Evaluation of CQC's local authority pilot assessments

We heard from both the local authorities and the internal team members how the timescales associated with the pilots made the preparation and planning for the assessments particularly challenging and resource intensive. This was exacerbated as it was during peak holiday season and summer recess.

In the later pilots, there was very limited time between fieldwork for each assessment, resulting in little sense of a break between them, which would make the workload more manageable for the assessment team. This also meant there was not enough time to make full use of all the information that was intended to help inform the fieldwork, including:

• elements of the information return and self-assessment
• the provider survey responses
• case tracking information
• other information provided by CQC’s Data and Insight team.

Local authorities also reported not always being clear how these types of information were informing the assessment.

Fieldwork timetables

Organising the timetable for the fieldwork was generally led by the planner role in CQC along with the assessment lead, and by communicating with relevant contacts at each local authority. Although individual mailboxes were set up for each pilot to manage communications with local authorities, at times they became difficult to manage due to the volume of queries and mailbox access being limited to certain team members. A more central way to handle communications is likely to be needed going forwards. There were also some technical issues reported with keeping the timetable up-to-date between CQC and the local authority, partly due to its format but also the fact it was changing so frequently. As such, there was suggestion of finding a way to share the timetable as a live document in future.

The team and local authorities reported that the on-site fieldwork timetables could not be finalised soon enough as the team managed competing demands from different local authorities. In some cases, fieldwork meetings were being confirmed up to the end of the week before the team were due on site. This posed challenges for the local authorities in organising people to attend meetings, especially external partners. There were also some reflections on how this prevented certain groups of people from being included, who would typically require significantly more notice and/or preparation to put them at ease with participating, for example carers. Similarly, organising the staff drop-ins used on some of the pilots were requested too close to the fieldwork. In some local authorities this meant limited time to communicate these to staff and encourage enough attendance. Larger local authorities needed to implement ways of managing the potentially large numbers of staff that might attend so that the assessment team were not overwhelmed and to ensure everyone’s voice could be heard. Some local authorities were keen that in future CQC considers the accessibility of the methods used in terms of people’s time, other commitments, and apprehension in participating.

In the early pilots, the team tested out varying levels of flexibility in how the timetable was prepared. This quickly led to the understanding that CQC needed to take control of this as far as possible. This learning was reflected in the pilots as they went on and appeared to result in fewer exchanges between local authorities and CQC. local authorities reported that CQC was responsive and often accommodating to requests in the timetable. It was also said that some of CQC’s stipulations were not set out early enough, which had a further impact on the planning. For example, that it was preferable that managers did not attend certain meetings with staff groups.

Future ways of working

The team and local authorities both reflected that the fact the assessment was a pilot may have inevitably made certain parts of the process more time-consuming as people gained confidence and momentum in the approach. Equally, as it was still a pilot, although certain ways of working were accepted, neither local authorities nor the team expect them to be sustainable in the future approach, for example local authorities being able to frequently email their lead contact with queries. This is on the basis that such things would be more centrally managed once the approach is scaled-up and alleviated by the fact that processes will naturally become more efficient, together with local authorities becoming more aware of what is expected of them. While this should improve, all local authorities were extremely clear that, overall, the process had been very resource intensive, and while they now have the benefit of having experienced this process and know what to expect, most local authorities will not have.