Tools and GUIDEs

CQC provider information return (PIR)

Often dreaded, the Care Quality Commission (CQC) provider information return (PIR) can feel like a sign of impending doom – you’re about to be inspected! But fear not! The PIR is your time to shine – so, read our guide to help showcase the outstanding care you’re providing.

Leighton Osbourne
Content & SEO Manager
Published on:
22/5/2020
· Last Edited On:
5/9/2022
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8-minute read

The big changes

You’ll only have to do a return once a year

The PIR is no longer sent out ahead of an inspection in the way it used to be. You’ll be asked to complete your PIR annually, on the anniversary of your first inspection. The CQC will send you a link to fill it in and you’ll have 4 weeks to get it completed.  

Because of this new approach, you can work out when it’s going to land - and that means you can get yourself prepared!

You can download a practice version from CQC’s website and can effectively work on it all year before you need to send the real one off. So, you can really polish it and hone it to perfection, because this is your chance to show the CQC how great your service is, before they inspect you.

This is especially invaluable if you have a new inspector or if you have a unique service that doesn’t shoehorn into the usual categories e.g., foot care. It’s not uncommon for CQC inspectors to struggle with how services like that should be inspected.

The more they know about you before they arrive, the better.

Completing your PIR

Let’s take a look at some of the more challenging sections of the PIR. For the purposes of this guide, we’ll look at the ‘Community Services’ and ‘Residential’ versions of the return, which are virtually identical until you get to section 5 on quality assurance.

Before we begin, bear in mind that many questions in the PIR require you to put in a number or a date and so on. If there are any questions in your practice version that ask you about data you don’t currently collect, make a point of starting to collect it. This way, when you are asked to fill in your real PIR, you will at least have some data to put in here.

1. Successes and barriers to good care

This section is about the changes you’ve made to your service in the last 12 months and what changes you've got planned for next 12.

The key term in these questions is impact.

They’re actually asking what’s the impact of these changes on the people you support.

So, you don’t need to describe in great detail that new accounting system you’ve purchased or the electronic care plans you’ve adopted – think instead about how it improves the service:

  • Does it mean you’ve eliminated invoice errors and identified needs that weren’t visible before?
  • Does your change mean your team is more responsive to variations in people’s needs and you’re now 100% confident people will always get the right medication all the time?

Consider even the smallest of changes you’ve made if it means it’s had a positive impact on people’s experience.

A word of caution here though - don’t ever make it up!

Never put anything in your CQC PIR that you can’t back up with factual evidence or actually show an inspector. You can big up your service by all means, but if the reader likes the sound of it, they may ask to see it or be shown the improved outcomes etc. so make sure you have the evidence.

2. People who use your service

A big part of this will focus on the dignity, fairness, respect, autonomy and equality of your clients.

For example, you’ll be asked about care needs and preferences. So, if you state that 8 people who use your service have a communication need or a specialist diet:

  • Make sure your documentation not only supports that fact, but also shows how you’re working with all of them to ensure they’re not disadvantaged in how they receive, or give communication to your staff, and demonstrates how they get meals that are appropriate, healthy, varied and of their own choosing.
  • Don’t make a rod for your own back by failing to adapt your service to meet needs you’ve actually identified, because your inspector will pick you up on this.

Similarly, you’re asked about recording information about safeguarding, notifications, use of restraint etc. Make sure that any numbers you put in are backed up by documentation and can withstand cross-referencing because again, you can be sure that the inspector will do this.

Next, you’ll need to describe how you’ve improved the service to meet the needs of people with protected characteristics as well as how you implement and apply human rights principles. The devil is in the detail here, just think about your service users with protected characteristics and try to think about the changes you’ve made to support them.

If you really can’t think of anything you’ve done, then at least think of something you could do, implement it and record it. The same goes for human rights – if you can’t think of anything around dignity, fairness, respect, autonomy and equality that you currently do, then your practice version gives you time to implement something.

5. Quality assurance and risk management

Here’s where things start to differ.  

The ‘Residential’ version is relatively straight forward, whereas the ‘Community Services’ version is a more open question around how quality is assured in your service. The key here, as with many other similar questions in the PIR, is to be clear, open and honest about what you do – don’t exaggerate or embellish.

Records

Recording and learning are core to this area and are an opportunity to show off your service and how you adhere to a continuous improvement principle. Consider describing working practice – supervisions, training, competencies, team meetings.

Whatever your processes, make sure they show a clear link between recording and learning.

Complaints

For example, let’s look at a typical complaints procedure:

  1. A complaint is received
  2. It’s then logged
  3. A holding response is sent
  4. It’s investigated
  5. An outcome letter is sent (within policy timescales).

Learning from the complaint is not only considered, but also clearly logged. With any change in operational practice communicated to staff and clients as appropriate, and even summarised in your letter back to the complainant.

Safeguarding alerts and serious incidents

Don’t forget to show your learnings from these examples. CQC will love this and think of your service as positive and progressive before they even knock on your door:

  • Have you got a tool that allows you to monitor all of these events and track them fully through your procedures as per your policies?
  • Have you got a self-assessment quality audit tool of some kind, that uses the Key Lines of Enquiry (KLOEs) as a basis for challenging your service and its managers on how well you stack up to the minimum ‘Good’ standard?

If not, create one or invest in a digital solution that does this for you.  

Medicines and controlled substances

You’ll also be asked about medication errors and safety incidents – again really make sure that whatever you put in here you have the full documentary evidence for. They’ll want to see it.

Whilst you are at it, make sure that any notifications to CQC were done and any that involved safeguarding were duly reported. A good reason to start your PIR early is that you can start to link these things together now, whilst you still have months to go before you are asked for the real version.

8/9. Supported living and extra care housing

Whilst the ‘Residential’ version ends here, the ‘Community Services’ version moves on to supported living and extra care housing, including questions on restraint and deprivation of liberty. Once again, make sure your ducks are nicely lined up and don’t describe anything you don’t do. Most importantly, make sure if you’re doing it, it’s properly recorded.

If you’re not sure, a practice version gives you time to find out. There’s a question here whether any deprivations of liberty have been authorised by the Court of Protection. You don’t actually have control over that, but just make sure you can clearly document all of the times you prodded and pushed your Local Authority to process your DoLS referrals, and that you kept on doing it every 6 months or so – just doing it once won’t cut it.

Simple, right?

So, there you have it. It’s a lot to take in, I know. But the sooner you get practising, the easier it will be.

The statistical questions are a bit easier to answer but remember, the open questions aren’t there to catch you out. They’re there for you to show the inspectors how good you are, how positively you impact upon people’s lives, how you seek to continuously improve and of course, to allow CQC to get to know your attitudes to these key issues ahead of any visit.  

If you’re honest and evidence everything you’re doing, you’ll be onto a winner!

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