Our response to CQC – Summary and detailed response
Our response to CQC – Summary
We were extremely disappointed and surprised to find that the recent CQC (Care Quality Commission) audit in Q1 2019 led to our company receiving a rating of “Requires Improvement”, a grading that we strongly dispute. Despite the report containing only positive feedback from clients about the level of care, safety and responsiveness that we provide, their audit grading focused more on the administrative improvements that could be made by consolidating reporting systems and in improving the robustness of our internal audit processes. Despite feeling that some of their recommendations had been based on factual inaccuracies, we nevertheless had addressed all of their recommendations within a week of receiving their report, most importantly by the completion of the installation of a new consolidated reporting system; as such, we now feel confident that our processes more than meet the required regulations. Our level of service to our clients is our priority and this is reflected in the reviews we receive on the homecare.co.uk website and in the CQC report itself, where both Care and Responsiveness were rated as “Good”; as a result of the changes we have made, we would now anticipate receiving a “Good” or “Outstanding” grading for all areas of assessment. For further details, please see our detailed response here (link in place), and if you have any further questions, please feel free to call our office on 01483 536266 at any time.
Our response to CQC – Detailed
We were extremely disappointed to find that the recent CQC (Care Quality Commission) audit in Q1 2019 led to our company to be rated as “Requires Improvement”, a grading we strongly dispute. Although we respect the inspector’s views and comments, we feel it only right to defend ourselves against the findings, some of which are simply factually inaccurate.
For a summary of the actions we have taken, all of which were completed within one week of receipt of the CQC report, please click here (goes back to summary). For more detail, please read below.
The points they raised and the actions we have taken are summarised below:
- Medication Records
CQC commented that our medication records were not being safely recorded.
Our care management system allows us to monitor medication tasks in live time. If a medication is missed or not recorded, the system sends an alert to the office. Unlike historical systems, which were paper based, we are able to immediately electronically update medication in the clients’ care plans.
Not only do we have daily monitoring via this system, but based on CQC’s recommendations, we have now implemented an additional weekly audit review of all medication records and charts. As mentioned in the CQC report, as further back up, we also have paper copies of medication lists within each home.
Finally, and despite it not being normal practice to treat domiciliary care in this way, CQC recommended that we engage a private pharmaceutical company to carry out a full audit of our medication management processes. We appointed a private contractor in Q3 2019 to review our electronic MARs sheets, policies and procedures and records; there were no concerns.
We believe our medication recording and audit processes are industry leading.
- Reporting/Auditing
CQC felt that our recording and auditing process was not always appropriately documented due to having multiple systems.
At the time of the CQC review, we were in the process of transitioning to a newer version of our electronic recording system, Mobizio; we were still using the original system to record certain information and to verify data in the new system. We have now fully transitioned and report everything in one centralised location.
Our use of Mobizio ensures that all our records, including Care Plans, Medication, and Visit details, are electronically accessible by managers, carers and families as and when required. This on-line system allows us to make any changes to a care plan remotely and immediately and gives an extremely robust communication framework for our team. The additional level of information in the new system builds on our approach of person-centred care, as even new carers have the necessary information to immediately build excellent relationships with the people for whom they care.
- End of Life Care Plans
CQC recommended to have personalised end of life care plans.
As you can imagine, this is an extremely sensitive topic for any client or family. At the time of inspection, we did not have any end of life clients. However, since the inspection, we have adapted our plans to include a plan if those clients so wish.
Anyone reading the positive client comments on the Homecare.co.uk website or in the CQC report itself, where both Care and Responsiveness are rated as “good”, can appreciate that our services are well received and that families have peace of mind that their family members are safe and being cared for with the upmost level of dignity and respect. We continue to feel that chasing end of life plans when they are not warranted goes very much against the values on which our business is built and as such will only be incorporating personalised end of life plans when absolutely warranted or when requested to do so by a client.
Having made these changes, we welcome a re-inspection of our services within the next year when we are sure we will once again be rated as “Good” and hopefully “Outstanding”.
For your reassurance, we absolutely want to make sure we meet all regulations and maintain thorough records. However, our primary focus is on the wellbeing and happiness of all our clients and ensuring their personal needs are being met with the highest level of care and attention. If this happens to be in conflict with the desires of CQC, then so be it, the care and safety of our clients will be prioritised above a CQC action, some of which (as is the case in some of the above) can be overly bureaucratic and not care focused.
I hope this curtails any reservations you may have about our service, but if you do have any questions, please do not hesitate to contact us at any time.
