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Am I An ‘Effective’ Provider?

We look at what exactly the CQC mean by the Key Question ‘Effective’, and share our expert guidance on the best evidence you can gather to prove that you are ‘outstanding’ in this area.

The CQC assess all providers against 5 Key Questions. These ask whether a service is:

1) Safe
2) Effective
3) Caring
4) Well-Led
5) Responsive

Under each of these, CQC Inspectors have hundreds of Key Lines of Enquiry (KLOE’s); individual questions that look more specifically at the criteria which demonstrates if and how your service meets the 5 core values above.

‘Effective’: A Broad Definition

If you are ‘Effective’, it means that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.

The CQC are looking to assess whether you deliver quality person-centered care which, importantly, is fresh, innovative, and current. This means your service is fully up to date with evolving legislation and compliance standards, and that it is adaptive in relation to the needs of your service users.

For instance, your staff training and processes must be completely in line with current standards, and you should be proactively utilising all resources available to you to deliver the best possible service. These resources could be other providers in the community, healthcare software, new technology, and modern means of adapting your service for accessibility.

Specific Key Lines of Enquiry

To assess whether your service is ‘Effective’, your CQC inspector will look for evidence that answers the questions below. These are from the CQC’s first series of ‘Effective’ KLOE’s. Specifically, they assess whether people’s needs are assessed, and care and treatment delivered, in line with current legislation, standards, and evidence based guidance.
(Note that there are dozens of additional questions the CQC ask to investigate other indicators of ‘Effective’ care- the below relate specifically to the prompt above).

1) How are relevant and current evidence-based guidance, standards, best practice, and legislation identified and used to develop how care and treatment are delivered (This includes from NICE and other expert and professional bodies).

2) Do people have their needs assessed and their care planned and delivered in line with evidence-based guidance, standards and best practice, including during: – Assessment – Diagnosis – Referral to other services – Management of long-term or chronic conditions, including for people in the last 12 months of their life.

3) How is this monitored?

4) Is risk profiling or risk stratification used to ensure that people have their needs assessed and care planned and delivered proactively? (This prompt will not usually apply to GP out-of-hours services.)

5) Is discrimination, including on grounds of age, disability, gender, gender reassignment, pregnancy and maternity status, race, religion or belief and sexual orientation avoided when making care and treatment decisions?

Our expert prompts to demonstrate compliance with the above KLOE’s 

Whilst knowing the KLOE’s can help to prepare you for what the CQC will be looking for, HLTH Manage supports you further by providing expert prompts from former National CQC Training Managers and Inspectors as to what specifically you should be doing to meet these standards, and how to evidence this. See some of our top tips for this series of KLOE’s below:

– Service should utilise the information within the quality outcomes framework (QOF) document which set out clear domains for GP services in regard to specific areas of care commissioned by the NHS. Services should also evidence how best practice is promoted across those domains and patient groups.

– Evidence of how the service is supporting people to address such issues as substance misuse, alcohol / drugs, smoking cessation programmes / obesity etc.

– It will be important to evidence how such guidance is used and embedded into practice at the service to the benefit of patients.

– Feedback from service users and others will provide essential strands of evidence, though CQC should also be arranging to survey service users / patients themselves who use the service at the time of the inspection.

How will HLTH Manage help me to be ‘Effective’ and demonstrate this to the CQC?

On HLTH Manage, you can see all the current series of KLOE’s under ‘Effective’ – in addition to those for the other 4 Key Questions. You can also access our expert guidance on the best evidence to compile to demonstrate how you are compliant with each one.

Our industry-leading system also recommends how many pieces of evidence to upload for each KLOE, ensuring that your evidence is not only what the CQC are looking for, but also that you have enough to demonstrate outstanding compliance.

When the time comes for your CQC Inspection, HLTH Manage’s compliance function ensures that you are fully prepared for what inspectors will be looking for, and can proactively demonstrate how you meet their criteria. It provides the insight and the tools you need to be well on the road to becoming an outstanding provider.