Areas to watch out for in care inspections – and how to stay ahead

Inspections can be stressful and overwhelming, but they really don’t need to be. The experts at Citation are here to help you out, having analysed 50 CQC reports from 2022 to pick up key trends that care businesses like yours could find themselves tripping up on, and they’re here to tell you about a couple of them.

Recruitment

Faced with skills shortages, recruitment has been difficult for care businesses for years now. Skills for Care statistics show that 70,000 people were recruited from abroad in 2022/23 compared to 20,000 people in 2021/22, showing how more businesses are having to look overseas to fill their vacant posts.

But with recruitment challenges can come crucial mistakes – more specifically, failing to carry out proper employment checks. Recruiting from abroad and dealing with sponsorship visas is obviously a whole separate beast from a process perspective, but even if you’re recruiting UK residents, it’s so important to carry out full and proper background checks and make sure you have all necessary information stored on file. The cases we looked at demonstrated that extremely clearly.

The CQC found that…

• Care services weren’t consistently collecting the full employment history of their staff since leaving education – for example, some candidates listed employment using years, without the specific dates they started and finished jobs
• There was a lack of thorough background checks
• Staff had incomplete or unreliable references – it’s a legal requirement to gather satisfactory evidence of conduct or the reason why staff left their last employment, and some services weren’t doing this
• Unsuitable application forms were being used – application forms asked for employment history of the last ten years, which doesn’t meet legal requirements

Key takeaway:

Due diligence in recruitment is everything – not just to meet your legal obligations, but also to save you money in the long run (replacing unfit staff isn’t a cost or hassle anyone needs to be dealing with).

So, make sure you always collect a full employment history, together with a satisfactory written explanation of any gaps in employment, as part of a robust recruitment process to make sure suitable staff are recruited to support people to stay safe. That also includes references and any necessary background checks.

It may also be useful to give staff an idea of a day in the life of the role they’re applying for, to make sure whoever you hire is aware of the demands of the job and is prepared to handle those, to help to reduce turnover.

Your checklist:

• Is staff recruitment robust? (DBS/references/gaps in employment history)

Care plans

Care plans are a crucial part of providing safe, appropriate care for the people using your service. They should never just be seen as a tick-box exercise, and they should be continually revisited and monitored – but sometimes providers can let things slip.

The CQC found that…

• Correct detail was lacking and there was too much unnecessary detail in some care plans, like an assessment of conditions they didn’t have
• Care plans and risk assessments were of poor quality and had conflicting information – some needed further development to ensure these were strength-based and reflected how to support the person with their needs
• There was missing medical information in some care plans – and one didn’t even include information about their significant illness, meaning staff didn’t have enough information to understand and respond to health risks
• Records of care were incomplete as they weren’t arranged in a way that meant the service could track people’s changing needs

Key takeaway:

This ultimately comes down to good quality assurance – things like making sure care plans are up to date, detailed, and reflect the needs of the people in your care, and you have a system in place to monitor plans and any changes needed.

Your checklist:

• Are care plans, charts and records up to date and fully completed?
• Are all records accurate, complete and maintained?
• Are there any care plans, risk assessments and staff guidance notes that conflict?
• Are electronic systems consistent with paper records?

Want to find out more?

Check out the full Citation guide which lists all 10 of the key problem areas, and goes into more detail on issues such as risk assessments, medication management and quality assurance.

As an WMCA partner, Citation is a trusted provider in the industry – so you can have faith that they know how to help you manage the challenges unique to your care home setting.

Your free Citation HR advice line is here when you’ve got an HR crisis and things aren't smooth sailing. Get in touch today at appointmentswithjonathan@citation.co.uk or call 0161 504 0843 between 9am-5pm Monday-Friday and quote West Midlands Care Association. Or book a slot in his diary here.

Your WMCA member benefit

If you’d like to chat about how Citation can help with the HR and Health & Safety side of your business, just give them a call on 0345 844 1111, or fill in their call-back form, and they'll get right back to you. Remember to quote West Midlands Care Association when enquiring to access preferential rates.