Homecare is an essential part of the care sector; it is also very complex to regulate. As the Care Quality Commission work towards an updated framework, some of the suggested updates raise challenges for homecare services.
Here are the challenges we are seeing providers navigate right now, and some practical thoughts on how to stay ahead.
Some homecare services have already been offered remote inspections rather than in-person visits. The feedback from providers has been broadly positive; many have said they felt more in control of the process and found the overall experience better.
The key take-away is that inspection does not have to feel like something that is done to you. Remote formats can actually shift the dynamic, giving your team more space to present evidence clearly and respond thoughtfully. If your service is offered a remote inspection, go in with a plan rather than treating it as second-best.
One of the more significant structural issues facing homecare right now is that
the current (soon to be retired) Single Assessment Framework does not list observation as an evidence category for homecare services. That makes sense as a carer working in someone's home is not in a hospital ward or a care home common room where an inspector can simply walk by and observe what is happening.
But the new framework signals a shift toward an 80/20 split, with observation making up the larger share of evidence. How that applies to homecare is still an open question. One scenario already emerging in practice, is some CQC inspectors actively seeking consent to visit people in their own homes and speaking with them directly. That is a significant change, and providers need to be thinking about it now rather than when an inspection is already under way.
One of the exciting developments in the proposed new version of the CQC assessment framework is a move to sector specific frameworks including an adult social care specific framework. However, the adult social care specific framework does not currently distinguish between service types. Chris Badger has cited homecare as an example where a more tailored version of the framework and inspection approach would be genuinely useful in the longer term. That direction of travel is encouraging, but it is not here yet.
This means there may still be some negotiating around how the framework works in practice for homecare services- an open dialogue with you CQC inspector will be key to ensuring the inspection approaches taken, work for your service.
Make it easy for CQC to hear from the people you support. Do not wait for an inspector to figure out who they can speak with. Keep a clear record of people who have given consent to be contacted, whether by a home visit or by phone. Doing that groundwork in advance takes the pressure off during inspection and shows CQC that you have nothing to hide.
Think carefully about how you prepare your staff. In a care home or supported living setting, an inspector can walk in and have an informal conversation with a member of staff in the corridor. Homecare does not work that way. Your staff are dispersed, often working alone, and an inspector cannot simply bump into them. That means you need a deliberate plan: who might be contacted, how they might best speak with CQC (e.g. in person at the office or over the phone/online), what staff need to know, and how you make sure they feel confident rather than caught off guard.
The regulatory landscape for homecare is shifting, and some of those shifts introduce genuine ambiguity. The providers who will fare best are those who treat inspection preparation as an ongoing process rather than a last-minute scramble. Good evidence, well-organised teams, and a clear picture of the people you support are your strongest assets.
Discover more about Log my Care and how we can support your homecare service with technology that always keeps you CQC ready.
Care Surveys works with homecare providers to make sure that evidence is there when you need it. If you want to talk through how your feedback processes line up with what CQC is looking for, get in touch with them.