Key Lines of Enquiry

The Key Lines of Enquiry are the 5 areas which a  provider gets inspected on.  These  come out of the regulations. Being the KLOE they can be added to taken always moved around unlike  the regulations.  But it sis important to look at how  your processes align with he Key Lines of Enquiry. There are 2 frameworks one for healthcare and one for social care. 

Develop you processes and see how they align with the regulations and Key Lines of Enquiry. 

The five areas which are looked at are Safe, Caring, Effective, Responsive and Well Led. The way I remember them is using the pneumonic SCREW 

SAFE

Here you need to show you have robust systems in place. These should include for safeguarding and recruitment. Safe a key are looked at here is Safeguarding. Safeguarding is seen as everyone’s responsibility. The Registered manager should be trained to level 3 other staff dependent on their roles can be at level 1 or 2 most staff should be level 2. 

Recruitment  and induction is key to have safe staff who are fit persons. Values based recruitment is important and a robust Induction as well as a robust training regimen.  I always say asking staff to read key policies is not enough you have to check competency too, ask at 3 key questions on the policy to ascertain understanding.  

You need to show that you have good risk management processes in place which are appropriate for the activity being undertaken. 

If you are responsible for medicines management you need to show how that is being done, and that staff are trained adequately and their competency checked. 

CQC know that even with the best processes in place things can go they want to know how you deal with the situation.  Are lessons learnt and how do you prevent  the issue arising again. Do you  talk about lessons learnt at meetings?

How do you manage Infection control this needs to be appropriate to the service you provide. For instance  infection control in a care home is different to a person home. Clinics will need different levels of infection control protocols dependent  on the level of treatments provided 

EFFECTIVE 

CQC want to know if you are an effective organisation . Do you have a good induction process in place. 

They want to know how you assess care and treatment. Is it evidence based following current practice and legislation. 

How will you monitor outcomes of your clients, have you discussed their outcomes with them?

ARE you checking that your staff have the right level f knowledge and skills to undertake the treatment procedure or activity. 

They also want to know that your staff work well in teams whether that is internal or external. To me external is those other health professionals you work with like GP, OT to deliver effective care 

 Where the service is responsible  howe will you help people to lead healthier lives?

Is consent taken consistently inline with legislation and guidance

If staff handover is required for your activity how is this managed. I have seen some very poor practice in this area. 

Is supervision undertaken? How often is it in an effective way?

If you are responsible for peoples Nutrition and Hydration is this done well is it in a person centred way.

CARING 

How will the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed? I always say how would you like your loved ones to be treated. 

Do you support clients to express their views? And actively encourage them in the decision making process 

Is people’s privacy and dignity be respected and promoted?

RESPONSIVE

How will people receive personalised care that is responsive to their needs? Do you take account of the particular needs and choices of different people? Can people access care in a timely manner.

If you look after people at End of Life how do you manage this process?

Do you have process for complaints and do you make your client’s aware of this? Is it provided in a Accessible Format if require? 

WELL LED 

Do you have leadership and capacity to sustain high quality care and treatment

Does the Management team have strategy and plans for robust delivery of outcomes 

What is the culture of the organisation? 

Is there a governance framework in place which is managed well 

Is there a system for ensuring  performance what happens when these are below par?

Are the people who use the services supported 

Is there a continuous improvement  strategy in place. 

So you see there is a lot to think about but it helps to do this in advance and look at what CQC are looking for. Some people come to me sating they wan t help with application  however they have not done this pre-requisite work .

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