Being on placement during a CQC inspection

Second year Nursing student, Florence Pownall, has recently returned from a placement where she was visited by The Care Quality Commission (CQC). The CQC is an independent regulator which inspects all health and social care services in England to determine whether certain facilities are meeting the required standards or not. Below, Florence gives us an insight into what life is like inside a hospital when the CQC pay a visit…

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There is a strain on any healthcare setting when they are due a visit from the CQC. The staff want to make sure that they are seen to be meeting all of the standards required by the inspectors in order to receive the best possible result from their inspection.

The results of all CQC inspections are published on the internet and are available for public viewing, meaning that it can be vital for healthcare settings to receive an excellent CQC rating. It can have an impact on not the future of the service but their reputation and status too.

It would be unusual for students to be asked about how the healthcare setting is run whilst the CQC are visiting, however – in my opinion – the CQC could benefit from asking individuals who aren’t permanent members of staff, such as students: this is because someone who isn’t tied to the institution might be able to give a better insight in to what life is really like in that setting.

Every student is different but some may be inclined to reveal that things aren’t as great as they seem (if that’s the case), whilst a glowing reference from a student could result in an even higher rating from the CQC.

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The checks that the CQC typically make all revolve around a number of fundamental standards. Ranging from person-centred care to fit and proper staff, the CQC argue that each health setting should reach a certain level with regards to these standards. They will typically notify a health setting when an inspection is imminent which allows staff to prepare for the visit.

From my experience, in the build-up to a CQC visit certain processes were undertaken that went against the norm: for example, green ‘I am clean’ stickers were placed on anything visible and every important document was filed away appropriately. Morally, this is questionable, as the CQC  inspection results should be representative of what actually happens rather than what should happen in an ideal world.

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Staff in health settings work incredibly hard and in a lot of cases, under-staffing is a major problem so maybe there should be more leeway. Whilst appreciating that the people on the ward, or whichever other healthcare setting desire the best CQC rating they can gain, it can be tough to watch everything change for the two or three days the CQC are present.

In the days after the inspection, the policies and procedures which are undoubtedly printed out in mass are filed away for the next inspection, the “I am clean” stickers are removed from any surface they are stuck on and everyone breathes a sigh of relief.

There will always be at least one member of staff who expresses that nothing should be changed for the CQC and that they should see all the cracks and problems, with the view that they will be ‘fixed’ and improved following a negative CQC inspection. Whilst this outlook on the occasion may be very honest and raw, if everyone acted this way it would potentially disarm and disengage the entirety of the NHS and send everything spiralling, ultimately impacting patients. So surely a few tweaks here and there for a few days shouldn’t be such a problem?

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Generally, the well managed and caring facilities are picked up by CQC inspections and rewarded accordingly, and the less effective services are made evident by these, however it is clear that some are able to slip through gaps, due to the perceived façade created in the days and weeks leading up to the 5-yearly inspection.


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