Improvement Inspections – Letter to Directors of Adult Social Services

The CQC has committed to helping create more capacity for discharge to adult social care by increasing the number of providers with a good or outstanding rating. The CQC anticipates it has capacity to carry out in the region of 300 of these ‘Improvement Inspections’ by the end of March 2023.

They can do this by inspecting providers (care homes and domiciliary care agencies) with a requires improvement rating where their evidence shows there has been improvement.

They can also inspect services which are registered and active but not rated, if the lack of regulatory history is a barrier to commissioning. The full criteria are outlined in the attached letter.

They’ve asked Directors of Adult Social Services to help identify care providers where extra capacity might be created.

I have added some questions and answers (in red) which we posed to the CQC in regard to this letter below which hopefully addresses some immediate questions, but if you have anything further to add, please do let me know.

• Provider has confirmed they are prepared to accept funded placements – by this the CQC mean local authority-funded placements.
• Will inspections be announced or unannounced? Unannounced but the CQC is expecting LA will have spoken with location registered manager to confirm they have staffing and will take LA funded placements.
• What methodology will be used? Focused inspection if the service is already rated. Comprehensive if it is the location’s first ratings inspection.
• Concern with over reliance of local authority data as relationship with a provider will be variable. The CQC will very much be looking at the information they hold alongside what LAs tell them. The CQC has been clear with ADASS that the decision to inspect rests with CQC. If the CQC don’t think a nominated location is suitable for an improvement inspection, they’ll let the LA know.
• If a provider is RI and they feel strongly they have improved can they speak to local inspector to nominate themselves for this? The CQC believe their intelligence and DMA outcomes will allow them to identify locations which have improved. The CQC also need to be confident that a LA will commission placements at the location if the rating improved. The CQC won’t know this if the provider self nominates.
• Is this just older people or would we also be looking at community eg LD/MH services. Yes, LD/MH locations are eligible. It is up to the LA to decide which locations they want to provide to meet needs in their area.
• On the point about Commissioners looking for good/outstanding – is there a way for conversations to happen earlier eg if you are an RI nominated for inspection, rather than wait for report/inspection – can things get moved earlier. If the provider agrees, the CQC can share the inspection outcome before the report is published. The CQC do need the provider’s permission to do that though.

20230113 CQC to Directors of Adult Social Services final