The Care Quality Commission has just
published guidance on the new way in which
treatment services will be inspected. The
process will be very different from before,
because the inspections are now organised by
the Hospital Directorate.
THE FIRST MAJOR CHANGE
is the introduction of a ‘briefing and planning session’
with an inspector at the outset of the inspection process. This will be an
opportunity for you to explain how your service works, and will enable the
inspector to plan the site visit appropriately.
At this stage you will also be asked for contact information for your stakeholders,
who will be surveyed by CQC. These will include commissioners, local authorities,
referrers from drug and alcohol teams, doctors, social workers and care managers.
THEN AN ‘INTELLIGENT MONITORING’ PHASE WILL START
, during which CQC will
gather data. Some of this will be provided by you, such as:
•
Outcome data, eg on completion or return to treatment, abstinence rates,
safeguarding alerts.
•
Information from service users and the public (usually obtained through
surveys).
•
Information from and about staff, eg turnover, stability, sickness rates and
concerns raised.
ComplianCe
David Finney
guides you through
the new CQC inspections
16 |
drinkanddrugsnews
| September 2015
FURTHERMORE
, you will be asked questions in a ‘provider information return’,
which will include specific questions about:
•
Safety and effectiveness, including serious incidents, DoLS (Deprivation of
Liberty Safeguards) or medication errors.
•
Complaints and how governance is exercised (do you learn from incidents and
mistakes?)
•
Equality and diversity, ie examples of how it is evidenced, or data to show that
specific groups are not discriminated against.
•
How improvements are made in the service.
ANOTHER MAJOR CHANGE IS THAT YOU WILL BE GIVEN A DATE FOR A SITE VISIT
and CQC will seek information about your service in the intervening period.
This will give you an opportunity to audit your service thoroughly before the site
visit takes place.
At the beginning of the visit, there will be an opportunity for you to give a
‘provider presentation’, in which you can:
•
Outline the background to your organisation. I suggest that you include an
explanation of your treatment philosophy.
•
Show that you provide quality care. Demonstrating an understanding of the five
key questions (safe, effective, caring, responsive and well led) will be helpful.
•
Demonstrate what is working well or is outstanding. You could focus the
success rate in terms of completions and the compliments you have received.
•
Highlight any areas of concern or risk. For example, you could mention any
boundary issues such as transition, or any issues you may have with mental
health teams.
THEN, DURING THE VISIT, THE INSPECTION TEAMWILL
observe interactions
between staff and service users, talk with service users, staff and the manager, and
look at some records.
There are actually very few questions in the methodology that are specific to
substance misuse treatment. However, those that are include:
•
Identification of drug and alcohol-related harm, and deteriorating health.
•
An opportunity to explain the restrictions on movement usually imposed as
part of a treatment programme.
•
The involvement of recovery champions.
•
Processes in place for unexplained or unplanned discharges.
•
The planning of services to take account of people with complex needs or
vulnerabilities – such as dual diagnosis, multiple drug use, homelessness,
pregnancy, or criminal justice involvement.
FINALLY, IT HAS NOW BEEN DECIDED THAT CQC WILL NOT BE ABLE TO GIVE
‘RATINGS’ FOR SUBSTANCE MISUSE TREATMENT SERVICES.
This is because they were
not included in the list of services given to the Department of Health when drafting
the regulations, so CQC has no legal power to provide ratings. This decision applies
to everyone in the sector, so no specific group of services will be disadvantaged by it.
The full information about the new inspection process can be accessed at
. I wish you the very best of success in
navigating this new system and will continue to update you through
DDN
as and
when new information becomes available.
David Finney is an independent social care consultant. His workshop is on 6 October
in London, details at
get in gear
