As a PM of a practice which has recently been awarded an ‘outstanding ‘rating by CQC I have experienced a range of emotions. Before the inspection I felt anxious because, unfortunately, rightly or wrongly, CQC ratings will be used to judge the practice in the future.
During the two week build up to the inspection, following notification of the inspectors pending arrival, I felt fear and trepidation. I personally think that a little bit of fear is not entirely a bad thing. It is usually just there because you care and are taking the inspection seriously. It is this ‘fear’ that is the driving force to ensure everything is in place for the impending inspection. I truly believe that long-term planning and communication with everybody involved is key to success.
Following the inspection, I experienced a huge sense of relief as it was over (and they wouldn’t be re-visiting for a while) and now having received the result I feel immensely proud of the practice team. Despite the pressure prior to the visit, the actual inspection day went well and the planning had paid off.
Top tips:
When you receive notification of the inspection, give them exactly what they ask for. If they want an Excel spreadsheet with staff training records on or your complaints log and action plan then start typing into Excel, even if you don’t already have it available. The extra effort to put it in a format that works for them is worth it.
Check out the CQC Mythbusters and make sure the practice is compliant. If there are areas which deviate from CQC guidance, then risk assess your system to demonstrate to CQC that you have given due consideration to processes and put actions in place to make it safe and effective.
Treat the inspectors with respect and make them feel welcome. Although they are not there to be your friend, it does no harm to demonstrate that you are a friendly team and are viewing the inspection positively.
Sell yourself! Prepare a comprehensive presentation which ‘sells’ the practice. Highlight all the things that you do well and mention the things that you do that are ‘above and beyond’ normal general practice. This is the inspector’s first impression of the practice and sets the scene for the rest of the day.
The whole practice team were involved in all the CQC preparation for up to two years before the visit. On the day they were confident in answering demanding questions, at the same time as carrying out their daily duties, with the primary aim of looking after the patients. Keeping the team informed and involved is essential to building up their support and getting them to ‘buy in’ to the whole process and make sure that they know where to find policies and which policies actually exist!
Policies need to be easily available on the day, checked and reviewed and up-to-date. Equipment checks and maintenance records, infection control audits, risk assessments, COSHH records, HR and training records completed and employment checks and annual appraisals in place. The main thing is to be able to prove everything. Sadly, it’s no use having good systems in place unless there is paperwork to back it up.
Make sure the practice is clean. If necessary ask the cleaner to put extra shifts in. Clean places that don’t get cleaned very often. Ensure there is a cleaning schedule and policy which is checked and signed off each week. I asked each staff member to look at their own work area to ensure it was spick and span. I found it very therapeutic cleaning out my office cupboards, shredding, filing and reorganising. This was a worthwhile job, as even well after the inspection, the place still looks tidy.
Apart from having all the paperwork in place, the main thing is what the patients actually think. Listen to patients, respond to concerns, put plans in place for continuous improvement and work with the PPG. Patients can be your greatest advocate and will readily tell CQC what they think of the service. Meeting the needs of patients doesn’t happen overnight. Good, long-term, ongoing care and consideration is evident in patient surveys, family and friends tests and NHS Choices comments.
Talk to others and build upon their experiences. Sadly mybedtimee reading consisted of other organisations inspection reports and advice from other providers! The more that you know, the better prepared you are for the inspection!
Don’t get caught out! If inspectors ask questions which are designed for you to let your guard down, think before you respond!
When it’s over, ‘celebrate’ and thank everyone involved – hopefully, the rating should be something to be proud of and recognition of the hard work that goes into running General Practice.
Julie Coles
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June 16, 2017 at 8:09 am
CQC ratings are highly subjective. I have been through 5 inspections at different surgeries. CQC doesn’t have a benchmark, as yet. Outstanding means nothing, really. It depends on the inspector’s mood! In one of my surgeries, they got requires improvements in 3, we chanllenged it and it was accepted and those 3 requires improvements were changed to Good, just like that. Incredible!
June 16, 2017 at 11:12 am
We did all the things you mention in your email and got Good. We challenged it on factual accuracy and the inspector accepted all our challenges and amended the report, but left all the ratings as they were. The problem was the inspector was just not very good – he only asked questions that would have uncovered “requires improvement” or “inadequate”. He didn’t ask a single question about any of the things we’d told him about in our presentation that we thought were outstanding. He couldn’t have awarded us outstanding because he gathered no evidence. He conducted the inspection only to distinguish between good and lower. The only practice in our area to get outstanding was one that was inspected by a different inspector when our usual one was off sick. We were going to complain but we’d wasted enough energy on CQC already. The thought of another inspection was more than we could cope with! Needless to say, while I still think CQC inspections are a good thing in principle and have improved standards, CQC needs to do a lot of work to get its house in order. I would rate CQC as “needs improvement”.
June 20, 2017 at 1:29 pm
Well done Julie for achieving an outstanding inspection 🙂
Congratulations to you and your team and thank you for sharing your tips
June 21, 2017 at 8:41 am
We too did all the things mentioned and, in addition, had successful projects which we could use to demonstrate our patient care. We were told by one of the inspectors during the meeting, that they were not awarding ‘outstanding’ anymore.