What are the CQC standards of care for the NHS?

The Care Quality Commission (CQC) is the independent regulator in England for health and social care. As an independent body, the CQC checks healthcare organisations to see if they meet the mandatory care standards.

Besides detailed descriptions on how hospitals, GPs and more should comply to safety standards, the CQC has also outlined 13 fundamental care standards. They are:

1. Person-centred care

Care or treatment must be tailored to the individual and must meet the individual’s needs or preferences.

This fundamental care standard we can clearly see highlighted in the NHS Personalised Care plan and the Five Year Forward View. Within the latter sits the social prescribing service. What matters to the person stands at the heart of the care delivered by social prescribing link workers.

Even more, NHS England has made it a point to stimulate person-centred care by, amongst other things, involve people in their own care. This level of patient participation has seen growing support and evidence. Part of NHS England’s strategy is offering the right conditions so person-centred care is enabled both from the NHS as well as the individuals themselves.

2. Dignity and respect

An individual must always be treated with dignity and respect when receiving care and treatment. The CQC lists three main items care providers need to take into account (though this is not an exhaustive list):

• Everyone is treated as equals
• A person can have privacy when they need and want it
• An individual is provided with support they need to help retain independence and involved with their local community

This care standard has seen positive results, following a 2019 survey conducted by the CQC. The survey looked at 75,000 adult inpatient individuals who had been discharged from hospital in 2019. Amongst the findings was an increased improvement in being treated respectfully and in a dignified manner in England.

3. Consent

Consent must be provided before any care or treatment is given. This must be done by either the individual who is given treatment or anybody who is legally acting on the behalf of that person. Consent must be voluntary and must not be influenced by medical practitioners, family or friends.

Secondly, consent must be informed, meaning that a person must receive all of the information about what a treatment involves, both the benefits and the risks.

Finally, the person receiving treatment must have the capacity to understand the information health professionals give and use it for informed decision-making.

Consent spans the wide range of offered healthcare interventions, such as medical prescriptions by a GP to an operation at a hospital.

There are certain exceptions to the above, for instance in the case of emergency treatment to save a person’s life. You can read on these and more on the NHS website.

4. Safety

An individual must not be given unsafe care, unsafe treatment or be put at risk of harm, which could be prevented.

Providers of healthcare services must evaluate the risks to individuals’ health and safety during any care or treatment. In addition, they must ensure their staff have the right qualifications, skills, competence and experience to keep a person safe.

5. Safeguarding from abuse

People must not suffer any form of improper treatment or abuse when receiving care, including:

• Degrading treatment
• Neglect
• Inappropriate limits on a person’s freedom
• Unnecessary or disproportionate restraint

NHS England has made it a point to address two specific groups that in particular need protection:

• Children and young people,
• and adults at risk due to for instance learning disabilities or physical impairments.

6. Food and drink

While receiving care and treatment, a person must have enough to eat and drink to keep that individual in good health.

As part of this standard of care, food and drink of an individual must meet nutritional needs and people’s preferences as well as religious and cultural backgrounds must be taken into account. Examples are:

• A patient who is on a halal diet
• A patient who is on a kosher diet
• A patient who is on a vegetarian diet

7. Premises and equipment

Locations where people receive care and treatment as well as the equipment used inside these places must be clean, suitable and looked after properly.

This standard of care is relevant to a host of relevant items, ranging from the physical tools a surgeon uses to gas safety maintenance and decontamination to prevent and control the spread of infections.

8. Complaints

An individual must be able to complain about their care and treatment.

The provider of a person’s care must have a system in place, which allows them to handle and respond to complaints. They must investigate these complaints thoroughly and take action if problems are identified.

9. Good governance

Care providers must have plans that ensure they can meet the 13 fundamental standards. Effective governance and systems must be in place to check on the quality and safety of care. These must help the service improve and reduce any risks to people’s health, safety as well as welfare.

10. Staffing

Care providers must have enough suitably qualified, competent and experienced staff to ensure the provider can meet the fundamental CQC standards.

Closely linked to this standard of care is training and informing care staff. One way in which the NHS does so is via NICE guidance. NICE is short for National Institute for Health & Care Excellence. The guidance as set out offers relevant staff guidelines for individuals who suffer from a specific condition or need. NICE guidance are evidence-based recommendations.

11. Fit and proper staff

Related to the 10^th standard of care, fit and proper staff means that care providers must only take on staff that can provide care and treatment as appropriate to their role. Providers must have strong recruitment procedures in place and carry out the relevant checks, e.g. on applicants’ criminal records and work history.

12. Duty of Candour

Duty of Candour is one of the more recent agenda items, as this item entered UK legislation in 2014 following incidents in Stafford that had been kept under the radar.

Duty of Candour means care providers must be open and transparent about the care and treatment they deliver to people. If something goes wrong, providers must tell the person (or their families/carers etc.) what happened, offer support and apologise.

13. Display of ratings

Care providers of individuals are obliged to display their CQC rating in a place where it can easily be seen. They must include the rating on their organisation’s website and provide people with the latest CQC report on their service.

In practice, there are different ways in which organisations do this. UH Bristol as an example has posted it under their ‘Key Publications’ underneath the menu item ‘About us’. Royal Wolverhampton decided on a similar category below their ‘About Us’ and labelled it ‘Our Performance’. In some cases organisations would show their CQC rating at the bottom of their webpage, e.g. Allerton & Westfield Medical Centres.

At the time of writing, these fundamentals have been last updated on the CQC website May 2017. For a full overview and further details on what these standards entail and how and where they apply, we recommend reading the information as presented on that website.