Your questions answered
Updated 7
May 2008
Get answers to frequently asked questions about quality
ratings.
- How do we decide your quality
rating?
- Where can I get more information about
quality ratings?
- How do you check quality ratings have
been decided correctly?
- How can I question your
decision?
- How can my rating change?
- Does every service have a quality
rating?
- How does my quality rating affect the
frequency of my inspection?
- Why do good and excellent services
have key inspections only every two or three years?
- What legislation gave CSCI the power
to reduce the number of inspections from a minimum of two per
year?
- What will we do to make sure that the
standard of care in good or excellent services does not fall
between the two or three yearly inspections?
- What are improvement plans and does
every service have to have one?
- What if I have further
questions?
1. How do we decide your quality rating?
Your quality rating is calculated following a key inspection. As
part of this inspection we look at a range of evidence from
different sources. This includes:
- interviews with your staff and the people who are using your
service
- the information you have given us in your annual quality
assurance assessment (AQAA)
-
surveys filled in by people using your service, their relatives
and other professionals involved in their care
-
observations from visiting your service and other relevant
information.
To ensure we interpret this evidence consistently, we use
guidelines called key lines of regulatory
assessment (KLORA).
We apply these guidelines to help us form a
judgment about how well your service is meeting
each of the outcome groups in the national minimum standards.
Our primary concern is to assess the quality of outcomes that people who use your service
experience.
Once we have used KLORA to reach a judgment about each outcome
area of the national minimum standards, we apply a set of rules to
calculate the overall quality rating for your service.
2. Where can I get more information about quality ratings?
Go to our quality ratings for care
services page.
3. How do you check quality ratings have been decided
correctly?
We will continue to send you a copy of the draft report so that
you can comment on factual accuracy.
All of our inspection staff have received extensive
training in assessing evidence and making balanced
judgements that focus on the outcomes for people using the
service.
We use our key lines of regulatory
assessment (KLORA) to ensure that we are consistent and
proportionate in our judgments about how well a service is
providing quality outcomes for the people who use it.
Our inspectors are managed by a regulation manager who must
agree the first three overall quality ratings for every new
inspector before they are shared with the provider.
This is part of our internal quality assurance
arrangements.
Regulation managers will continue to routinely review the
inspection reports and ratings produced by inspectors at least once
each month.
Regulation managers will also review every change in the overall
quality rating.
Each region will have a quality board that will include
membership from external stakeholders (such as
people who use services, their representatives and providers) to
monitor our internal quality management systems.
4. How can I question your decision?
We have set up our new quality rating review service (QRRS) to
let providers bring any concerns about their quality rating to our
attention.
5. How can my rating change?
Your rating can only be changed following a key inspection.
Information we receive between key inspections may bring the rating
into question and if this happens we may bring forward the next key
inspection.
6. Does every service have a quality rating?
Yes they do, except a service that is registered with us for the
first time or a service that has been
re-registered with us. They will not have a quality rating until
their first key inspection.
This will be carried out within six months of
the date of their registration.
At this first key inspection services that have registered with
us for the first time cannot receive an excellent rating because
they must demonstrate a proven track record of
providing excellent quality care over a sustained period of
time.
Services that are re-registering will be able to receive an
excellent rating. To achieve an excellent rating the service will
need to have demonstrated excellent and good practice consistent
with the key lines of regulatory assessment
(KLORA). Excellent services will have a sustained track record
of delivering good performance and managing improvement.
Those without a rating in their printed inspection report or
showing as ‘Not yet rated’ on the website will
either be:
- a new service
- a service that has not had a key inspection in 2008.
7. How does my quality rating affect the frequency of my
inspection?
3 stars - excellent
One key inspection at least once every three years.
2 stars - good
One key inspection at least
once every two years.
1 star - adequate
One key inspection at least once a year.
0 stars - poor
Two key inspections a year.
We can also carry out random (a short, focused inspection) and
thematic inspections (an inspection that looks at a particular
theme) at any time.
8. Why do good and excellent services have key inspections only
every two or three years?
Good and excellent services have demonstrated a proven record
for providing high quality care over a sustained
period. However, if we have any concerns about the quality
of the care provided, we can carry out a key inspection at any
time.
This puts the responsibility on care providers
to maintain and improve their service.
It also allows us to focus our resources on
poor and adequate services to ensure they improve and drive up
quality.
9. What legislation gave CSCI the power to reduce the number of
inspections from a minimum of two per year?
The Commission for Social Care Inspection (Fees and Frequency of
Inspections) (Amendment) Regulations 2006 took effect in April 2006
and changed the frequency from two inspections a year to a minimum
of once in every three-year period.
10. What will we do to make sure that the standard of care in
good or excellent services does not fall between the two or three
yearly inspections?
As a minimum we will carry out an annual
service review of every service rated as good or excellent.
This does not include a visit to your service, but
is an analysis of all the information that we have received from
you, or that we have gathered through our regulatory role since
your last key inspection.
We will usually carry out an annual service review after we have
received your annual quality assurance
assessment (AQAA).
The information that you provide in your AQAA will help us to
understand what you do well and how you intend to improve.
The AQAA has to include information that shows how the views of
people using your service are taken into account.
If our assessment raises concerns that the
quality of your service has changed and the well being of people
who use it is affected, we will bring forward a
key inspection.
The annual service review is how we assure ourselves, and the
public, that the quality of your service has not changed since the
last key inspection.
11. What are improvement plans and does every service have to
have one?
When an inspection report is sent to you and your service is
rated as poor, you will have to fill in an
improvement plan.
If your service is rated as adequate, you will
only have to fill in an improvement plan if our inspector asks you
to.
Providers must use the improvement plan to tell us what action
they will take to improve the quality of their service.
12. What if I have further questions?
Contact the customer services team:
Telephone: 0845 015 0120 or email enquiries@csci.gsi.gov.uk