) by March 2024. The CQC will notify each provider when it’s their time to transition to the new portal, so ensure that your organisation’s contact details are up to date. The existing regulatory approach will continue in areas where the single assessment framework has not yet been implemented.

The new provider portal will be introduced and progressively implemented starting in August 2023, with a full rollout expected by March 2024. In August, 230 providers will receive invitations to join the portal, with additional invitations sent out in September.

All the CQC Evidence Categories are equally weighted and this was an important element when these were being devised. The CQC will be exploring whether any other evidence supports the evidence to triangulate the process and all these will go through their quality assurance programme. There will be certain quality statements in some sectors where it might be that how the evidence is scored to give the quality statement score, may be counter intuitive such as data vs what people’s experiences are like and in these situations a moderation team will review the data and evidence and be clear with the reason for having taken that moderation step and adjusting the score.

This would be the homecare guidance. The level that the CQC rate and report services is changing, for example a provider who provides domiciliary care and a care home in the same location at the moment is inspection and given one rating which the CQC realised doesn’t do a service any justice and going forwards homecare and care homes are going to be separately rateable entities in the new approach.

Ratings such as Outstanding, Good, Requires Improvement, and Inadequate, as well as the five key questions (Safe, Effective, Caring, Responsive, and Well-led), will still be utilised. However, the key lines of enquiry (KLOEs), prompts, and ratings characteristics will be substituted with quality statements that focus on specific topic areas under each key question.

The CQC haven’t pulled this together although are welcoming feedback. It is hoped the new approach it prevents some of the duplication that the KLOEs bought with them and that the quality statements splits out easily the difference of each key question. There are new ones such as workforce wellbeing, environment and sustainability.

There is currently an option to download one page or a whole set as a PDF on the CQC website. It is important to remember guidance is updated, so you should check the CQC website for the latest and up to date guidance.

The CQC emphasises the importance of the PIR as a key element of their information gathering process. The new portal streamlines the data collection process from various sources and stakeholders, including care providers, NHS England, and Local Authorities. The goal is to eliminate the need for the lengthier PIR form in the future. Providers will also have access to this information to offer a more real-time view of their performance, aiding in determining the inspection outcome.

The CQC’s new assessment framework will be applicable to providers, local authorities, and integrated care systems.

Each aspect of the new assessment methodology may lead to changes in your rating. The CQC aims to update the information they hold about a service, including all required quality statements and evidence categories, within a two-year timeframe.

While inspections will remain a vital part of CQC assessments, the new regulatory model indicates that the CQC will conduct an ongoing assessment of quality and risk. This means that inspections will not be the sole method of assessing your service. The CQC will collect evidence from six categories, including people’s experiences with health and care services, feedback from staff and leaders, input from partners, observations, processes, and outcomes, to make informed decisions about your service.

The CQC wont routinely look at that evidence at the moment, but they have said they are learning from their new approach and if they find in practice a particular evidence category is routinely needed during inspections, they will change that in the future. They will ensure they communicate changes to the assessment framework as they roll this out so providers have a chance to be prepared.

Where there is consistent and national data sets such as mortality rates, admission to hosptial, vaccination data, this is what we are feeding into the outcomes. In social care, where national data sets aren’t currently in place the CQC will prioritise people’s feedback with care, satisfaction rates etc. If providers feel like they have other forms of outcomes, that is welcomed.

The CQC have given thought to their assessments that they are not following the risk and responding to information of concern, but that they are able to proactively assess all providers on a regular basis to ensure they are capturing where services are improving too, and not just concerns with quality. They will be prioritising some of the quality statements (as a minimum scope for a routine assessment) over a period of one or two years and this will be tailored to different services. Inspectors and assessors will be able to widen out the scope of an assessment. The CQC will publish providers know what those priority statements are once they have confirmed them.

The evidence categories have been released and in the coming weeks, the detail will be worked out for each for the quality statements for each service type based on national standards, best practice and guidance (sector and non-sector related)

The ‘I Statements’ are mapped to the quality statements to help build out the standards expected by the regulator. The CQC have said there is more work to do as they embed in the new model to understand people’s experiences and going forward they will have a strong role in helping both the CQC and the provider understand what people expect. The CQC have said they are set at North and the quality statements are the compass and there will be an expectation of how providers meet these. The CQC are looking at ‘I Statements’ for Well-Led.

The CQC have stated that the core guidance should help people to understand but open to produce supporting resources (booklets, videos) and welcome feedback on the types of resources providers find useful.

The CQC have some detail published on their website which sets out the four point scale they are going to use and the high level description of each score. It is very much about what the evidence tells the inspector about the services performance. The CQC are open to suggestions about if guidance is needed and would be helpful to providers. The framework is benchmarked at ‘Good’, so not meeting these would be ‘requires improvement’ or ‘inadequate’ and for ‘outstanding’, providers need to be creative and innovative.

The CQC have stated that they will not be prescriptive and are not changing the amount of evidence that is needed but making it clearer and more transparent with their new model about what is needed. A checklist would not drive innovation and person-centred care but become a tick box exercise to just meet an inspection.

The CQC realise that under the new framework, this is only one way of them collecting evidence and are moving away from the rating being about a single point in time. It is no longer about coming on site and expecting to see lots of documents but gathering data from various sources. It may be that they collect data remotely, will request documents, undertake interviews, may talk to people who use the service or your teams, they may come on site and observe care but they will use evidence from third parties too.

The CQC are aware of vitaceous whistleblowing and reviews and in the new model they will also be collating other evidence to back these so they triangulate the review process.