Most managers needing healthcare training are very familiar with the CQC but did you know that the HSE also has significant authority and the power to close part of a premises or process if they feel there is serious risk of personal injury?
So how do busy managers satisfy both enforcing bodies without duplicating time and effort?
It is understandable that the primary focus of the CQC is the care of people using care services. To achieve this, it’s also necessary to ensure the safety and health of the staff who are providing the care, and this is clearly shown in the CQC domain’s main six questions they ask care providers. We believe it’s no coincidence that the CQC’s first line of enquiry relates to safety. Whilst many people, including some CQC inspectors that we have come across, feel this only relates to safety of those using the care service it clearly includes safety of those providing the service. After all, how can staff in care services guarantee the safety of those they are caring for unless they feel reasonably safe themselves?
The six questions from CQC they ask regarding healthcare
The key lines of enquiry that the CQC always ask are given below, and for the purposes of this guidance we have highlighted how this also relates to management of the staff which is where the HSE comes into healthcare:
- Are your staff safe at work?
- Staff must be safe whilst providing the services offered by the care. Typical questions that CQC use when assessing safety in a care setting include whether staff receive effective training in safety systems, processes and practices, and whether the maintenance and use of equipment keep people safe? Another key area that is question relates to the organisation’s track record on safety.
- Are they effective?
- A key line of enquiry is whether people’s needs are assessed and their care and treatment is delivered in line with current legislation, standards and evidence-based guidance to achieve effective outcomes? This is a loaded question as it covers so many areas of care management. From our experience, this is where many care providers lose perspective of HSE requirements in favour of priorities given by the CQC, when both could easily be satisfied if an integrated approach were to be adopted. For example, when assessing someone’s needs and creating a care plan, it is usual to see a file/document outlining the individual’s needs when receiving care. Although, controls for staff’s safety whilst delivering the care are often not included in this document, or even cross-referenced to other protocols to ensure safety of employees. Visibility of staff consideration is key to avoid potential HSE criticism when they review the workplace health and safety; a simple solution is to include brief notes for staff safety in care plans etc.
- What are the arrangements for supporting and managing staff to deliver effective care and treatment? (This includes one-to-one meetings, appraisals, coaching and mentoring, clinical supervision and revalidation.)
- Are staff encouraged and given opportunities to develop?
- This line of enquiry can be addressed by reference to NVQ and other skill-based development. It can also link with one-to-one meetings, staff meetings and appraisal processes.
- Are they caring?
- How does the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed? To fully demonstrate this, employers should make clear arrangements for supporting staff, including agency workers, as they are facing a wide range of physical, emotional and mental health pressures when caring for the people they are supporting. This is particularly relevant when the people receiving the care are life-limited, have mental health challenges or learning difficulties. arrangements may be as simple as ensuring there’s a comfortable / separate place for staff to take breaks, access to counselling or a quick and easy process to feedback on concerns. Note that any processes for staff to provide feedback must include arrangements for the employer to respond – otherwise there is risk that staff will not report anything as they might feel there is no point.
- Do staff raise concerns about disrespectful, discriminatory or abusive behaviour or attitudes? Any policies about discrimination or abuse should include a process for staff to report as well as the person receiving the care, i.e. an integrated policy rather than separate ones for staff and service users.
- Are they responsive to people’s needs?
- Are reasonable adjustments made so that people with a disability can access and use services on an equal basis to others? This is an interesting one because, once again, CQC focus on the person receiving support when in fact, the Equality Act which underpins this line of enquiry and therefore your systems for arranging access should also refer to staff who may need reasonable adjustments to be made in order for them to work effectively. A recent BBC documentary highlighted this fact when they highlighted a GP who was also a wheelchair user and the challenges this person faced when treating the patients.
- Are they well-led?
- Managers cannot be effective leaders unless they adopt a holistic approach to management of the services being offered as well as the staff delivering them. There are two ways for managers to have clarity on what is required to meet health and safety standards. The first is to arrange a Healthcare Safety Audit which will consider all areas of safety and health management that an employer should be delivering. Any audit should integrate CQC requirements with the HSE requirements and give prioritised recommendations to achieve minimum legal compliance. The second way is for managers to receive practical healthcare training in the principles of safety management in healthcare so they have the knowledge and skills to know what is required to meet both regulatory bodies and how to comply with them without having to duplicate systems, time and effort.
Learn more about our healthcare training courses
There are many sources online where care providers can obtain further information about the types of questions that the CQC may ask when measuring against these standards. Here is an example from the CQC website. It is clear to see that many questions across all the Domains either relate directly to staff, or to both staff and people receiving care.
If you would like to know more about our tailored audit approach and IOSH accredited training for managers (IOSH Principles of Safety Management in Healthcare), please click here.