This week, I have been reflecting upon my experiences using the CQC Portal with a provider client. Anecdotally I was aware of the very real limitations of the portal but this has been my first personal experience of directly submitting a Factual Accuracy Response following an assessment and receipt of a draft assessment report. It was fraught with challenges and there is no doubt in my mind that this must severely be hampering CQC’s abilities to carry out their statutory functions properly. Not only was it incredibly time-consuming and frustrating for providers, it is not a system that is fit for purpose in its current state.

2,000 Character Limit

It surprised me that each quality statement was only given a 2,000-character limit (including spaces) for the provider’s response. This equates to roughly 300 words.

This undoubtedly will be helpful for the CQC team reviewing the response but increases the burden on providers to respond fully but also concisely and clearly. Careful but comprehensive wording to responses will be vital.

If it is genuinely not possible to fit your response within the 2,000-character limit in the boxes, providers could consider putting their response in a separate document and uploading it as evidence. It will be important for this response to be very clearly labelled to make it easy for anyone reviewing the response to interpret.

Navigating the form

The form was set out clearly and had a useful guide down the sidebar of the screen. However, unfortunately it did not allow for easy navigation between the pages. In order to get back to the first point, we needed to click through the entire assessment. We found this time-consuming and confusing. It was yet another barrier to submitting a clear coherent response. We would recommend that providers allow plenty of time to input the response in good time ahead of any deadlines.

Hopefully a click through menu will be facilitated soon as it would make navigating the form significantly clearer for providers and would save a significant amount of precious time.

Saving Answers

We would strongly encourage providers to draft their responses on a separate word document in order to have a record of their responses.

In our experience, this was absolutely essential. We got to the final stage of clicking through to the review and submit answers page numerous times. Each time we tried, we had to go through the entire process clicking through each response again. We found that it mostly saved our responses, but sometimes it didn’t pull them through. If this happens to you, we would urge you to double-check the responses and use your separate document to make sure that they are properly populated prior to submission.

It is accepted that this was a tedious exercise, which we conducted several times, but when you are responding it is important to make sure that responses are correctly inputted into the CQC form.

Attaching Evidence

One of the most important things that struck me was the way it appeared that evidence could only be attached at each quality statement. There was no opportunity to attach any evidence to the overall service commentaries. Furthermore, it initially appeared that only one piece of evidence could be attached per quality statement. We had three audits to attach in relation to one particular quality statement, and I was frustrated that it didn’t seem to allow me to attach them all.

However, when I ultimately got to the submission page, it became apparent that we had accidentally attached the evidence every time I had tried to submit the page and had attached multiple documents many times by accident.

Once a document has been submitted, there is no way to remove it or replace it.

It goes through to the CQC system immediately. The only way to tell what has been attached is in the review page (which incidentally proved very hard to get to). The title of the enclosure shows up on the summary. It was embarrassing but I had no way to remove the duplications.

This is of significant importance for providers when responding to CQC. It is essential that providers upload the correct documentation and that they attach any evidence that is supportive of their case. Supporting evidence is key to any Factual Accuracy response.

Providers are not limited to one item per quality statement. It will seem that it has disappeared but the summary page will show what has been uploaded.

We would recommend creating a folder of the evidence and checking it very carefully prior to submission. Remember anything that is uploaded, cannot be removed. Make sure you have the correct version and only disclose what you intend to share with CQC.

Finalising the response and submission

The most frustrating element of the portal process was undoubtedly final submission. We had been working hard to populate the form in the format required by CQC and were ready to submit but when we got to the review responses page, we were thwarted. Each time we clicked on that button we received an error message and were kicked out of the portal. It was a hot Friday afternoon and we had tried repeatedly for some time with no success.

Eventually, after numerous attempts, we relented and sent the FAC response on a word document with the supporting evidence via email to the Inspector and CQC enquiries to ensure that the deadline was not missed.

We were informed on the next working day that CQC are no longer accepting responses via email and an extension was granted. Interestingly on the portal the extension granted was almost three weeks later. Bizarrely this extension was more than the initial time providers are given to respond in the first place.

We did submit the response via the portal ultimately. It required a great deal of patience when clicking review responses and waiting for the page to respond. It did take about five minutes but at least it did not kick us out of the portal this time.

Additionally, there was no option to download my responses upon submission so we would urge providers to carefully check through and then print the review page to PDF and save a copy on your files prior to submission.

What to do if you encounter technical difficulties?

It is clear to me that the current portal is simply not fit for purpose and everyone I have spoken with about it has had complaints. It doesn’t appear to have been tested and implemented carefully. As has been pointed out to me on many occasions, providers would be sure to be penalised for poor governance if this were to happen in their services.

CQC Inspectors are painstakingly aware of these limitations and, in my experience, have genuinely been trying to rectify the IT issues but are constrained by the systems being used.

While the system is evidently not suitable, the onus will remain on Providers to ensure that they are compliant with the regulations and they are able to evidence this.

Should you experience barriers to communicating with CQC via the portal, be it notifications or FAC responses, we would urge you to communicate directly with your inspector and to keep records of these attempts. If the portal is not working and you are unable to submit something in time, do send emails and keep records of your efforts.

Conclusion

We would urge providers to voice their concerns to CQC directly and to be savvy when submitting anything on the portal. Above anything, please take extra care when submitting evidence to accompany any responses and allow yourself plenty of time when attempting to do anything with the portal. We are happy to assist providers to respond and have extensive experience navigating difficult situations with the regulator.

While the portal is extremely frustrating at the moment, it does have the potential to make responding to draft assessment reports easier for providers. It is such a shame that it has not been tested properly and is fraught with difficulties. Not being able to submit the response on the portal but only accepting responses via the portal is simply inexcusable. My hope is that it will be rectified by CQC as a matter of urgency, and soon, this will be a matter of the past, but for now, we will all simply have to do our best to work around it.

 

About the Author

Lucy Bowker

Lucy Bowker

Solicitor

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Lucy is a regulatory lawyer acting for health and social care providers within the firm’s Health and Social Care Department. Clients include care homes for adults, domiciliary care agencies, children’s homes, nurseries, childminders, Pre-schools and independent hospitals.