Key Lines of Enquiry, or KLOEs for short, is the framework used by the Care Quality Commission (CQC) to assess whether a care home is providing the best quality of care. 

There are five different KLOEs that apply to every health and social care setting: safe, effective, caring, responsive and well led. Against each of these KLOEs, the CQC rates a care provider as either outstanding, good, requires improvement or inadequate. 

The CQC will also give a separate rating for the organisation as a whole.  

In this article we’ll explore how each KLOE is assessed, some common inspection pitfalls to avoid and how the CQC’s approach is changing in light of the Covid-19 pandemic.  

What each KLOE means 

Is your service safe?  

Is your organisation and its residents protected from abuse and avoidable harm?

Is your service effective? 

Do your care, treatment and support achieve good outcomes? Do they help you to maintain quality of life and are they based on the best available evidence?

Is your service caring?  

Do your staff treat your residents with compassion, dignity, kindness and respect?

Is your service responsive?

Is your service organsied to meet people’s needs?

Is your service well led?

Does the management of your organisation make sure you’re providing high-quality care that's based around your residents’ needs? Do you encourage learning and innovation and do you promote an open and fair culture?

Five top tips for meeting each KLOE

When care providers fall down in their CQC inspections, more often than not it tends to be in one of the following five areas. 

Focus on these points, document your approach and you’ll be in a great position.  

  1. Recruitment practices.

Make sure that all staff in your home have the appropriate robust recruitment checks.  This especially includes agency staff. You can check out how Florence ensures compliance with CQC recruitment practices here.

  1. Resident safety.

Risk assess, risk assess, risk assess!  When it comes to resident safety, it’s essential that you can demonstrate your understanding of risk and how your organisation takes steps to minimise that.  Now more than ever, risk assessment around your infection control procedures is critical.  

  1. Resident experience.

Be able to demonstrate that you have a good process around how you handle complaints and gather feedback from your residents and their families. Remember, receiving complaints isn’t bad - it’s an opportunity to improve the experience for everyone!

  1. Training and supervision.

With so many things going on, staff training can fall by the wayside - but being able to evidence how you’re continually looking to upskill your staff is critical. If you need help with this, you can sign up to Florence Academy for free. Here your staff can do hours of eLearning that’s recorded in one simple ePortfolio.

  1. Medicines management.

Make sure you have a robust system in place for dealing with medications. Many care providers are now using eMAR systems to manage their entire medication lifecycle.  

What are PIRs?

PIR stands for ‘Provider Information Return’. It is a standardised form that usually must be completed annually in order to comply with CQC regulation of your care home.  It gives the CQC background on how your service runs and allows them to plan their inspection.  

As a result of the Covid-19 pandemic, the CQC have changed the way they inspect care homes and instigated their ‘Transitional Monitoring Approach’. This replaces the normal process around preparing for and planning inspections. This includes the completion of a PIR.  

How have things changed?

As a result of the Covid-19 pandemic, the CQC has changed the way in which they monitor services. Rather than inspecting all services in the same way, they are triaging their inspections and focussing more on services where they have concerns. They are bringing in a renewed focus on safety, leadership and access to services.

Rather than through regular completion of a PIR, instead CQC inspectors will gather information by arranging a video call with you. This will take 1-2 hours and they will ask you different questions centred around each KLOE. They’ll probably ask you to provide evidence for some of the points in your discussion at the time of your video call or via email.  

Based on the outcome of this video call and the information gathered, the CQC will either decide whether or not to proceed with a full inspection or other action. If no further action needs to be taken, they will issue you with a monitoring summary record. This is not an inspection report and does not give your home any ratings.  

On the other hand, should the CQC decide that further action needs to be taken then they may proceed with a full, traditional inspection.  

Conclusion

There are lots of things that are up in the air at the moment and the way the CQC inspects care homes is no exception. Whilst the PIRs may no longer exist and every conversation seems to happen on Teams, the core KLOEs remain the same - focus on your home being safe, effective, caring, responsive and well led.  

If you’ve got any questions about this or how Florence might be able to help you through these challenging times then please do get in touch. You can reach us on [email protected] or by calling 020 3911 2555.