“This report sets out the Care Quality Commission’s (CQC’s) assessment of the state of care in England in 2019/20. We use data from our inspections and ratings, along with other information, including that from people who use services, their families and carers, to inform our judgements of the quality of
care. Most of the analysis in this report is generated by CQC, specifically:

Quantitative analysis of our inspection ratings of more than 31,000 services and providers, drawing on other monitoring information including surveys to engage staff and the public including using CQC’s online participation platform. In previous years, we have used ratings as at 31 July, to enable as contemporaneous a view as possible. Because we suspended our routine inspections and ratings in March 2020 as a result of the coronavirus pandemic, the ratings in this report are as at 31 March 2020 and all comparisons with the previous year are with ratings as at 31 July 2019.

A programme of primary qualitative data collection and analysis to gather evidence to inform the messages of this report. Through this work, we have heard from 153 people through focus groups or interviews with CQC inspection colleagues and external stakeholders. All interviews and focus groups took place between February and April 2020. Due to the timing of the data collection, these evidence sources represent a pre-pandemic view. We adopted the following methods and objectives for this work:

− Thematic analysis of 22 focus groups, four interviews and five written responses. These were conducted with CQC inspection colleagues and representatives from local Healthwatch and supplemented by a small number of interviews with other external stakeholders. Focus groups with inspection colleagues operating in each of the seven NHS England/Improvement regions aimed to gather insight about cross-sector working and successes and challenges at a regional level. In addition, interviews and focus groups with external stakeholders in each of the regions aimed to explore what stakeholders understood to be the primary successes and challenges for their local health and social care systems. The discussion focused on pre-defined themes: access, local communities and innovation. Analysis identified high-level findings related to these three themes.

− Thematic analysis of two focus groups with a total of 19 CQC inspection colleagues, including mental health and adult social care inspectors and Mental Health Act reviewers with a particular knowledge and interest in Deprivation of Liberty Safeguards (DoLS). Acute hospital inspectors were unable to take part due to operational pressures relating to COVID-19. The work aimed to provide insight into CQC’s knowledge about the operation of the DoLS system this year. We also carried out secondary qualitative analysis of 100 care home and 40 hospital inspection reports to understand what good,  poor and improvement in DoLS practice looked like.”

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