CQC Inspections - Lessons Learnt and Future Focus

Last week, we had the pleasure of hosting a discussion around the complex dynamics between CQC inspections and adult social care. The session welcomed experienced leaders in the field who generously shared their valuable insights.
Nik Shah, Associate Director in interim management at Tile Hill, opened the discussion alongside colleagues Helen Alwell and Chris Barrow, Senior Consultants in the executive search practice. All three specialise in children’s and adult social care recruitment.
The three speakers were Georgia Chimbani, Suffolk County Council's Director of Adult and Community Service, Graeme Betts, Birmingham City Council's Strategic Director for Adult Social Care and Glen Garrod, Executive Director of Adult Care and Community Wellbeing at Lincolnshire County Council. The speakers provided an analytical perspective on their roles as pilots in the Care Quality Commission inspection process, offering a detailed critique of the procedure. 
During the session, our speakers discussed their findings following their pilot inspections, including how to prepare, what to expect, and how to overcome barriers. Below are some of their key insights:

Inspection expectations
Georgia discussed the prolonged timeline of the inspection process, which demands extensive evidence collection and in-depth self-assessments, leading to increased workloads. However, she acknowledged the self-assessment stage is a useful tool for local authorities to communicate their achievements and challenges effectively.
Additionally, the significance of preparing the team for the inspection was discussed. It was mentioned that although the CQC inspections focus on adult social care, it is the responsibility of the entire council, and in their experience between 90 to 100 staff members should be expected to participate in the assessment. The importance of readiness and coordination among the council's team is vital in facilitating a smooth inspection process.

Overall, the speakers were in agreement that the CQC process has undergone significant evolution, reflecting on lessons learnt from both its inception and the feedback received along the way.
The panel also looked at how CQC conducts a preliminary survey before their onsite visit. They aim to identify key themes and trends for discussion and will inform the local authority of the scheduled site visit dates. Before the onsite evaluations, CQC will meet with the senior management team to understand the structure of the local authority. Therefore, it is important to ensure that your team is adequately prepared in advance.

The importance of reflection 
In order to be prepared, services should engage in a reflective process, examining and exploring what your challenges are. Glenn and Graeme both highlighted the need to recognise and evaluate your areas for improvement and consider the steps needed to address them. 

Challenges surrounding the process. 
Throughout the process, each speaker noted the challenges of compiling information in a limited timeframe, describing it as a demanding task. This is exacerbated by national pressures such as COVID-19 and the cost-of-living crisis. Graeme highlighted the importance of considering the implications for authorities and their role within the broader healthcare system.

How to prepare and train your teams
Helping to build resilience in your team during the assessment process is crucial. It is recommended that teams engage in confidence-building exercises, preferably in small groups, dedicating 20 to 30 minutes to revisiting core principles such as corporate priorities, adult social care strategies, and CQC themes. 

Breaking down the self-assessment process and encouraging the team to highlight the moments where they successfully managed risks. By engaging in this process you will enhance their confidence, particularly when they are required to articulate and present themselves to an inspector.
Senior leaders should participate in training sessions to offer support to the broader team whilst also cultivating an atmosphere of dependability and trust.

Top risk areas with CQC inspections
It’s important to note that risks vary across different authorities, but Georgia discussed the specific challenges her team faced during their assessment.
Due to CQC's practice of gathering information throughout several teams, senior leaders should aim to communicate a singular message to all staff. This allows team members to relay messages in their own words whilst maintaining the core message. It is vital that the data you provide through case studies is consistent. 

Implications for recruitment
In our experience, we are aware how inspections can impact on recruitment, both positively and negatively, as we have seen this frequently in Children's Services. We know the toll it can have on leaders and the benefit of support networks in preparing for, going through, and responding to inspection is key, whilst also ensuring service delivery is maintained. During the session it was highlighted that additional staff were recruited to aid both the preparation and enable the smooth running of the service. 

Stay in touch
We would welcome a conversation with you to discuss some of these points in more detail. We also plan to host other sessions during the year and we invite you to stay engaged with us as we explore further topics and strategies from industry experts sharing their insights.

To find out more please contact nik.shah@tile-hill.co.uk, helen.alwell@tile-hill.co.uk,  or chris.barrow@tile-hill.co.uk 

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