- Published: 02/11/2022
- Contains public sector information licensed under the Open Government Licence v3.0.
Over the next few months, we will be exploring the CQC key lines of enquiry by each question and sharing resources we think you might find useful.
Sources of evidence: what CQC inspectors look at against each KLOE
By effective, the CQC mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.
Questions
E6.1 How are people involved in decisions about the environment?
E6.2 How do the premises meet people’s diverse care, cultural and support needs?
E6.3 What arrangements are there to ensure people have access to appropriate space:
- in gardens and other outdoor spaces
- to see and look after their visitors
- for meaningful activities
- to spend time together
- to be alone?
E6.4 How does the signage, the decoration and other adaptations to the premises help to meet people’s needs and promote their independence? How are any changes to the environment managed to avoid causing distress to people who live there?
Potential sources of evidence
People & their carers, friends and relatives:
Feedback about:
- The premises are suitable, comfortable, and meet people’s needs.
- People are listened to and involved in decisions about changes.
Customer Feedback
- Share your experience forms.
- Information of concern enquiries.
Staff
- Discuss suitability and accessibility of the building and grounds for people.
- Ask about planned changes and improvements.
Observation / Tour of the premises
- Clean, fresh, hygienic, odour free, good repair & upkeep of communal areas,
bedrooms, hallways, corridors, bathrooms, dining rooms, kitchens. - Promotion of privacy and dignity.
- Functioning locks in WCs and bathrooms etc.
- Adaptations to meet the needs of the people who live there (for example people who
live with dementia, sensory impairment, disability, physical frailness); signage,
orientation aids, accessibility, adapted baths/showers/WCs, hand rails. - Adequate and safe storage areas.
- Safe, secure & accessible garden areas.
- Window restrictors above ground floor level.
- Wardrobes secured to wall.
- Call bells in reach. Clean and odour free bedding, mattresses & clothing in cupboards and wardrobes.
- Disposal arrangements for continence products.
- Personal protective equipment available and in use; gloves, aprons.
- Cleaning products locked away.
- Hand washing/cleaning, paper towels.
- Communal equipment available, stored safely and accessibly – wheelchairs, hoists, slings, transfer boards.
- Laundry, waste disposal facilities and arrangements (including clinical waste).
- Any unnamed items in bathrooms and cupboards.
- Appropriate segregation of waste, with bin bags.
- Food in kitchen fridge stored safely.
- Suitable refrigeration arrangements for relevant medicines.
- Fire exits clear of obstructions, signposted, accessible.
Records and policies
- Meeting notes and minutes referring to buildings and grounds discussions. Cross refer to any case files and accident / incident records.
- Complaints and compliments.
In Specialist Colleges
Ratings characteristics
- Outstanding
The service uses innovative methods to engage people in discussions and decisions about the environment they live in or use. This means people’s environment reflects their individual preferences and culture, and supports their needs in the way they choose.
The service is designed around people’s needs and wishes and uses innovative ways to help people to be as independent as possible. Where possible or appropriate, people are encouraged to help with decorating or furnishing the premises.
There are different areas for people to use for their preferred activities, and private space to spend time with their families or visitors, or to have time alone. All areas are maintained and decorated to a high standard, in a way that people have asked for, and take into account people’s cultural needs for how the space is used. Space is maximised and used creatively to promote independence.
New equipment and technologies are used to support the delivery of high-quality care and independence. This is personalised so the equipment used is the most suitable for individuals. People are able to do more things independently, or carry out existing tasks more comfortably, easily or quickly.
- Good
People are involved in decisions about the premises and environment, regardless of their ability to communicate.
Individual preferences, and cultural and support needs are reflected in how premises are adapted or decorated.
People have access to outside space that has been assessed for risks, a quiet area to see their visitors, an area suitable for activities and private areas when people wish to be alone. Decorations and adaptations to the premises are laid out in a way that is accessible and helps to promote independence.
Specialist or adaptive equipment is made available as and when needed to deliver better care and support. People are helped to make choices about adaptive equipment.
The service uses technology and equipment to meet people’s care and support needs and to support their independence, in line with their best interests.
- Requires improvement
The service involves those people who can easily communicate their wishes in decisions about the environment, but people who cannot communicate easily are not involved and they are not asked for their views. When changes are made to the environment, these are often made without consultation.
People’s cultural and support needs are not always taken into account when the premises are adapted or decorated.
The physical environment is not decorated or adapted to a consistent standard to meet people’s needs, or can feel impersonal. Facilities and premises are not designed in an accessible way. Private space is not always available for people to spend time with visitors or spend time alone. Gardens and other outdoor spaces may be inaccessible, and risk assessments have not been carried out or are out of date.
Some specialist and adaptive equipment is provided, but this is not always available. The service is not aware of innovations in new technology and equipment in care and support and of the positive impact this can have on outcomes for people who use the service.
- Inadequate
The service makes decisions about changing or altering the environment without involving the people who use the service, or considering their cultural or support needs.
The facilities and premises do not meet people’s needs or help maintain their independence. There is limited accessible space for people to use, and the service does not carry out risk assessments where the environment may have an impact on people using the service.
The service has not adapted the premises to improve people’s quality of life and promote their wellbeing.
There is no specialist or adaptive equipment available and this compromises people’s safety, dignity and treatment. The service does not see the benefits of technology for improving the outcomes for people who use the service.
Does your service need some support with making sure you have the policies, processes, and evidence to respond to the CQC to achieve your desired rating?
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