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Care Quality Commission confirms new approach to inspecting and rating care services

25 September 2014
  • Media

The Care Quality Commission (CQC) today confirms how it will regulate, inspect and rate hospitals, community health services and mental health services in England.

Following a consultation earlier this year, it has published a range of documents that will help providers of care services to understand how they will be assessed and rated from 1 October 2014.

The new style of inspection has been developed and tested since the first inspections under the new approach in September 2013 using larger and more specialist teams of inspectors, expert and experts by experience – members of the public with experience of hospital care.

The documents for the acute, mental health and community health sectors, are published alongside our response to the consultation, the hospitals regulatory impact assessment (which reviews our new model) and equality assessment and our human rights approach.

Professor Sir Mike Richards, CQC's Chief Inspector of Hospitals said:

"The publishing of the provider handbooks marks an important milestone for CQC.

"During the past year we have been testing our new style inspections in hospitals, mental health and community health services. We would like to thank everyone who took part in our consultation.

"We have listened to feedback and refined our approach to ensure that we’re consistent and our judgements are fair regardless of whether we're inspecting a large teaching hospital or a small community provider.

"The handbooks outline how we will be carrying out our inspections and rating providers based on whether services are outstanding, good, requires improvement or inadequate.

"We continue to learn and update our methods so that we continue to make sure that health and social care services provide people with safe, effective, compassionate, high quality care that encourage services to improve."

CQC is publishing a suite of documents:

  • NHS acute provider handbook and appendices
  • Community health services handbook and appendices
  • Specialist mental health services handbook and appendices
  • Hospitals handbook consultation response document
  • Hospitals regulatory impact assessment
  • Hospitals equality impact assessment
  • Human rights approach document

During the consultation we asked a number of questions. These were broadly broken down into seeking views on: how we will seek out and listen to the experiences of the public, including patients and their relatives, friends or carers; whether the core services were the right ones to inspect; whether our KLOES (key lines of inquiry) are robust; and how we would we make sure that our ratings are consistent.

In response, we:

  • will use multiple sources of evidence, where they exist, to support our findings and make a judgement about the quality and safety of care provided
  • have reflected on how we define some of the core services so that they more accurately reflect the scope of the service
  • have revised our KLOEs to ensure we had the right level of focus on particular issues, and rephrased the prompts as questions for our inspection teams to consider
  • have reviewed the principles that we use to aggregate individual ratings up into overall ratings. 
Last updated:
30 May 2017

Notes to editors

From 9 April to 4 June 2014, we consulted on our plans for regulating, inspecting and rating NHS acute hospitals, community health services and specialist mental health services. The detailed proposals set out in handbooks for providers of these services build on the principles described in our April 2013 consultation, A New Start.

We received almost 200 responses to the consultation and held nine events across the country with providers, charities and other stakeholders.

All providers of NHS acute hospitals, NHS and independent residential and community based mental health services, and NHS and independent community health services will be inspected and regulated under the new regulatory model from 1 October 2014. CQC has issued signposting documents and will consult shortly on the detail of its approach to rating independent acute hospitals, and NHS and independent ambulance services.

Inspectors will base quality of care judgements on whether or not a service is safe, effective, caring, responsive and well-led.  We will continue to use a mixture of unannounced and announced inspections, and will make use of comprehensive, focused and themed inspections based on the service to be inspected.

All our inspectors will be expert inspectors.  The size of inspection teams will depend on the size and complexity of the service to be inspected, but we expect to make full use of Experts by Experience and other experts/professionals as required.

Our intention therefore is not to change the core elements of our assessment framework – key lines of enquiry, characteristics of good care and other rating levels, and ratings principles – until all services in a sector have been comprehensively inspected and rated at least once.

About the Care Quality Commission

The Care Quality Commission (CQC) is the independent regulator of health and social care in England.

We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve.

We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find to help people choose care.