Care Quality Commission
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Statement from our Chief Inspectors on developing our monitoring approach

As we move forward from the last year, we’re making some changes to how we regulate.

In March 2020, we suspended our routine inspection programme in response to COVID-19 and developed our ability to monitor services using a mix of on-site and off-site methods. We’re further evolving our monitoring approach to ensure the public have assurance about the safety and quality of the care they receive, while still focusing on risk. We'll start piloting changes in how we monitor services from this week, before rolling these out to more services from July.

Over the last year, driven by a need to adapt to the pandemic, we made real progress in our ability to monitor services. The introduction of the emergency support framework gave us a structured way to have conversations with providers to help monitor risk and support them. We built on this with our transitional monitoring approach. The developments we’re announcing today carry on the progress in how we monitor services in three key areas by:

  • improving our ability to monitor risk to help us be more targeted in our regulatory activity
  • bringing information together in one place for inspection teams, presented in a way that supports inspectors with their decision making
  • testing elements of how we want to work in the future, including how we provide a more up-to-date view of risk for people who use services.

Developing our monitoring approach

We want to build on our learning over the last year to make changes in our ability to monitor services. We’ll use the pilot to help improve the process further before rolling out to all services.

We’ll carry out regular reviews that will help support our ability to monitor risk. Where the information we have does not find evidence that tells us we need to re-assess the rating or quality at a service, we will publish a short statement on the profile page on our website for these services. This will inform the public and people who use services, that this review has taken place and that we had no concerns based on the information we held at that time. We will also communicate this with the provider by email prior to the public statement being published.

We currently plan to carry out this review each month. This will enable our teams to target their resources where they are most needed.

Responding to risk

In cases where the information review indicates that we may need to re-assess a rating or the quality of care, our inspectors may want to gather more evidence. For services where we believe people may be at an increased risk of poor quality care, we may undertake an immediate on-site inspection and this may happen at any time. In these cases, we may update the rating for a service.

Inspectors judgement will still be at the heart of our approach to inspection, the improved access to information will allow inspection teams to act quickly using their judgement, supported by our quality assurance mechanisms, where other sources of information indicate greater levels of risk elsewhere.

To ensure we’re making consistent and robust decisions we’ll also carry out some sampling of services by carrying out an inspection. In this way, we’ll be able to check that our monitoring activity is consistent with our inspectors’ findings when they gather evidence either by telephone or by making an on-site visit.

We recognise the dedication and professionalism of everyone working in health and social care. Over the last year, COVID-19 has been, and continues to be, the biggest challenge to face the health and care system in living memory – and the response from all those working in the health and care system has been extraordinary. Thank you.

  • Kate Terroni, Chief Inspector of Adult Social Care
  • Professor Ted Baker, Chief Inspector of Hospitals
  • Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care
  • Kevin Cleary, Deputy Chief Inspector and Lead for Mental Health Services

Further information

Rollout for other service types will begin on:

  • GP Central Region 15 June
  • Full roll out (excluding primary care dental services and NHS trusts currently) 13 July
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