Preparing for a CQC Inspection: PART THREE

Preparing for a CQC Inspection: Staff and Workforce

When it comes to staff and workforce, CQC will want to discuss your recruitment processes, especially when it comes to hiring agency or bank staff in case of unplanned vacancies or staff absences. 

To demonstrate that you have a strong recruitment and selection policy that incorporates equalities requirements and minimises risks to people who use services, keep evidence of your recruitment process, including adverts, shortlisting, and interview notes.

Make sure that you can provide evidence of your workforce induction program and what it covers. For care and senior care workers, this will include the Care Certificate. Additionally, ensure that you can show evidence that you refresh the knowledge and skills of your staff based on reviews of legislation, guidelines, statutory guidance, standards, and recommendations. Skills for Care has published helpful guidance on Core and Mandatory Training requirements for social care providers. 

It is crucial to conduct annual appraisals and document them. Ensure that your service holds personnel folders for the entire workforce with an index of up-to-date key information, which may be held in hard copy or electronically, or both. 

Here are some suggestions for the contents of personnel folders: 

• Appraisal and supervision reports
• A signed copy of their employment contract
• Proof of any professional indemnity insurance they hold
• Evidence of any professional registration they have, such as with HPC or NMC
• Emergency contact details and next of kin information
• Evidence of an enhanced DBS check for staff working with adults or children
• Proof that healthcare professionals, social workers, or other registered professionals meet the standards of their profession
• Evidence of skills, competence, and experience gained
• Job description
• Name, current address, and telephone numbers
• Notes on any equality issues that were taken into account and any reasonable adjustments made due to disability or caring responsibilities
• Photo ID (CQC may want to see this, or at least a record of its type and serial number)
• Records of any disciplinary action taken
• References
• Training records
• For any staff with criminal convictions or cautions revealed by a DBS check, a record of a risk assessment showing how any identified risks are being managed

Having all this information organised and easily accessible can help ensure you are prepared for any regulatory inspections and demonstrate your commitment to maintaining high standards for your staff and the people in your care.

Access to the Registered Manager

During inspections, CQC may inquire about the manager's availability for communication, such as responding to phone calls, emails or other forms of contact, from both care staff and those supported by the service, as well as their families, including outside normal office hours.

To ensure compliance, it's important to maintain a record of who is available to take calls from staff or address any concerns raised by the people you support regarding the care they receive or the timing of delivery.

Health & Wellbeing of Your Staff

As an employer, it's crucial to prioritise the health and well-being of your staff. This means providing suitable working conditions and support to ensure their success.

It's essential to offer staff proper training, support, supervision, and appraisal as needed to perform their job duties. In homecare, workers often work alone without direct supervision, so it's the employer's responsibility to manage any health and safety risks beforehand. This applies to all individuals working under your contract, including self-employed people.

Lone workers face higher risks without supervision, which can lead to accidents and injuries. This is especially true for homecare workers, who may face hazards such as work-related road risks or slips and falls in icy conditions. The Health and Safety Executive has developed guidance for employers on lone working and for lone workers themselves.

Download your Lone Work Risk Assessment Template here. 

Preparing Staff for Inspection

It is important to prepare your staff for a CQC inspection by ensuring they understand the process and what questions may be asked. You can prepare your staff in meetings or through individual supervision, and reassure them that the inspection is focused on the organisation's performance rather than their personal performance.

All staff, regardless of hours worked or frequency of attendance, should be aware of current policies and procedures, as this is an expectation of the CQC.

Here are some sample questions that care staff may be asked by a COC inspector. It's important to note that the inspector may ask different questions, but these are the types of questions that can help core staff prepare for their inspection:

• How long have you been working for this organisation?
• What is your role and what tasks do you carry out in your job?
• Do you have a written description of your job role, responsibilities, and contract?
• Have you read the staff handbook?
• Do you feel supported by your manager/supervisor?
• What was the process for applying to this job? Did you have an interview?
• What references were taken when you were appointed?
• What do you enjoy about your role?
• Is there anything that worries you about your role?
• Did you have a DBS check when you started?
• What training have you received and can you describe it?
• Do you have regular meetings with your manager/supervisor?
• Does your manager/supervisor have meetings with groups of care workers?
• How do you prevent the spread of infection?
• What would you do if you suspected that someone you support was being abused or neglected?
• What would you do if you were concerned about how another care worker was treating someone you support?
• Can you explain how someone you support could make a complaint to the manager?
• How do you protect the information about the people you support?
• What does "treating people with dignity and respect" mean to you?
• What would you do if you were running late for a scheduled visit?
• What would you do if a person you support is unable to make decisions about their care?
• What would you do if there was a serious incident in a person's home, such as if you found them on the floor or if there was an accident that caused bruising or a break in the skin?
• Do you know which tasks you are able to do and which tasks you are not trained to do?

Remember, these are just examples and it's important to be prepared for any questions that may come up during your inspection.

Skills for Care - Adult Social Care Workforce Data Set (ASC-WDS)

Skills for Care publishes the Adult Social Care Workforce Data Set, an online data collection service that covers the entire adult social care workforce in England. The service allows you to store and access key information about your staff in one place, as well as record their training and qualifications data. It can also provide alerts when you need to update training or if you have gaps in mandatory training. The training reports within the service can help you demonstrate to CQC that your staff training is up-to-date.

In assessing staffing levels, CQC considers staffing levels a key factor in services rated as "Inadequate" or "Requires Improvement", particularly under the Safety domain. CQC will review rotas over a period of several months, as well as handover records, incident reports, and other relevant records. You should be able to demonstrate that you are constantly monitoring, reviewing, and adapting staff on the rota based on their skillsets and the needs of the people you support. Record your decisions about staffing levels so that you can show CQC what decisions were made and when.

Leadership in Health and Social Care

Effective leadership is a crucial factor in achieving a Good or Outstanding rating from CQC. To demonstrate strong leadership within your service, consider taking the following actions:

• Hold regular meetings with your staff to discuss shared goals and record minutes
  
  
• Ensure all staff understand your company's values and vision, and know how to apply them in practice
  
  
• Make sure your workforce feels supported and valued, with appropriate employment policies, procedures, and systems in place
  
  
• Conduct regular staff supervision sessions, and keep records of discussion points and agreed actions
  
  
• Have a clear and effective whistleblowing policy, as CQC may ask staff about it
  
  
• Understand your responsibilities under Duty of Candour
  
  
• Stay informed of relevant guidance and standards
  
  
• Ensure your service has secure and available systems for sharing and protecting confidential data
  
  
• Be prepared to show CQC that your staff and managers can identify and learn from mistakes

PART FOUR

Find out about Staff Training in part 4, Preparing for a CQC Inspection. Find out what induction, care certificates and training records CQC may request to see.