This month, we have been talking to Healthcare Business about the importance of regaining the trust of the authorities after an ‘Inadequate’ CQC.
The full story appears on page 44 of the new issue and you can read it here bit.ly/KD6emx

We know that a poor inspection report can have a dramatic and detrimental impact on a care home.
The consequences can often be severe and, if remedial work and required improvements are not made within the timeframes given, operators may end up being forced to contend with anything from loss of support from local commissioning teams to home closure.
Services found to be providing ‘Inadequate’ care face special measures to ensure that they improve. This includes providing a clear timeframe within which the quality of care needs to improve to avoid further action.
So what can you do in this situation?
If you are going to rebuild trust, there are key things to consider. The first is to understand how crucial it is to build a good relationship with the CQC going forward. Here are our tips:
• Before the report goes live, check to see if you agree with it. Make any challenges on the factual accuracy report – but be careful not to challenge for the sake of it and only when you have grounds in which to do so.
• Start by immediately contacting CQC – and the Inspector if you have their name – to acknowledge receipt of their report.
• Review the report in detail and pull together a comprehensive action plan. It is essential that you ensure all your breaches are covered and the plan contains sufficient detail.
• Once complete, respond to the CQC with the detailed action plan at the earliest opportunity. It is important to look – and be – proactive.
• Consider how the action plan will be carried out and implemented over the coming weeks and months. This is a good opportunity to consider if the home needs additional resources such as new staff, better cash flow or investment. Consider where these resources may be able to come from and where there might be gaps. Get a handle on the finances and understand the cost implications of everything that needs to be done.
• Make sure you follow through on everything: be careful not to miss a target or a deadline. When you are in control of setting realistic deadlines, for example within the action plan, try not to make the mistake of setting unrealistic deadlines which you cannot meet. You don’t want to set yourself up to fail.
• Never underestimate the power of keeping a good line of communication going. It is why it’s such a good idea to keep in touch with CQC throughout the process. Organise regular meetings with them, consultations and encourage their feedback. It’s something you may feel is difficult to do, but it is very important for the future wellbeing of the business.
• It can be helpful to involve the Local Authority and other commissioners in the process. It is likely that they will have their own Quality Monitoring teams involved at this stage. Working together is critical.
• Organise meetings with the home’s residents and their relatives to explain the situation and what is being done to address any issues. These people are your customers and you need to carefully manage the situation. Poor communication can quickly lead to a bad reputation. Explain how you want to ensure that there is a minimal negative impact on the residents.
• Believe in yourself and your team. Don’t panic. Try to stay in control. Avoid having open discussions in front of residents in respect of the report or the findings. Do it appropriately.
• Embrace change. Be prepared to throw out bad habits and work differently going forward. After an ‘Inadequate’ CQC rating, it is often a question of working in a new more effective way, not just working harder or longer hours.
• Take a hard look at your existing processes and all the key individuals within the home. Be ruthless and consider if either have contributed to the root cause of the failings. If you suspect they have, you need to make all necessary changes. If management are inadequate, urgent changes need to be made. If the quality of care has been criticised, standards will have to be raised and staff potentially retrained.
• Avoid falling into the trap of encouraging a blame culture. When dealing with any of the authorities, try to tackle the issues at hand and focus on this rather than looking to make excuses or assign blame.
• Finally, if you are struggling to cope, consider bringing in outside help. If Caresolve were involved at the point of receipt of an inadequate report – or if we were appointed shortly afterwards – we would make early contact with CQC, explain who we are and what our role is. For all sorts of reasons, it can often be beneficial to have an independent view.

By Ben Challinor, Co-founder and Consultancy Director of Caresolve, the specialists in care home transformation.