Site visits enable us to talk to people using services, staff and other professionals to find out their experiences.
They allow us to observe care being delivered and to review records to see how people's needs are managed both within and between services.
Gathering evidence during the site visit
To structure the site visit, inspection teams use the key lines of enquiry (KLOEs) and associated prompts in CQC's assessment framework for healthcare services. They also look at any concerns identified beforehand through our monitoring activity. This enables them to focus on specific areas of concern or potential areas of outstanding practice. They collect evidence against the KLOEs using a variety of methods.
People who use services
We will gather the views of your patients, their family and carers, by:
- speaking with them individually or in groups
- using information from complaints and concerns sent through our website
We will also send you:
- posters to publicise the inspection and give people the opportunity to speak to the inspection team
- comment cards for people to fill in
We ask you to display these in a prominent position at reception and in other busy areas.
Sometimes we include Experts by Experience on inspections, particularly in mental health services. Experts by Experience are people who use care services or care for someone who uses health and/or social care services. Their main role is to talk to people who use services and tell us what they say. If we include an Expert by Experience on an inspection, they will talk to people at the premises on the day of the inspection or by telephone. In some services, people find it easier to talk to an Expert by Experience rather than an inspector. Experts by Experience can also talk to carers and staff, and can observe the care being delivered.
Your staff
The inspection team will interview staff at all levels. We will usually interview the following people or their equivalents:
- chair of the medical advisory committee
- director of nursing/matron/clinical services manager
- service leads for each of the services (for example, clinical director, nursing lead, directorate manager, theatre manager/ward manager)
- complaints lead
- senior lead for human resources
Where appropriate, the inspection team will hold focus groups to gather feedback from other members of staff, which may include:
- consultants and other medical staff
- registered nurses and midwives/sisters
- healthcare assistants
- allied health professionals
- administrative and support staff
Focus groups may not always be appropriate because of the small number of staff or disruption to patient care. In these cases, we will gather views by speaking with staff during the inspection. We may also seek the views of staff through an online survey or email.
Gathering information in other ways
We may also gather information by:
- tracking a patient's journey through their care pathway
- observing care
- reviewing records
- reviewing operational policies and supporting documents
Feedback on the visit
At the end of the inspection visit, the lead inspector will meet with your registered manager or nominated individual to provide feedback. This is high-level initial feedback only, illustrated with some examples. We will carry out further analysis of the evidence before we can reach final judgements on all the issues and award ratings.