Adult Social Care Inspections, a CQC Update Sue Howard Deputy Chief Inspector Central National Care Homes Congress 19 May 2015
Our purpose and role Our purpose We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve Our role We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care 2
Our new approach 3
The 5 key questions we ask Is it Safe? Is it Effective? Is it Caring? Is it Responsive? Is it Well-led? 2
Rating four point scale High level characteristics of each rating level Innovative, creative, constantly striving to improve, open and transparent Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong Significant harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve 5
What is new since April 2015?! Fundamental standards! Fit and proper person requirement! Duty of candour! Special measures! Scores on the doors! Market oversight 6
Duty of candour! Purpose! Promotes adoption of openness and transparency in services! Supports development of safety culture! Actions for providers! Inform people when things go wrong! Provide support, truthful information & apology! CQC! Registration! Inspection existing key lines of enquiry 7
Fit and proper person requirement! Purpose! Ensure directors or equivalents are held accountable for the delivery of care and! They are fit and proper to carry out this role! Actions for providers! Ensure recruitment of directors tests whether candidates meet the requirement! CQC! Registration! Respond to concerns raised 8
Special measures! Purpose! Ensure failing services improve or close! Actions for providers! Use time available to improve service! CQC! Services rated as inadequate will go into special measures! Time limited period to improve! If improvements made out of special measures! If no improvement move to cancel registration 9
Scores on the doors! Purpose! Public able to see rating of service quickly and easily! Actions for providers! Display ratings in service and website! Suggest accompany with additional information! CQC! Will provide template! Inspection check that rating is displayed 10
What will market oversight do? Purpose:! Protect people in vulnerable circumstances by spotting if a provider may fail and make sure right action is taken CQC will:! Monitor finances of difficult to replace providers 40-50! Provide early warning to local authorities! Assist with system response if failure occurs It will not:! Either bail out struggling providers, or pre-empt failure through inappropriate disclosure of information 6 11
A new approach 12
Safety and leadership 13
Adult social care 14
Findings since April 2015 Hospitals 3 Outstanding Adult Social Care services 20 Outstanding Primary medical services 23 Outstanding 62 Good 85 Requires Improvement 11 Inadequate 2020 Good 1139 Requires Improvement 294 Inadequate 584 Good 77 Requires Improvement 24 Inadequate 15
Ratings by key question 16
Services rated inadequate themes 46 services: 27 nursing homes, 19 residen/al homes Source: CQC Inspec/on Reports Q1 3 2014/5 17
Ratings by service type 18
Ratings by size of care home 19
Ratings by manager turnover or absence care homes 20
CQC s journey in 2015/16 Remaining focused on registration and ratings, while protecting people who use services. 1. Regulating new care models. 2. Looking at the quality of care pathways. 3. Looking at quality of care in your locality Identifying, championing and sharing good and outstanding practice. Encouraging collaboration, joined-up care and improvement across local areas and organisations. 21
Regulating new care models Registering care providers and assessing delivery of safe, effective, responsive, caring & well-led services. Developing a more modern and efficient online registration process. Working with Five Year Forward View vanguard sites to understand how we can assure high quality and encourage improvement. Sharing our learning and good practice with providers and the public. Reinforcing to providers CQC s expectations about joined-up care centred around the people who use services. 22
Looking at Quality of Care Pathways children s services Using thematic reviews to better understand care pathways and the outcomes they achieve for people Delivering multi-agency inspections prisons secure settings Working to better understand how to assess coordinated care provision, including how commissioning affects quality urgent care diabetes care in the community mental health crisis care care for older people end-of-life care 23
Quality of care in your locality By the end of 2015 we will have inspected the majority of all health and adult social care services in some local places, allowing us to bring together inspection findings across sectors to describe how well people in those communities are being served by their local health and care system. We will carry out this approach in two places in 2015/16. We will develop a comprehensive picture of the quality of care in a local place and identify issues (including the quality of leadership, funding and commissioning) that need to be addressed at the cross-organisational level as well as at the provider level. 24
Thank you www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm 25