How we inspect services: adult social care services

Residential services

Comprehensive inspections

The inspector reviews the information we hold about the service and contacts relevant stakeholders and professionals for their feedback before carrying out an inspection site visit. During the site visit, the inspector speaks with people using the service and their visitors, staff, volunteers and visiting professionals to assess all of the key questions. They also review relevant records and inspect the layout, safety, cleanliness and suitability of the premises, facilities and equipment.

Focused inspections

Focused inspections broadly follow the same process and use the same methods as a comprehensive inspection, but focus on one or more specific key questions (always including well-led) rather than all of them.

Community services

Comprehensive inspections

The inspector reviews the information we hold about the service. They contact people who use the service, care staff, relevant stakeholders and professionals for their feedback. They do so by telephone or by visiting them in person. The inspector will also either visit the service’s office or will use technology to review relevant records virtually.

Focused inspections

Focused inspections broadly follow the same process and use the same methods as a comprehensive inspection, but focus on one or more specific key questions (always including well-led) rather than all of them.

Changes to our methods of inspecting from 2021

In some cases, we'll use phone and online methods to help us carry out our inspections. This means we will not always need to visit in person. For everything else, we will continue to follow our existing practices in our inspection, rating and enforcement activity.

We piloted this approach with home care (domiciliary care) services and extra care housing services in 2020. To begin with, we will continue using it to assess these types of provider.

How we use remote technology to inspect home care (domiciliary care) services and extra care housing

We sometimes use phone and video calls and other types of remote technology to carry out inspections. This means we may not need to visit your service in person.

We only use this type of inspection for home care (domiciliary care) companies and extra care housing services. We will not use this approach for shared lives or supported living services.

The main difference between this approach and our usual inspections is that we do not visit your office. Apart from this, these inspections work the same way as our standard targeted, focused or comprehensive inspections.

The inspector will look at each provider individually to see what type of inspection is appropriate. You cannot request to have an earlier inspection using remote technology. If you would prefer not to have an inspection using remote technology, you can talk to your inspector about it.

It's important to understand that this type of inspection can still result in a change to a rating.

How to submit information to us

Our inspector will talk to you about the options for how to share information with us. They will do this at the start of the inspection or during a planning call.

Ways to share information include:

• by secure email
• by screen sharing over a video call
• using a secure portal (SFTP).

We prefer to use the secure portal. If we use this method, our inspector can set up an account for you and show you how it works.

If you have any technical problems, it's important to let your inspector know as early as possible. They may decide to visit your service in person instead.

How long the inspection takes

An inspection using remote technology is more flexible for you and the inspector. It should take about the same time as a standard inspection.

We aim to work within the following timescales:

• five working days to gather evidence
• two weeks to produce the draft report

How we talk to staff and people who use the service

When we inspect using remote technology, we:

• use phone and video calls to speak to the manager and other staff
• use email, phone and video calls to contact people who use the service and get their consent - we'll discuss this with you in advance
• encourage you to ask people that use your service to give feedback about their care through our online form

What happens after the inspection

At the end of the inspection, the inspector will send you their feedback by email. They will discuss this with the manager or provider by phone or video call. This will happen within five working days after we have finished gathering evidence.

You will have the opportunity to comment on the draft report following the usual factual accuracy process. We will then publish the report and rating on our website, which will make clear that we did not carry out a site visit.

Why we use this way of inspecting

We carried out a pilot in late 2020. This helped us to test the benefits of using technology in this way. It assured us this that the approach was an effective way of assessing performance.

We consulted on the roll-out of the approach in January 2021.

Our use of the word 'inspection' in this context

For the time being, we are referring to these as 'inspections'. They are actually 'performance reviews' as set out in our duties under section 46 of the Health and Social Care Act 2008 (the Act). As well as our duties under section 46, we have a power to inspect under section 60 of the Act. This power specifically relates to the use of site visits, so 'inspection' legally means using a site visit to gather evidence.

We think 'inspection' makes more sense to the public than 'reviews', so we will keep this language for now.

Feedback on the visit

The lead inspector (and possibly other members of the inspection team) will meet with the registered manager and/or other appropriate members of staff to provide feedback. Where possible, this meeting will take place in person at the end of the visit. However, when this is not possible or practical, the lead inspector will arrange a mutually convenient time to provide feedback over the telephone or a video call. This will be high-level initial feedback only, illustrated with some examples.

At the meeting with the registered manager and/or other staff, the inspector will:

• thank them for their support and contribution and tell them about any issues that were escalated during the visit or that require immediate action
• tell them if we need additional evidence or if we need to seek further specialist advice to make a judgement
• tell them about any plans for follow-up or additional visits (unless they are unannounced)
• explain how we will make judgements against the regulations
• explain the next steps, including how we process the draft inspection report
• answer any questions from the provider.

This feedback will not include information about ratings. We will carry out further analysis of the evidence before we can reach final judgements on all the issues and award ratings. The site visit is one element of the inspection, and information may be received after the site visit, which we may report on.