The Care Quality Commission (CQC)

The Care Quality Commission (CQC) register, inspect and regulate health and social care services in England and were identified as one of the best placed organisations to undertake the initial baseline assessments. Their expertise in regulation and inspection supports the development of independent external assessments.

A Service Level Agreement (SLA) was signed and CQC were commissioned to assist with recommendation 3 and conduct baseline assessments in adult social care (ASC), primary medical services (PMS - including GPs, dental care, minor injuries and out of hours) plus acute (hospital based) and community services and Hospice care.

CQC were able to assess the majority of the services Manx Care deliver or commission, however there are some that CQC do not regulate and therefore fall outside of their scope.

CQC engagement and activity

Work with CQC on the island was undertaken in three phases.

The initial scoping exercise mapped out the bespoke end-to-end process to fit services on the Island.

CQC staff and specialist advisors held a series of workshops and face to face meetings across Manx Care, DHSC and commissioned services to understand what engagement was required and how CQC would apply its current assessment methodology to the nuances of health and care on the Isle of Man.

Question and Answer (Q&A) sessions were held to communicate directly with the providers, CQC and DHSC regarding the assessments.

A Dental, General Practice and Acute pilot assessment was conducted and the assessment framework shared to be disseminated for feedback.

Phase 1: Validation, scoping exercise, methodology workshops and engagement (July – November 2021)

Phase 2: Discovery, self-assessment, framework co-production and Pilots (December 2021 – March 2022)

Phase 3: The initial baseline assessments (April 2022 – March 2023).

What the CQC inspectors assess

Prior to an assessment taking place the DHSC, Manx Care and CQC have been in communication with the service to prepare the documentation for the assessments and discuss the CQC assessment process. There have been no unannounced assessments at any service.

Inspectors assess services to ensure they provide safe, effective, compassionate and high-quality care, taking into consideration the specific requirements of the Island.

Observations and analysis consider all aspects of services including:

patient safety
effective governance processes
the level of compassion and dignity afforded to people using services
the outcomes following people’s care, treatment and support

Any assessment day is ‘business as usual’ and management and staff should work as they normally would. Staff can explain clearly to patients and service users who the inspectors are.

As part of the assessment process CQC have contacted people using the services, employees working in the services that observe care, individual care pathways, records, documentation, policies, the locations where people are cared for and assess employee records. This information helps to form the baseline of the level of care being delivered and we encourage this as an opportunity to share your views.

Inspectors followed the 5 key lines of enquiry - Safe, Caring, Responsive, Effective and Well- led and each area was assessed with its own bespoke co-produced framework including the feedback from local area specialists.

If CQC are concerned about people’s immediate safety during a visit, an escalation process is followed, to report the findings to the DHSC and Manx Care to investigate the matter further as outlined in the Manx Care Act 2021.

CQC assessment timeline

Adult Social Care – 24 April to 12 August 2022

43 x Adult Care Homes, Adult LD Care Homes & other Social Care Services

Dental Surgeries – 4 to 15 July and 29 November 2022

13 x Dental Surgeries

General Practice Surgeries – 26 July to 8 November 2022

13 GP Surgeries

Hospice End of Life Care – 31 October to 4 November 2022

Integrated Mental Health – 1 to 4 August 2022 and 31 January to 1 February 2023

Acute (Hospital) and Community Services

Comprehensive 3 to 6 October 2022
Manx Care Well-led 24 to 28 October 2022

The Well-led assessment of Manx Care is an assessment of; leadership and governance at board and executive team level, overall organisational vision and strategy, organisation-wide governance, management, improvement, organisational culture and levels of engagement.

CQC are a regulator of health and social care in England and do not have enforcement powers on the Isle of Man.

CQC assessment reports

Reports produced by CQC are at provider level for acute/secondary care and location level for all other services. When the factual accuracy process with services and internal CQC quality review is complete, the report is shared with the DHSC and the Manx Care Board. Reports cover CQC’s findings against the five key questions detailed in the assessment frameworks.