Preparing for a CQC Inspection: PART TWO

Home Care Policies and Procedures

CQC expects to see a variety of current policies and procedures in either paper or electronic format. Each document should have a note indicating the date of its review, amendment, and approval, demonstrating that your processes are continuously monitored. It is crucial to ensure that the review date has not expired during CQC's inspection.

In addition to presenting written documents, you must also provide evidence that they are being implemented. It is essential that your staff comprehend the policies and procedures' and can apply them during the delivering of care. 

The following is a list of suggested policies and procedures; however, it is not exhaustive. CQC may request to review any or all of them. Your titles may differ from those in the list, and you may have policies and procedures specific to your service.

  • Appraisal
  • Business Continuity and Disaster Recovery
  • Clinical Governance
  • Complaints
  • Confidentiality and Data Protection
  • Consent to care
  • Cyber security
  • Data Protection and GDPR
  • Emergency procedures, including health emergencies of clients
  • End of Life care
  • Engaging with the local community
  • Equality, Diversity and Human Rights
  • Health and Safety, including personal safety of staff, out of hours and lone working
  • Infection Control
  • Information Sharing
  • Managing Risk
  • Managing clients’ money
  • Manual handling
  • Medicines management
  • Mental Capacity Act
  • NICE Guidelines
  • No Reply from client
  • Preparing food and drink
  • Quality Assurance procedures
  • Record keeping
  • Recruitment
  • Safeguarding
  • Significant events
  • Smoking
  • Staff Welfare, including mental health and bereavement support
  • Statement of Purpose
  • Supporting children and young people
  • Training staff and volunteers
  • Use of personal mobile phones by careworkers
  • Weather Alerts (hot and cold weather)
  • Whistleblowing
  • Working with local authority and health services

Home Care Records

Maintaining accurate records is important to demonstrate how your service is being delivered. CQC inspectors rely on records to verify your actions and ensure that the service is safe and effective. If records are incomplete or not up-to-date, it may be considered a failure on your part and affect your rating for Effective and/or Well-Led categories. Your records should include the name of the person, date, who made the record, and any comments or approvals.

CQC looks for accuracy, completeness, legibility, and safe storage of records. However, official records alone may not tell the full story of a person's life. Including scrapbooks, photographs, certificates, and birthday cards can enhance the quality and personalisation of care people receive.

Below is a list of official records that CQC may ask to see, including care plans, medication administration, training, and supervision records. Additionally, keeping a record of clients' activities, hobbies, outings, and achievements can provide a fuller picture of their lives and help fill in gaps in their memory, especially for people with dementia.

List of Records:

  • Appraisal
  • Accidents at work (RIDDOR)
  • Care Plans
  • Compliments and Complaints
  • Contact details of organisations that commission care from you. (Record how many clients from each commissioner)
  • COSHH
  • Duty rotas
  • If you are a branch, the number of visits from senior management/internal quality auditors from the head or regional office
  • Insurance
  • Medication administration and medication errors
  • Mental Capacity Act — number of clients affected, including and subject to Deprivation of Liberty
  • Notifications to CQC
  • Number of people supported by your service. Separate out figures for those clients who receive a domestic service from those receiving personal care
  • Number of people with a valid advance decision to refuse treatment (ADRT)
  • Number of people with a Court Appointed Deputy
  • Number of people with a valid and active Lasting Power of Attorney
  • Pay Roll
  • How many people pay for all of their care
  • How many people pay for some of their care
  • How many people are funded wholly by the local authority.
  • How many people are funded wholly by the NHS
  • Recruitment
  • Supervision
  • Survey results
  • Training, including induction

Home Care Risk Management

As part of the inspection process CQC may request to see risk management documents to provide evidence that your service is "Safe". Here are some examples of risk management documents you should have in place:

Risk management policies suggestions: 

  • Staff absence procedures
  • Admission of clients to hospital or care home
  • Business Continuity planning
  • Equipment safety policies for staff
  • Fire safety policies
  • Flood management policies
  • Health and safety policies for staff and premises
  • Infection Control policies
  • Procedures for major road traffic accidents
  • Medication management policies
  • Policies for complying with the Mental Capacity Act
  • Procedures for responding to Patient Safety Alerts via the Central Alerting System
  • Policies for managing recalls and rapid response reports issued by the Medicines and Healthcare Products Regulatory Agency (MHRA)
  • Risk assessments for clients
  • Procedures for conducting risk assessment reviews and outcomes
  • Safe storage and protection of essential documents
  • Client safety policies, including accompanying them outside their homes
  • Policies and procedures for severe weather conditions
  • Procedures for sharing care with another provider or the NHS

Digital Records

Digital records are becoming more prevalent in the social care sector, with both providers and regulators using them more frequently. One such example of this is CQC's Provider Portal. 

To assist providers in creating good quality digital records, CQC has created a guide that outlines what constitutes good digital records and how providers can achieve this standard. The guide also outlines the commitments that CQC has made to support providers in their use of digital records, as well as the criteria that they will look for during inspections.


PART THREE

Find out more about staffing and preparing for a CQC Inspection in part three. If you have any questions about CQC inspections join us in Care Begins at Home, a group created to provide free knowledge and information to care providers and family carers.