What is the CQC Caring KLOE, and how can you achieve a Good or Outstanding rating?

As of April 2024, the CQC launched the single assessment framework across all health and social care providers. This framework has included a number of changes to the way the CQC perform inspections and provide a rating. Therefore the information below may contain some outdated information. For the latest information on what has changed and what you need to know, please head here.

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As a home care agency, we know that you continually strive to be a service that cares. However, in practice, ‘caring’ can mean different things to different people – one of the ongoing challenges you face in maintaining high standards in home care.

To help you prepare for your CQC inspection, we’ve outlined the various Key Lines of Enquiry (KLOE) on which you’ll be assessed. In this article, we’re going to focus on the CQC Caring KLOE framework and the requirements for a good or outstanding CQC rating.

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What are the key elements of the CQC Caring KLOE?

The CQC Caring KLOE examines how caring a service is. The CQC says that,

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“By caring, we mean that the service involves and treats people with compassion, kindness, dignity and respect.”

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So, what does this mean for your home care agency?

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‍As well as providing physical care to your clients, you also need to demonstrate how you care for their emotional needs. Your service must have a culture of caring, where staff always show respect and kindness to the people around them.

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As a service, the CQC also expects you to consider the needs of the people within your team and anyone they come into contact with, including relatives, volunteers, and other professionals.

Let’s take a closer look at the three criteria of the CQC Caring KLOE and how to achieve a ‘good’ or ‘outstanding’ rating in each. 

The CQC asks:

“How does the service ensure that people are treated with kindness, respect and compassion, and that they are given emotional support when needed?”

What does this mean for you?

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Staff must show empathy and personalised care for every individual in their care - not only at the time of inspection, but all the time. The CQC considers the opinions of the adults receiving care, their families, and other professional bodies to gain a broader picture of staff attitudes, so a caring approach must be at the core of all you do.

Inspectors will be looking for the creative ways your service recognises:

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• Personalities
• Cultural beliefs
• Personal histories
• And interests

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Birdie's About Me profile is a great way to digitally record and recognise these attributes. Following a structured template, designed to help you ask and record person-centred questions, the new About Me profile covers a broader spectrum of questions around gender, ethnicity and religion, giving you the tools to get the full story of the person sitting in front of you, when on-boarding. Carers can also use this to get an understanding of the client before a visit. It can help start conversations, break the ice and improve trust between clients and carers. Find out more, here.

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The CQC also recommends matching staff members to clients based on interests and rapport. So, if you have a client who’s a retired football coach, the Sunday-league football player in your team will probably get on well with them and should be the preferred match.

To award an outstanding rating in a CQC Caring KLOE, inspectors will check that you’re paying close attention to The Equality Act protected characteristics, such as age, sex, and disability, and making your service accessible to all (this is a legal requirement, so it’s important to get it right). They’ll also want to see respectful and professional interactions between staff within the team, as well as with clients. 

The CQC asks:

“How does the service support people to express their views and be actively involved in making decisions about their care, support and treatment as far as possible?”

What does this mean for you?

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The CQC inspectors are considering all the people involved in the day-to-day life of your home care agency, including clients, team members, visitors, relatives, and external professional bodies. They want to see a culture of open communication, where feedback is welcome from everyone involved. An inadequate CQC rating can be down to staff not listening to clients or failing to respond appropriately to concerns. The CQC wants to see that you invite feedback and sees complaints as an opportunity to improve.

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Managing expectations and considering multiple viewpoints can certainly be challenging! But it’s a skill the inspectors expect to see from a good or outstanding service.

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You must demonstrate an openness and willingness to listen and to resolve tensions or conflicts as they arise. We know that clients disagree with their relatives from time to time, for example. Rather than stay away from the situation, the CQC is looking for ways in which you help both parties reach a resolution. Don’t shy away from signposting individuals to an independent organisation or advocacy body that can offer additional support if relevant.

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Visits must be long enough for the carer to build rapport and encourage communication with their client. Clients who feel rushed tend to avoid striking up a conversation with their carer. Adequate staffing levels and fair rota systems can help you meet CQC KLOE evidence requirements to show that you provide sufficient time for each visit.

The CQC Caring KLOE recognises that new technologies can also help facilitate communication. People with additional needs, disabilities, or who simply respond well to a creative approach can benefit from innovative communication methods. The Birdie About Me tool allows carers to check the preferred method of communication for every client before they start their visit.

The CQC asks:

“How are people’s privacy, dignity and independence respected and promoted?”

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What does this mean for you?

Carers must maintain privacy and dignity for their clients, particularly when giving physical or intimate care.  Any expressions of pain, discomfort or emotional distress from the client should be addressed quickly and with compassion. As part of the CQC Caring KLOE, inspectors will assess how well your systems support these aims.

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To achieve a good or outstanding rating, you need to show that your staff receive adequate training and support underpinned by key values, such as respect, kindness, compassion, and empowerment. Staff at all levels are expected to uphold client confidentiality, including when working with other providers. Wherever possible, the service must encourage clients to retain independence and make their own decisions around their care.

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 A culture of respect that prioritises privacy and dignity works best when it’s led by management and runs through everything you do as a service. Staff benefit from plenty of training and must feel able to report any behaviour they witness that isn’t in line with this approach.

Barriers to achieving a good or outstanding rating in the CQC Caring KLOE

• Clients or other parties voice concerns regarding the way staff treat others.

• Staff don’t know or have the time to find out about the preferences and histories of the people in their care.

• Carers show a lack of respect or compassion.

• Carers show kindness and compassion, but this is not recognised or supported by the service.

• Staff do not offer details of relevant advocacy agencies or external bodies who may be able to provide support.

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At Birdie, we understand that consistently providing a caring environment for clients can be a challenge for home care agencies. Using the CQC Caring KLOE as a framework can help you shape your policies and practices with the ultimate aim of delivering extraordinary care.

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