Staying one step ahead of the CQC

Welcome to Therapeia’s online Self-Assessment service!

Although for many providers Care Quality Commission (CQC) inspections are seen as something to be endured rather than welcomed, it is perhaps worth remembering that all the CQC are doing when they visit is conducting an exercise in quality assurance (QA) across the whole service, and in a very systematic way. And more to the point, this is something every provider can do themselves on a continuous basis, rather than simply waiting for the next CQC visit.

There are many advantages to doing your own ‘inspections’ or self-assessments, not least that it gives you back a sense of control over the whole QA process, and means you are essentially one step ahead of the game when it comes to CQC inspections. But perhaps even more importantly, it helps you ‘speak the same language’ as the CQC, which is often half the battle when it comes to inspections. This is particularly true if you adopt the same methodology that the CQC uses for its visits.

Therapeia can help you with such self-assessments in a number of ways:

  1. By conducting a full assessment of your service, which involves an onsite visit coupled with a review of all relevant documentation (care plans, policies, training records, etc), which can be carried out remotely where possible.  The aim here is to gather evidence for each of the key lines of enquiry (KLOEs). This is followed by a full report detailing the findings of the assessment and any recommendations.
  2. By providing access to an online Self-Assessment Tool, which allows you to conduct your own self-assessments.  Again, this is based on collecting evidence for all of the service's KLOEs.
  3. An analysis and diagnosis of your own evidence, in order to help you ascertain whether such information is helpful both for your own management needs, and to satisfy the CQC that you are providing a quality service.

Therapeia can provide a full assessment of your service based on the CQC's key lines of enquiry (KLOEs).  The aim is to collect evidence for each KLOE which is then used to make an overall assessment of the quality of the service.  This essentially follows the same process that the CQC uses when conducting its inspections. 

However, unlike CQC inspections, the aim of the assessment process is primarily to provide a learning experience for the service.  Therefore, rather than trying to replicate exactly the same conditions as a 'live' CQC inspection, the focus here is to work closely with the service manager in order to help them gain a better understanding of how safe, effective, caring, responsive and well-led their service is.  And, if necessary, what remedial action they need to take in order to address any outstanding problems. 

The aim of the assessment is not to put the manager and other colleagues under any undue pressure, but rather to help them understand, in a very practical manner, the way the CQC carries out its quality assurance of individual services. This means that when an actual CQC inspection does occur they are properly prepared and know how to access all the relevant evidence. Furthermore, this assessment process can be conducted on an ongoing basis, rather than simply being used to help prepare for CQC inspections.

Each service assessment follows broadly the same pattern:

  1. An initial, pre-visit evaluation of the service, collecting relevant background information regarding the service.  This is similar to the pre-inspection work carried out by the CQC.
  2. An onsite visit to the service for at least one full day, depending on the size and complexity of the service.  This is in order to meet and talk with key stakeholders, including service users, relatives, staff, management and visiting professionals.  It also provides an opportunity to inspect the physical infrastructure of the service and to observe staff-service user interactions.
  3. A review of all key documentation in the service including care plans, risk assessment, policies, training and staff records and other relevant information.  If at all possible this information will be reviewed off-site, i.e. through the emailing/uploading of the documentation.  Again, this in line with much current CQC practice.
  4. A thorough assessment of the gathered evidence, which is then used to write a detailed report with recommendations for the provider.

Therapeia’s online Self Assessment Tool aims to encourage providers and service managers to use the CQC's own inspection methodology in order to conduct their own quality assurance (QA) reviews on an ongoing basis.  It can either be used an an alternative to having Therapeia conduct its own full assessment of your service, or as a follow-up to such an assessment, in order that you can continue the QA process at your own pace.

You can use the tool to collect evidence of quality across different aspects (‘domains’ in CQC jargon) of the service using the CQC’s key lines of enquiry (KLOEs). This allows you to build up a picture (or ‘map’) of quality based on up-to-date information. One of the great advantages of the tool is that you can add and update evidence with a few clicks of the mouse and keyboard. It also means you can essentially conduct an ‘inspection’ or self-assessment of your service on an ongoing basis, and be continually gathering and updating evidence.

By spending only 30 minutes a day using the Self-Assessment Tool, it is possible to build up a complete picture of quality, based on the 25 KLOEs, in less than a month. This is based on the good practice of collecting a minimum of three pieces of evidence per KLOE.

Please take a look at this demo table which shows you the type of information the Self-Assessment Tool can track and record.

The underlying philosophy behind Self-Assessment Tool is quite simple: quality and quality assurance should be at the heart of any service, not just an afterthought or add-on. And remember: CQC inspections are just QA conducted by an external agency, nothing more and nothing less.

Please click here to register an account so you can use the Self-Assessment Tool. And please click here to begin entering your own data.

Please note: you will need to pay a one-off registration fee £249.99 to access and use the CQC Self-Assessment Tool. This price includes any updates to the Tool, as long as these do not reflect any major changes to CQC's inspection methodology. It is also considerably cheaper than hiring someone to come out and conduct an onsite ‘mock inspection’ (though Therapeia can offer this as well!). Please also note: payments are made through the Stripe payment gateway, which is a very tried, tested and secure online payment system.


In addition to providing the full service assessments and the online Self-Assessment Tool, Therapeia can also provide an analysis of the evidence that providers and managers may being collecting, either with the Self-Assessment Tool or their using their own system.  Sometimes it is not easy to be able to interpret the value or relevance of such information, or what it means in terms of a potential rating for the service.  Because of my background in CQC inspections and change management over the last 20 years or so, I feel I am well-placed to give an honest assessment of the evidence, and to suggest any remedial work that may be required to improve service quality.

If you would like to find out more about how Therapeia  help you stay one step ahead, please call me on 07712 176180 or email me.  Alternatively, you can contact Therapeia using the form below.