Adult social care providers have no doubt been watching closely over the last year as the Care Quality Commission (CQC) has employed a new strategy for regulation, inspection and monitoring of adult care services.

In the June 2013 publication, A new start: Consultation on changes to the way CQC regulates, inspects and monitors care, the CQC explained that it was committed to ensuring people within the system receive safe, effective, high-quality care, and planned to implement numerous changes to encourage care services to improve. To ensure adult social care providers are informed and prepared, we’ve outlined one of the biggest changes and what it means for providers; the introduction of Key Lines of Enquiry (KLOE).

In consultation with service users, family carers, key providers and their staff, the CQC has introduced a number of new initiatives, including the role of Chief Inspector, expert inspection teams, and organisational care ratings. The CQC has also resolved to highlight good practice and seek out the views and experiences of people who use social care services. The process in which adult care services are inspected has also changed, with the introduction of KLOE. This process is centred around five key questions, which inspectors use to help establish whether a service is providing the high standard of care expected of them.

Is your service:

Safe? Service users, staff and visitors are protected from abuse and avoidable harm.

Effective? People’s care, treatment and support achieves good outcomes, promotes a good quality of life and is evidence-based where possible.

Caring? Staff involve and treat people with compassion, kindness, dignity and respect.

Responsive? Services are organised so that they meet people’s needs.

Well-led? Leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.

Inspectors then use a set of standard KLOEs that are directly linked to the five key questions listed above. These include a set of mandatory KLOEs which address the key priorities of every service, such as, “How are people protected from bullying, harassment, avoidable harm, abuse and breaches of their human rights?”. Inspectors also select a minimum of four additional KLOEs which will support their effort to determine quality and identify risks. An example of an additional question an inspector may choose to ask is, “How are people supported at the end of their life to have a private, comfortable, dignified and pain free death?”. A list of all current KLOEs are available to providers and are listed in the consultation handbook, Appendices to provider handbook: Community adult social care services.

There has been a level of confusion from some care providers around how the inspectors will be measuring the answers to KLOEs. Within their report, A fresh start for the regulation and inspection of adult social care: Working together to change how we inspect and regulate adult social care services, the CQC outlined that they will, “…use these questions when making decisions about registering providers; as a framework for our use of data, evidence and information in our surveillance of services; and in our guidance, inspections, ratings and published inspection reports”.

Source: Care Quality Commission Provider Handbook: Residential adult social care services

Before a site visit, inspectors will select which KLOEs they intend to use, based on an ‘information pack’ the CQC provides to its inspectors. This pack is collated from information provided from people who use the service, stakeholders and from the provider itself. Once at a site visit, inspectors will then indicate which KLOEs they will be inspecting, and will gather evidence by talking to service users, visitors and staff, by observing care, as well as reviewing records and tracking individual care pathways. Providing documented evidence to inspectors can be challenging for many providers who operate on paper based systems, particularly when they are unable to locate an older report. The use of management software for both home care and care home providers can assist by providing supporting evidence for an inspection in a timely and simple manner.

By ensuring documentation is up to date and accurate, and that staff are well informed about the process of inspections, adult social care organisations can prepare themselves for CQC inspections and KLOEs to the best of their ability. More information about the future of CQC inspections and KLOE will become available over the coming months as the assessments progress.

iCareHealth aims to keep providers informed about these developments with a series of blog posts, so make sure to visit our blog regularly for more helpful explanations and tips.

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How To Embed KLOE Into Your Care Organisation

  • KLOE need-to-knows,
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