Care Quality Commission

Essential Standards of Quality and Safety

What does this mean for me?

Version 2.0 (18.6.13)

There are 16 Quality and Safety Standards (also referred to as Outcomes) and these are grouped into 5 domains:

•	Involvement & Information
•	Personalised care, treatment & support
•	Safeguarding & Safety
•	Suitability of staffing
•	Quality & Management

The CQC can make an assessment visit, unannounced, to the Trust at any time and it is important we can demonstrate that we provide the highest standards of patient care, at all times.

CQC Inspectors will speak to patients, relatives and staff and will observe patient care.

It is important all staff understand the outcomes and what this means in their daily practice and that they are prepared should a CQC inspector visit their ward or area. 

This booklet is intended as a helpful guide to what the CQC Essential Standards mean to each member of staff.

Outcome 1: Respecting and Involving people who use care

People understand the care and treatment choices available to them. They can express their views and are involved in making decisions about their care. They have their privacy, dignity and independence respected, and have their views and experiences taken into account in the way in which the service is delivered

Things to consider:

•	Do I involve patients in their care plans by explaining their treatment, options and care?
•	Do I give relevant information leaflets/contact details to patients?
•	Do patients on the ward participate in decision-making about their care and treatment?
•	Do I give patients information about the risks and benefits of alternative treatments?
•	Do I document in the patient’s record when they have discussed their treatment options or when they have given them information?
•	Do patients sign their care plan/assessment to confirm that they have been involved and understand their treatment?
•	Do I know how to access interpreter services?
•	Am I up to date with my Equality and Diversity training?

Outcome 2: Consent
People give consent to their care and treatment, and understand and know how to change decisions about things that have been agreed previously

Things to consider:
•	Do I understand when we need to obtain written consent?
•	Do I understand when we can take verbal and/or implied consent?
•	Do I know how to document and keep records of consent?
•	Can I identify people who cannot give valid consent?
•	Do I respect people’s decisions and respond appropriately to those decisions?
•	Do I provide sufficient information (of benefits and risks) to enable valid consent to be obtained?
•	Do I understand when it is appropriate to respect the confidentiality of children?
•	Do I document assessment of capacity if the person is unable to consent?
•	Do I consult with relatives if the person lacks capacity to consent?
•	Am I up to date with my Mental Capacity Act training?
•	Have I read the Consent policy?
•	Can I apply the procedures within my practice to effectively ensure valid consent is obtained?
Outcome 4: Care and Welfare of people who use services

People experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

Things to consider:
•	Do I involve patients in their plan of care or treatment?
•	Do I explain the risks, benefits and alternatives of treatment?
•	Are care plans regularly reviewed, taking into account all aspects of welfare and wellbeing?
•	Do I give patients my name, job title and contact details?
•	Do I know how to report an error or incident regarding the care or treatment I give a patient?
•	Do I give patients (or people acting on their behalf) information to enable them to make choices?
•	Do I act upon safety alerts?
•	Do I know what to do in the event of an emergency?

Outcome 5: Nutrition

People are encouraged and supported to have sufficient food and drink that is nutritional and balanced, and a choice of food and drink to meet their different needs.

Things to consider:

•	Do I support patients who need help with food and drink?  
•	Do I assess, plan and monitor patients’ nutritional and hydration needs and is it documented in the care plan? 
•	If patients are assessed as 'at risk' do I take the correct action? 
•	Do I help ensure patients have a choice of food and drink?
•	If relevant to my role, have I completed food hygiene awareness training?

Outcome 6: Cooperating with other providers
People receive safe and coordinated care when they move between providers or receive care from more than one provider.

Things to consider:
•	Do I know what information I should share with other services/providers? 
•	Do I document the information I have shared on the patient’s file? 
•	Do I know how to share information securely? 
•	Have I completed Information Governance training? 
•	Have I signed the Confidentiality Code of Conduct?
•	Do I dispose confidential waste correctly? 

Outcome 7: Safeguarding people who use services from abuse
People are safeguarded from abuse, or the risk of abuse
and their human rights are respected and upheld.

Things to consider:
•	Do I know who to contact if they have a concern regarding an adult or child that they need to discuss? 
•	Do I know how to report a concern regarding an adult or a child? 
•	Do I know how to escalate concerns if I believe that other professionals have not responded to my concerns appropriately? 
•	Do I know what to do if I think someone is unable to consent to treatment? 
•	Am I up to date with Safeguarding Adults/Children training?
•	Do I understand the role and know when to instruct an IMCA?

Outcome 8: Infection control
People experience care in a clean environment and are protected from acquiring infections.

Things to consider:
•	Do I always wash my hands/use gel before touching a patient? 
•	Do I know how to ensure equipment is decontaminated appropriately after use? 
•	Do I know who to contact in the event of an infection control concern? 
•	Have I read the Infection Control and the Decontamination Policy? 
•	Have I  attended Infection Control training? 
•	Is my Hand Hygiene training up to date?

Outcome 9: Medicines Management
People have their medicines when they need them
and in a safe way. People are given information about their medicines.

Things to consider: 
•	Do I update patients’ records with medicines information? 
•	Do I know how to obtain advice on medicines? 
•	Do I know what procedures to follow for controlled drugs? 
•	Do I know how to report a medicines incident? 
•	Do I act on drug alerts related to medicines? 
•	Do I receive and act according to the latest Standard Operating Procedures? 
•	Have I received Medicines training?
•	Am I familiar with the relevant sections of the Medicines Policy?

Outcome 10: Safety and suitability of premises

People receive care in, work in, or visit, safe surroundings that promote their wellbeing.

Things to consider: 
•	Do I undertake site risk assessments when appropriate? 
•	Do I know what to do in the event of emergency evacuation from the building? 
•	Have I attended Health and Safety and Risk Assessment training? 

Outcome 11: Safety, availability and suitability of equipment
Where equipment is used, it is safe, available, comfortable and
suitable for people’s needs.

Things to consider: 
•	Do I only use equipment that I am competent to use?
•	Have I carried out any checks that are needed before using this equipment?
•	Does our service have enough equipment to meet clinical needs? Do I speak to senior staff to raise concerns?
•	Do I know and follow the Trust’s policy on single use, and single patient use, devices?
•	Do I make sure that malfunctioning equipment, or equipment that I am concerned about, is taken out of use and repaired or maintained?
•	Do I report any safety incident involving Medical equipment, and quarantine the equipment?

Outcome 12: Requirements relating to workers
People are kept safe, and their health and welfare needs
are met, by staff who are fit for the job and have the right qualifications, skills and experience.

Things to consider: 
•	Do I have a Personal Development Plan (PDP)? 
•	Is all my mandatory (MAST) training up to date?

Outcome 13: Staffing
People are kept safe, and their health and welfare needs are met, because there are sufficient numbers of the right staff.

Things to consider: 
•	Is the monitoring and recording of staffing levels robust?
•	Do I raise concerns regarding staffing levels with an appropriate line manager?

Outcome 14: Supporting workers
People are kept safe, and their health and welfare needs are met, because staff are competent to carry out their work and are properly trained, supervised and appraised.

Things to consider: 
•	If I am new to the organisation, have I attended corporate and local induction? 
•	Do I have regular supervision? 
•	Have I had an appraisal in the last year? 
•	Do I report any incidents of bullying, harassment or violence? 
•	Do I know how to raise concerns (the Whistleblowing process)? 
•	Have I attended Appraisal/Appraisee training?

Outcome 16: Assessing and monitoring the quality of service provision
People benefit from safe, quality care because effective decisions are made and because of the management of risks to people’s health, welfare and safety.

Things to consider: 
•	Do I change a patient’s care plan if a risk is identified of inappropriate or unsafe care or treatment? 
•	Do I know how to raise concerns about risks to people, poor practice and adverse events? 
•	Do I participate in clinical audits and share learning from these with the team? 
•	Do I report incidents when they occur? 
•	Do I and my team learn from incidents, comments and complaints? 
•	Do we discuss action plans and lessons learnt at Team Meetings? 
•	Have I read the Incident Reporting policy?

Outcome 17: Complaints

People, and those acting on their behalf, have their comments and complaints listened to and acted on effectively, and know that they will not be discriminated against for making a complaint.

Things to consider: 
•	Do I seek out patient feedback and make changes as a result of it?
•	Do I know where to find information on the complaints process to give patients? 
•	Does my service/team learn from complaints and comments and make changes as a result of them? 
•	Do we discuss complaints at Team Meetings? 
•	If I am responsible for responding to complaints, have I attended complaints training?

Outcome 21: Records
People’s personal records are accurate, fit for purpose, held securely and remain confidential. The same applies to other records that are needed to protect their safety and wellbeing.

Things to consider: 
•	Do I document verbal discussions about care, treatment and support on the patient’s file? 
•	Do I link new patient records with any previous records that exist for that patient? 
•	Do I ensure that all patient records are up to date, accurate, and kept confidential? 
•	Am I familiar with the archiving process? 
•	Are records stored and transferred securely according to our policy? 
•	Have I completed Record Keeping training?