All lines of enquiry related to this area of the CQC inspection are listed below. Visit the CQC website if you need to clarify which ones relate to your service.

To learn more about how to gain access to our products and services, click here

  1. Click on one of the icons related to the Care Quality Commission inspection questions: is it safe, effective, caring, responsive or well-led. This will show the key lines of enquiry (KLOEs) associated with each question.
  2. Choose the KLOEs that relate to the type of service you provide (eg residential adult social care, community adult social care and hospices). This will reveal the resources most relevant to your type of service.
  3. Add the products you are interested in to My List.
  4. Go through each KLOE and continue to Add to My List. You can edit your list at any stage by deleting or adding more items.
  5. Email your list to yourself or colleagues. Just fill in your email address and press Send. You don’t need to register on Care Improvement Works to do this.
  6. Open your email and click on the links to the products in your list.

Prompts that may be used by CQC inspectors to explore this...

S1.1 How are safeguarding systems, processes and practices developed, implemented and communicated to staff?

S1.2 How do systems, processes and practices protect people from abuse, neglect, harassment and breaches of their dignity and respect? How are these monitored and improved?

S1.3 How are people protected from discrimination, which might amount to abuse or cause psychological harm? This includes harassment and discrimination in relation to protected characteristics under the Equality Act.

S1.4 How are people supported to understand what keeping safe means, and how are they encouraged and empowered to raise any concerns they may have about this? If people are subject to safeguarding enquiries or an investigation, are they offered an advocate if appropriate or required?

Products that can help include...

Safeguarding Guide
Safeguarding Guide

Strengthen your staff's understanding of safeguarding using Skills for Care's:

  • Safeguarding guidance - including what CQC inspectors look for and best practice record keepingSafeguarding route planner - tips for different approaches to embed safeguarding using practical resourcesSafeguarding induction and learning materials, including the Care Certificate and Learn from Others case studies

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Care Certificate
Care Certificate

Using our guidance, free workbooks and presentations make sure new workers meet the Care Certificate standards related to safetfy, avoiding harm and managing risk:

  • Equality and Diversity
  • Safeguarding Adults / Children
  • Privacy and Dignity
  • Health and Safety
  • Awareness of Mental Health, Learning Disabilities and Dementia Standard

These should be completed by anyone new to or lacking experience in social care.


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Domestic violence and abuse (2016) (QS116)
Domestic violence and abuse (2016) (QS116)

NICE quality standard on services for domestic abuse on adults and young people. It includes statements and measures on

  • asking about domestic violence and abuse
  • response to domestic violence and abuse
  • referral to specialist services
  • in particular, please see statements 1, 2 & 3

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SCIE Guide 46: Commissioning care homes: common safeguarding challenges (2012)
SCIE Guide 46: Commissioning care homes: common safeguarding challenges (2012)

This guide identifies issues that commonly lead to safeguarding referrals from care homes, identifying the underlying causes. Prevention checklists help commissioners and providers work towards reduction in occurrences​​.


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Safeguarding adults: looking out for each other to prevent abuse (2014)
Safeguarding adults: looking out for each other to prevent abuse (2014)

Good communication can improve safeguarding.  Use these examples of community projects to see how people in residential care:

  • are encouraged to look out for each other
  • can report any concerns about the safety of individuals

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Adult safeguarding: sharing information (2015)
Adult safeguarding: sharing information (2015)

This guide supports implementation of the adult safeguarding aspects of the Care Act 2014 in terms of the sharing information:

  • at the right time
  • with the right people

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Safeguarding (Good and outstanding care guide)
Safeguarding (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Train staff, involve people, connect with Safeguarding Board, etc.
  • Avoid failing to investigate and report issues, document actions etc.

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Prompts that may be used by CQC inspectors to explore this...

S2.1 What arrangements are there to manage risks appropriately, and to make sure that people are involved in decisions about any risks they may take?

S2.2 How do risk management policies and procedures minimise restrictions on people’s freedom, choice and control, in particular for people who lack mental capacity?

S2.3 Are people’s records accurate, complete, legible, up-to-date, securely stored and available to relevant staff so that they support people to stay safe?

S2.4 Are formal and informal methods used to share information with appropriate parties on risks to people’s care, treatment and support?

S2.5 Are there thorough, questioning and objective investigations into whistleblowing or staff concerns, safeguarding, and accidents or incidents? Are action plans developed, and are they monitored to make sure they are delivered?

S2.6 How is equipment, which is owned or used by the provider, managed to support people to stay safe? Relates to: All Services, How are the premises and safety of communal and personal spaces (such as bedrooms) and the living environment checked and managed to support people to stay safe? Relates to: Care homes?, How does the provider manage risks where they provide support in premises they are not responsible for? Relates to: All Services

S2.7 How do staff seek to understand, prevent and manage behaviour that the service finds challenging? How are individuals supported when their behaviour challenges? How well does this align with best practice?

Products that can help include...

Positive Behaviour Support
Positive Behaviour Support

If you are supporting people with challenging behaviour you need well trained and competent staff. The guide Positive behavioural support (PBS): a mini guide to arranging and paying for training to support with PHBs, covers: ​what to look for in PBS training for staffhow to find a suitable learning provider paying for training​


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Managing Risk (Good and outstanding care guide)
Managing Risk (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Follow legislation, human rights, provide freedom, etc.
  • Avoid inconsistencies between assessments and plans, etc.

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Restrictive Practice guidance
Restrictive Practice guidance

​This guide developed in partnership with Skills for Health is aimed at employers seeking to minimise the use of restrictive practices in social care and health.  The guide includes focus on;

  • Helping decisions when planning, purchasing or providing learning and development about supporting people positively and carrying out restrictive practices and interventions.
  • Effective workforce development to minimise the use of restrictive practicesImplementation: information for specific situations

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Lone Working Guide
Lone Working Guide

By providing comprehensive policies and training on safe lone working, you will ensure your staff are less likely to experience a serious incident at work.  Aimed at homecare and some community based services Skills for Care's lone working guide focuses on:

  • ​​employer responsibilities
  • employee responsibilities
  • risk assessment
  • safety measures
  • legislation 

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Delirium in adults (2014) (QS63)
Delirium in adults (2014) (QS63)

NICE quality standard on the prevention, diagnosis and management of delirium in adults in hospital or long-term care settings. It includes statements and measures on;

  • assessing recent changes in behaviour
  • interventions to prevent delirium
  • the use of antipsychotic medication for people who are distressed
  • providing information about delirium

The statements are specific and concise and focus on priorities for quality improvement.
In particular, please see statements 1 & 2.


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Falls in older people (update 2017) (QS86)
Falls in older people (update 2017) (QS86)

NICE quality standard on the prevention of falls and assessment after a fall in older people (aged 65 and over) who are living in the community or staying in hospital. It includes statements and measures on;

  • identifying people at risk of falling
  • risk assessment for older people at risk of falling
  • strength and balance training
  • home hazard assessment and interventions

The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statements 1, 2 & 3.


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Preventing excess winter deaths and illness associated with cold homes (2016) (QS117)
Preventing excess winter deaths and illness associated with cold homes (2016) (QS117)

NICE quality standard on preventing health problems associated with cold homes. It focuses on people particularly vulnerable to the effects of the cold, such as people with cardiovascular or mental health conditions and older people. It includes statements and measures on;

  • identifying people who are vulnerable to health problems associated with a cold home
  • asking them about keeping warm at home

The statements are specific and concise and focus on priorities for quality improvement.
In particular, please see statements 1, 2, 3 & 4.


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Recognising and preventing delirium: A quick guide for care home managers (2017)
Recognising and preventing delirium: A quick guide for care home managers (2017)

This is a short and visually appealing guide for care home managers, containing key information from the relevant NICE guidance.


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Violent and aggressive behaviours in people with mental health problems (2017) (QS154)
Violent and aggressive behaviours in people with mental health problems (2017) (QS154)

NICE quality standard on short-term prevention and management of violent and physically threatening behaviour among adults, children and young people with a mental health problem. It includes statements and measures on;

  • Identifying triggers and warning signs
  • Prevening and managing violent and aggressive behaviour.  In particular, please see statement 1.

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Minimising the use of restraint (2015)
Minimising the use of restraint (2015)

Use these films to examine good practice in minimising the use of restraint in health and social care. What needs to be taken into account are:

  • an individual's human rights
  • putting people at the centre of decisions

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At a glance 31: Enabling risk, ensuring safety: Self-directed support and personal budgets (2013)
At a glance 31: Enabling risk, ensuring safety: Self-directed support and personal budgets (2013)

Use this briefing to find out emerging research and practice regarding risk taking and safety in the implementation of self-directed support and personal budgets.


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QS163 Mental health of adults in contact with the criminal justice system (2018)
QS163 Mental health of adults in contact with the criminal justice system (2018)

NICE quality standard on the recognition, assessment and management of mental health problems in adults (aged 18 and over) who are in contact with the criminal justice system. It includes statements and measures on:
•  responding to mental health problems
• mental health assessment
•  sharing mental health care plans
• risk management during transfers
The statements are specific and concise and focus on priorities for quality improvement. In particular, please see statement 3.


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CG185 Bipolar disorder: assessment and management (2018)
CG185 Bipolar disorder: assessment and management (2018)

This guideline covers recognising, assessing and treating bipolar disorder (formerly known as manic depression) in children, young people and adults. In particular see recomendations 1.4.1-1.4.3


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CG90 Depression in adults: recognition and management (2018)
CG90 Depression in adults: recognition and management (2018)

This guideline covers identifying and managing depression in adults aged 18 years and older, in primary and secondary care. In particular see recommendations 1.3.2.1-1.3.2.4 and 1.10.2.1-1.10.2.3

 

 


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Prompts that may be used by CQC inspectors to explore this...

S3.1 What arrangements are there, including within the rotas, for making sure that staff have the right mix of skills, competencies, qualifications, experience and knowledge, to meet people’s individual needs?

S3.2 How is safety promoted in recruitment practices, arrangements to support staff, training arrangements, disciplinary procedures, and ongoing checks?

S3.3 Do staff receive effective training in safety systems, processes and practices?

Products that can help include...

Safe Staffing (Good and outstanding care guide)
Safe Staffing (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Base levels of the needs of the people, ensure the right mix of skills etc.
  • Avoid over-reliance on temporary workers, ensure staff can respond to unplanned needs, do not miss visits etc.

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Recommendations for CQC providers guide: recruitment and retention
Recommendations for CQC providers guide: recruitment and retention

The people your service supports are more likely to receive personalised, responsive care, if you have recruited staff with the right values. 
The recruitment and retention section of our CQC providers guide covers: 

  • Think Care Careers (recruitment resources)
  • A Question of Care (recruitment tool)
  • Values based recruitment (advice and guidance)
  • Core Skills (resources)

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Finding and keeping workers: Take on the right people
Finding and keeping workers: Take on the right people

Embedding and maintaining a positive culture is easier when you have staff with the right values.​ Use these resources to think about and plan how you take on the right people.


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Recruitment (Good and outstanding care guide)
Recruitment (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Recruit people with the right values, involve people who use care and support in the recruitment etc.
  • Avoid not undertaking employment checks before new workers start, recruitment practice that does not align with your own policies etc.

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Practical Approaches to Workforce Planning: guide and workbook
Practical Approaches to Workforce Planning: guide and workbook

Make sure you have the right staff in place to meet the changing needs and future opportunities of your business. Skills for Care provides:

  • a free introductory guide
  • Practical Approaches to Workforce Planning (including practical tools and templates): £20

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End of Life Care hub (2013)
End of Life Care hub (2013)

​Advice and guidance to improve quality of life for people who are dying by raising standards of end of life care in care homes, nursing homes and at home.​​


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Safe Recruitment (Good and outstanding care guide)
Safe Recruitment (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • What to consider when recruitment new care workers
  • How to avoid unsafe recruitment practices that may put your service at risk

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Relates to: Services that administer medicines as part of providing regulated activity. Prompts that may be used by CQC inspectors to explore this...

S4.1 Is the service’s role in relation to medicines clearly defined and described in relevant policies, procedures and training? Is current and relevant professional guidance about the management of medicines followed?

S4.2 How does the service make sure that people receive their medicines (both prescribed and non-prescribed) as intended (including controlled drugs and ‘as required’ medicines), and that this is recorded appropriately?

S4.3 How are medicines ordered, transported, stored, and disposed of safely and securely in ways that meet current and relevant legislation and guidance?

S4.4 Are there clear procedures for giving medicines covertly, in line with the Mental Capacity Act 2005?

S4.5 How does the service make sure that people’s behaviour is not controlled by excessive or inappropriate use of medicines?

S4.6 How do staff assess the level of support a person needs to take their medicines safely, particularly where there are difficulties in communicating, when medicines are being administered covertly, and when undertaking risk enablement assessments designed to promote self-administration?

S4.7 How does the service engage with healthcare professionals in relation to reviews of medicines at appropriate intervals?

S4.8 How do staff make sure that accurate, up-to-date information about people’s medicines is available when people move between care settings? How do medicines remain available to people when they do so?

Products that can help include...

Medicines (Good and outstanding care guide)
Medicines (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Train and refresh staff, follow NICE and Royal Pharmaceutical Guidelines, regularly review plans etc.
  • Avoid out of date records, poor management, unlocked medicine cabinets etc.

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Medicines management in care homes (2015) (QS85)
Medicines management in care homes (2015) (QS85)

NICE quality standard on managing medicines in care homes. Residents should have the opportunity to make informed decisions about their care and treatment in partnership with health and social care professionals. Safeguarding and mental capacity issues are considered in relation to medicines.​​ In particular, please see statements 1, 2, 4, 5 & 6.


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Managing medicines in care homes (2014) (SC1)
Managing medicines in care homes (2014) (SC1)

The guidelines covers good practice for managing medicines in care homes. It aims to promote the safe and effective use of medicines in care homes by advising on processes for handling and administering medicines. This includes recommendations on developing medicines policies, supporting residents to make informed decisions, sharing information, record-keeping, medicines related safeguarding, storing and disposing of medicines.


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Managing medicines for adults receiving social care in the community (2017) (NG67)
Managing medicines for adults receiving social care in the community (2017) (NG67)

NICE guideline covering the management of medicines for adults receiving social care in the community including home care, extra care and sheltered housing, Shared Lives and supported living.


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Discussing and planning medicines support
Discussing and planning medicines support

This is a short and visually appealing guide for home care managers providing medicines support, containing key information from the relevant NICE guidance.


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QS164 Parkinson's disease (2018)
QS164 Parkinson's disease (2018)

NICE quality standard in the management of Parkinson's disease in adults. It includes statements and measures on:
• point of contact with specialist services
•information about impulse control disorders
• referral to physiotherapy, occupational therapy or speeach and language therapy
• levodopa in hospital or a care home
The statements in this standard are specifc and concise and focus on priorities for quality improvement. In particular, please see statement 4.


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CG137 Epilepsies: diagnosis and management (2018)
CG137 Epilepsies: diagnosis and management (2018)

The guideline covers diagnosing, treating and managing epilepsy and seizures in children, young people and adults in primary and secondary care.


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Prompts that may be used by CQC inspectors to explore this…

S5.1 What are the arrangements for making sure that premises are kept clean and hygienic so that people are protected from infections that could affect both staff and people using services? Relates to: All services responsible for premises, hygiene and cleanliness

S5.2 Do staff understand their roles and responsibilities in relation to infection control and hygiene?

S5.3 Are policies and procedures maintained and followed in line with current relevant national guidance?

S5. Where it is part of the service’s role to respond to and help to manage infections, how does the service make sure that it alerts the right external agencies to concerns that affect people’s health and wellbeing? Relates to: Services that respond to or manage infection

S5.5 Have all relevant staff completed food hygiene training and are correct procedures in place and followed wherever food is prepared and stored? Relates to: Services that provide, prepare or serve food as part of providing regulated activity, or that support people to do so for themselves

Products that can help include...

Care Certificate
Care Certificate

Use Skills for Care's guidance, free workbooks and presentations to take new care workers through this standards. The following Care Certificate Standards relate to this:

  • Infection, prevention and control
  • handling information​

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Infection and control (Good and outstanding care guide)
Infection and control (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • Involve people in understanding associated risks, communicate good practice and compliance etc.
  • Avoid ineffective systems and failure to clean premises or take action etc.

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Infection prevention and control (2014) (QS61)
Infection prevention and control (2014) (QS61)

NICE quality standard on the prevention and control of infection for people receiving healthcare in primary, community and secondary care settings including the person’s own home, care homes and hospitals. It includes statements and measures on;

  • hand decontamination
  • insertion and removal of urinary catheters and vascular access devices
  • education about infection prevention and control. 

The statements are specific and concise and focus on priorities for quality improvement.
In particular, please see statements 2, 3, 4, 5 & 6.
 


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Prompts that may be used by CQC inspectors to explore this…

S6.1 Do staff understand their responsibilities to raise concerns, to record safety incidents, concerns and near misses, and to report them internally and externally, where appropriate?

S6.2 What are the arrangements for reviewing and investigating safety and safeguarding incidents and events when things go wrong? Are all relevant staff, services, partner organisations and people who use services involved in reviews and investigations?

S6.3 How are lessons learned and themes identified, and is action taken as a result of reviews and investigations when things go wrong?

S6.4 How well is the learning from lessons shared to make sure that action is taken to improve safety across relevant parts of the service? Do staff learn from reviews and investigations by other services and organisations?

S6.5 How effective are the arrangements to respond to relevant external safety alerts, recalls, inquiries, investigations or reviews?

Please note that no specific resources have been developed by Skills for Care, NICE or SCIE relating to this specific part of the CQC inspection. 

Learning from accidents and incidents (Good and outstanding care guide)
Learning from accidents and incidents (Good and outstanding care guide)

Recommendations and practical examples from services rated good and outstanding including;

  • How to safely investigate and respond to accidents and incidents
  • How to avoid insufficient investigations and failure to use learning to inform improvements

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