Understanding the new evidence categories under CQC’s Single Assessment Framework

Under the Care Quality Commission’s new Single Assessment Framework (SAF), care providers’ existing ratings will no longer be used as the main basis for their next inspection. Now evidence collected or given to the CQC can prompt an assessment at any time, marking an end to point-in-time ratings based on periodic inspections.

CQC will use evidence gathered from both on-site and off-site sources to score services across 34 Quality Statements based around the statutory fundamental standards and underpinned by between one and six new evidence categories. Together, the Quality Statements and the evidence categories form the backbone of the new assessment framework. This shift in approach reflects the CQC’s focus on becoming more ‘dynamic’ and ‘data-led’.

New evidence categories

CQC have grouped the different types of evidence they will look at into six categories. Each category sets out the types of evidence the CQC will use to understand the:

• quality of care being delivered and
• performance against each Quality Statement

CQC hopes to bring consistency to assessments and to make their judgements more transparent and consistent for providers and other stakeholders.

The six evidence categories cover:

1. People’s experiences
2. Feedback from staff and leaders
3. Feedback from partners
4. Observation
5. Processes
6. Outcomes

Evidence under the six categories will be collected using a variety of methods from both on-site and off-site sources and updated on a rolling basis over a two-year period or in response to concerns. Sources of evidence within the categories will be wide ranging covering whistleblowing reports, safeguarding concerns, statutory notifications, and feedback from partners in the wider health and care system.

Factors influencing the use of evidence categories

Under the new framework, the number of evidence categories that the CQC will consider and the sources of evidence they’ll collect will vary according to:

• the type or model of service
• the level of assessment (service provider, local authority or integrated care system)
• whether the assessment is for an existing service or at registration

SAF dispenses with the separate registration process. However, it will be interesting to see what changes the introduction of the evidence categories make to the registration process, with many of the categories difficult to evidence pre-registration. The exception being the processes categories as evidencing policies is a requirement of registration.

Quality Statements will be assessed using the evidence, which falls into one of the six categories although not every evidence category applies to every Quality Statement.  The evidence categories will require a renewed focus on how services are manged and how to evidence compliance.

CQC have said that to make clear what they’ll look at in their assessments, they’ll set out the key evidence categories that they’ll focus on when assessing a particular Quality Statement as there will be different evidence categories for different types of services. Care providers can expect to receive some examples of the types of evidence required to make it easier to understand what CQC will look at.

Opportunities knock

The evidence categories provide care providers with an opportunity to continue to drive improvements in the quality and safety of services, and to proactively demonstrate quality beyond mere compliance – similarly, they provide potential opportunities for differentiation in the sector.

Getting ahead of the curve

While the exact timeline for implementation remains uncertain beyond ‘later in 2023’, we know care providers are working hard to review their internal processes to ensure these are aligned with the new Quality Statements and in particular the specific evidence categories relevant to their types of services. Familiarising your compliance team with the evidence categorises will be key to being inspection ready.

A version of this piece first appeared in the September issue of the Caring Times.