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Care Quality Commission and case managers

The Care Quality Commission (CQC) informs and influences the day-to-day work that case managers perform. We look at just how the CQC affects case managers.

Who are the Care Quality Commission?

The Care Quality Commission are an executive non-departmental public body of the Department of Health and Social Care of the United Kingdom. They were born of the Health and Social Care Act 2008 following the amalgamation of its predecessors the Healthcare Commission, Commission for Social Care Inspection and the Mental Health Act commission.

The CQC was established in 2009 and independently regulates and inspect services within health and social care including care homes, hospitals, home care, GP’s, dentists, clinics, community & mental health services.

The CQC provides support, guidance and training to assist services to achieve high standards of care.
The core values are:

  • Excellence – being a high-performing organisation
  • Caring – treating everyone with dignity and respect
  • Integrity – doing the right thing
  • Teamwork – learning from each other to be the best we can

How does the CQC operate?

The CQC maintains a register of care providers who they monitor, inspect and rate. If there are grave concerns the CQC has the power to take action to enforce change and protect the client from harm.
The CQC also publish their views on major quality issues in health and social care with the aim or raising standards and expectations nationally.
The CQC dictates what good and outstanding care should look like and aims to ensure services meet these fundamental standards below:

  • Person-centered care – care must be tailored to meet the client’s needs
  • Dignity and respect
  • Consent
  • Safe care and treatment
  • Safeguarding from abuse
  • Food and drink – to maintain good health
  • Premises and equipment – safe and suitable for needs
  • Complaints – a system in place to handle and address complaints
  • Good governance -The provider of care must have plans that ensure they can meet these standards
  • Staffing – must have enough suitably qualified, competent and experienced staff
  • Fit and proper staff – including a strong recruitment procedure in place to carry out relevant checks such as applicants’ criminal records
  • Duty of candor – must be open and transparent about care and treatment
  • Display of ratings – must be displayed and visible

Do all case managers need to register with the CQC?

Many case managers support their clients to employ and manage their own support staff using direct payment or private funds. However, there have been recent questions regarding whether the employers, i.e. case mangers come under the remit of the CQC, as the provision of support workers would fall into the category of ‘home care’ in the same manner as a care agency.

On the 9th May 2019 the Chair of BABICM and CMSUK wrote to the CQC Registration Advisor to clarify the position of case managers with regards to CQC registration.

The CQC responded on the 27th June 2019 and BABCM and CMSUK issued joint Best Practice Guidance regarding CQC for case managers.

The Guidance document states that…

‘BABICM and CMSUK are of the understanding that a case manager or organisation involved in the ongoing direction and control of personal care…. does need to register. In line with best practice, a case manager should always be working with the best interests of the client in mind. Therefore, a case manager’s decision whether or not to be registered with CQC should not restrict client choice in relation to regulated activity, such as whether to use directly employed or agency workers for the delivery of personal care. Where a case manager is not registered with CQC they should consider what actions they can take to offer client choice in relation to regulated activity.’

Essentially, case managers who provide supervision and management of their clients’ support staff who provide personal care may be brought into CQC Regulation. If the case manager has been involved in the employment or engagement of care support services but then has no further input then they are excluded from Regulation – the key difference is ongoing involvement.

Under the Health and Social Care Act 2008 “Any person who carries on a regulated activity without being registered under the chapter… is guilt of an offence”. Therefore it is imperative that all case managers and case management companies must read the relevant legislation and documents before reaching a decision on the need to register with one or more bodies for themselves.

What is involved in maintaining CQC registration?

Many case managers have a pivotal role in employing, line managing and supervising support staff paid for by their clients Direct Payment or with private funds.

Case managers have a responsibility to their clients to ensure that the care provided meets the CQC standards. Some of the activity involved in maintaining registration includes:

  • Auditing – ensuring documents are in place which serve as evidence to demonstrate how a client’s care needs are being met. This process can be thought provoking as it covers a range of topics including end of life choices which is not always something a client has in place.
  • Case managers and the support staff team can all sign up to a policies and procedures platform like Quality Compliance System – it has a wealth of information which is continually amended and updated so always current. A reading record can also be generated from this software.
  • Completing the relevant paperwork such as risks assessments, care plans and annual health checks. It can be useful to store these securely online e.g. in Dropbox to ease access and make updates smoother.
  • Inspection – support the inspection and provide evidence as required. Use this as an opportunity to learn to improve the quality of care provided to the client.
  • Registered manager – the support team will require a registered manager in order to register with the CQC. This is the person with the knowledge and skills to support the implementation of the CQC standards.
  • Deliver regular supervision, appraisals and staff team meetings. Use these as an opportunity to address various aspects from CQC guidance e.g. discussing specific policies or aspects of care.

What can you do if you have concerns about the quality of care provided?

Naturally, we all want the best standard of care for our clients, but sometimes for any number of reasons there are shortfalls.

If you have any immediate concerns about a client’s safety it is important to inform your clients local safe guarding team. The next step would be to follow your local complaints guidelines. The CQC team can then be contacted for support to implement the required changes to ensure the standard of care is improved.

The overall aim of the CQC is to ensure that the health and social care people receive is safe. Ensuring that the employer of the care team is registered with the CQC means that the care provided to the client is regulated and inspected.

Where can you get more information from?

Case management companies such as Circle Case Management are registered with the CQC. They can provide advice to other companies and individuals seeking registration.
For further information please refer to The Health and Social Care Act 2008, Regulations 2014 and the CQC website www.cqc.org.uk.

The full publication for the joint BABICM and CMSUK Best Practice Guidance regarding CQC for case managers can be viewed at https://www.cmsuk.org/babicm-professional-practice-and-membership-groups-ppmg-guidance-relating-to-registration-with-cqc.

With thanks to Sian Bailey, case manager at Circle Case Management for her assistance with this article.

About Circle Case Management

Circle Case Management are based in East Devon and cover Devon, Cornwall, Somerset, Hampshire (including the Isle of Wight) and South Wales.

They work with individuals with complex needs including brain injury, cerebral palsy, complex orthopaedic injury and amputation.

Find full details about Circle Case Management and how they may be able to assist your clients on our website https://www.braininjurygroup.co.uk/services-a-z/circle-case-management-ltd/

What is the Brain Injury Group?

Brain Injury Group is a free service designed to connect those affected by a brain injury (whether there is a claim or not) to a range of experts who may be able to offer advice and assistance.

If you’d like to find out more about the work of Brain Injury Group, you are at the right place! You can follow the links below to:

The Brain Injury Group exists to support individuals and families affected by brain injury and the health and social care professionals working in this specialist field. Our mission is to provide anyone affected by brain injury with access to advice on legal, financial and welfare benefit issues delivered by proven experts in the field who have been chosen not only for their skills and knowledge, but also for their passion and dedication to helping people.

As well as providing legal and welfare advice, Brain Injury Group provide training for legal, health and social care professionals. View our award winning Brain Injury Group brain injury training events.

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How can Brain Injury Group help you?

If you would like advice about bringing a brain injury claim, capacity, deputyships, managing the award of compensation or any other aspect of brain injury welfare, legal or financial advice, we have specialist brain injury solicitors and Court of Protection solicitors who can assist.

You can find full details of Brain Injury Group members on our website or there are several ways to get in touch:

  1. Call us on 0800 612 9660 or 01737 852203
  2. Email us at enquiries@braininjurygroup.co.uk
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