I wrote a number of CQC-themed blogs during the pandemic; the first focused on the ever-changing CQC environment followed by continuing to sail on the sea of CQC change. Coincidence? Perhaps not, as at the time of writing this blog, the CQC remains in a state of change.

The new monitoring approach, piloted in the East of England in June, and then rolled out across England in July, sees the CQC conducting reviews of service providers virtually. Using the information they gather, the CQC will determine whether it needs to re-assess the rating or quality of service that is being provided.

Of course, this is beneficial to all involved as the CQC doesn’t invade your practice and you don’t have to spend lots of time chatting to members of the inspection team – result! Or is it? What happens if the CQC decides they do need to reassess, and you become the target for inspection activity?

So, the CQC is going to come and take a closer look at your practice. When they open the cupboard under the stairs, what do they find? What did you miss? It happens folks, as there’s always an area overlooked unintentionally, but the consequences could be rather unfortunate.

So, to make sure everything is ‘all shipshape and Bristol fashion’, you need to inspect your practice from top to bottom, leaving no cupboard, drawer or storage space unopened. “Time is everything; five minutes make the difference between victory and defeat” (Vice-Admiral Horatio Nelson).

Remember one of my previous blogs and the Churchillian façade (“We shall fight CQC in the waiting room” etc.)? Use the time before your inspection wisely and make sure your practice is prepared. A cursory glance won’t suffice; the devil is in the detail. It will take time to check all areas and it’s something you will have to do.

How do you do it? Keep it simple! It’s time to get out your smartphone and take images of your findings to share with the team. Why? Because you can point out the issue(s) and defects, and then explain what needs to be corrected – it’s as simple as that. Plus, if you’ve got a record of all images, you can respond to any CQC questions such as, “What are you doing about the cracked window in the staffroom?” with, “Well, that’s on our defect log and Mr Chippendale is coming in next week to repair it.” You could even upload an image to your defect log.

Another approach could be to record your walk round and verbally explain the issues and what must be done to rectify them. Now I’m not suggesting you become the next Kirstie Allsopp or Phil Spencer, but please don’t become Mr or Mrs Monotone; you need to engage your team, not send them to sleep! On the subject of engaging the team, it’s good for morale to highlight areas of good practice – give the team credit where credit is due.

Where do you start your own inspection? The car park (if you’ve got one). You can check for potholes, litter, poor signage and so on. Next, stand back from the entrance and see how it looks. Clean and tidy, with an array of information for patients? No? You shock me; why not?! What about access? Is your practice accessible to all patients?

You’re through the door; it’s easy for you – you’ve just opened it and walked in. Is it that easy for all your patients? If it’s automated, is there clear signage that suggests so? OK, into the waiting area we step. Looks clean, smells clean (I hope). Is it welcoming, informative and relaxing? Does music or television cushion the noise? Do your patients face reception or away from it? Are they far enough away from the desk not to overhear conversations?

If during your ‘30 minutes to shine’, one of your examples of outstanding practice was your ‘employee of the month’ scheme and how that’s shared with patients, is there a dedicated noticeboard in the waiting area for this? Remember, you can’t bluff the CQC; they’ll want to see the evidence!

You may have said to the CQC that ‘we listen and act upon patients’ suggestions and/or comments’. Proving it is easy: introduce a ‘You said, we did’ noticeboard in the waiting area, where comments cards are displayed with the patients’ suggestions and your responses.

When patients are called to see the clinician, how does this happen? Is there clear signage to follow to get to the consulting room? Is your signage dementia-friendly? What happens after the consultation? Is the way out clearly marked? I’m thinking about COVID-secure environments – one way in and one way out.

Dare you let them into the staffroom? What about the fridge? Let’s hope there aren’t vaccines in the staffroom fridge and sandwiches in the vaccine fridge (I’ve seen it, honestly)!

Where’s left? Ah, the COSHH locker or cupboard. Has care really been taken of those hazardous substances? Are COSHH risk assessments available, in date and do they include material safety data sheets (MSDSs)? Of course they do! You’re prepared (right?). Who can access this cupboard? I’m hoping access is restricted.

We’re almost there. A quick check outside and in the clinical waste storage area. That too has restricted access. Bins secured and so on? Only authorised people can access this area. A quick knowledge check for staff: what is the process for disposing of clinical waste? I’m thinking about the requirement to wear PPE when doing so!

Right, back to your office and it’s now time to either create a photo album with comments or to edit your video and share it with the team. Hang on, did you see the practice vision statement? Was that up to date? What about the emergency exit signs? What about lighting? What about this and what about that?

Yes, there’s so much to think about; that’s why we updated the CQC – A guide to success [PLUS], and now includes a pre-inspection checklist and an inspection evidence table for you to use as you walk around your practice, ahead of your CQC inspection. Templates for success perhaps? I am sure the guide will be useful, and I hope you agree!

That said, what happens when you want to know more, maybe you’re new to primary care and need an overview of the CQC, it could be that you need to understand the registration process, given all this talk of change you may need clarification on how the CQC monitor and inspect service providers? Or do you just want the answers to some frequently asked questions?

If the answer is yes to any or all of the above, you’re in luck! Coming soon is the CQC Handbook [PLUS], which is packed full of useful information and is certainly something that will help your practice shine.

Phil Coates.