Preparing for and undertaking care assurance visit

Quality of care review guidance

Care assurance visits (CAVs) are integral to local care assurance processes which assure high quality, safe and effective, person-centred care and will complement existing leadership walkrounds which boards currently undertake. They are an opportunity for clinical leaders to focus on the quality of care delivery, identify areas of good practice and those requiring targeted support and improvement. An area may also opt to invite colleagues from a neighbouring clinical area or Board to undertake a CAV, peer review.

For a description of where CAVs fit within the local processes for care assurance see the diagram below.

 

Levels of care assurance

Peer review - across all levels
Executive / board level
(leadership walk round)
Clinical area/service
(CAV)
Team leader level
(care assurance audit)
Organised visits with senior leadership teams to areas with a focus on quality and safety. The aim is to connect with front line staff and provide a platform for open dialogue, mutual learning and idea-sharing.
Clinical nurse/ midwifery managers/ professional lead carry out observational visits speaking with staff, patients and relatives with a focus on quality of care. Utilising the EiC framework to focus and articulate when improvements are needed.
Senior charge nurse/ midwife/ team lead carries out regular audits using local templates and or information from systems e.g. Care Assurance Improvement Resource to review data and document actions and quality improvements.

 

The CAV tool describes how each of the elements of the EiC framework can be used during a visit to a clinical area to inform observations and conversations with staff and people in receipt of care/families. The CAV template can be used to record reflections during the visit. This can be used to identify and agree with local team the areas to celebrate/share, the priority areas requiring support and improvement planning.

Not all elements of the EiC framework will be relevant for each CAV. Using professional judgement, you can select the number of relevant elements to use on the visit.

Preparing for a care assurance visit (CAV)

  • Consider the focus of the visit. Use the QoC review guidance - sections:
  • Board to consider if a review is scheduled/proactive or responsive: determine whether to be announced or unannounced for the host team
  • Preparation for host team: outline the purpose as part of local care assurance process, share the scope, identify who will be visiting, share date, time and duration of visit, outline what to expect and request to share information with multi-disciplinary teamsand people in receipt of care, family and visitors regarding the visit
  • Building capacity and capability in local teams: consider the opportunity to involve peers, colleagues and aspiring leaders
  • Identify and consider information from previous walk rounds or reviews: Health and Safety, IPC, culture of the area
  • Consider use of other validated tools: 15 Steps, psychological safety

Undertaking a care assurance visit (CAV)

  • Engage staff at different levels, from different disciplines: promote attendance from MDT
  • Engage people in receipt of care and family/visitors
  • Observe and discuss delivery of care: using the Elements of EiC framework to structure observations (see template to record observations/discussions)
  • Identify alignment between policy/best practice and your observations of care
  • Consider the physical environment: noise, IPC integrity of the fabric of the clinical area and equipment
  • Consider the Output/Summary: via professional judgement, RAG rating
  • Identify areas to celebrate/share, priority areas requiring support and plan for improvement
  • Feedback to teams: consider Stage 6 of QoC review process - consider when, how and who will be involved, support requirements, improvement plan development and how to thank the host team for engagement