Post on 03-Feb-2016
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Partners in Care Conference February 2012Debbie Westhead
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Background
Regulator for health and social care – created in April 2009
Putting people, their families and carers at the centre of everything we do
Doing things differently – by using information to target poor provision
People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights, wherever care is provided and wherever they live, despite changes in the system
Role of a regulator
The regulation system
Regulation
Adult social care
NHS
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Innovative use of information
Reduced overall cost
Single system of registration
Single set of standards – the essential standards of quality and safety
Strong enforcement powers
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4Independent
health care
CQC – what CQC does and does not do
What CQC does not do
We do not make assessments of commissioning – although we can comment on
shortcomings via themed reviews and investigations
We do not assess quality above essential standards
We only promote improvement by focusing on non-
compliance
Inspectors are encouraged to describe what they see,
comment on good practice and reference it
CQC’s role
Register – inspect – enforce – publish
CQC registers care providers then checks whether they are meeting essential standards
If not, we take action – they must put problems right or face enforcement action
We publish what we find as quickly as possible
We share what we know with our partners
We put a premium on users/ whistleblowers
We monitor the care of those detained under the MHA
About us
We look at outcomes: a person’s experience of care
We involve people who use and provide services and listen to their voices
We use a wide range of sources of evidence and use local networks and intelligence
We focus on how care is delivered
We are responsive – taking swift action to follow up concerns
We carry out unannounced visits
Where we are now
Since launch in April 2009 we have introduced a new and radically different regulatory system for health and adult social care in England
We have registered the NHS (April 2010), independent health and adult social care (October 2010), and in dental and independent ambulance services (April 2011)
We have implemented a complex piece of legislation against a series of inflexible Parliamentary deadlines
We have developed and rolled out new systems, processes, methodology, guidance, new ways of public reporting
We are still processing high volumes of new providers and variations to existing registrations
GP registration on hold until April 2013
CQC in a changing environment
We have had a challenging external environment – but we are acknowledging mistakes and adapting to changing circumstances
CQC was set up as a risk-based regulator – but the public and providers want regular inspection across the board
We have committed to review and evaluate our model and have received additional funds from government to do this
We have listened to challenges to our regulatory model
We seek to strengthen and simplify our regulatory model to improve how we inspect and take action
Our approach will continue to be outcome-focused, responsive and risk-based but in addition we want to:
inspect most providers more often
focus our inspections on the relevant standards
take swift regulatory action to tackle non-compliance
Consultation on our proposals began in September 2011 and will end in December 2011
Refining our regulatory model
Principles ofinspection
New approach to inspections
Timely
At least once a year or once every two years depending on the provider
Focused
Inspections will focus on outcomes that are important
to people using services
Flexible
We can use different types of inspection to respond to concerns
Unannounced
We do not notify providers before we carry out inspections
How we gather evidence to monitor compliance
Looking at outcomes, a person’s experience of the care they receive
Involving people who use services in our reviews of compliance
Using a wide range of sources of evidence
Focusing on how care is delivered
Being targeted and responsive – taking swift action to follow up concerns
How we capture information
We hold a Quality and Risk Profile on each provider summarising all relevant information
The Quality and Risk Profile enables us to assess where risks lie and prompt front line regulatory activity, such as inspection
As new information arrives, it is added to the profile and assessors and inspectors are alerted to take action proportionate to the risk
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Forms of regulation
How can meeting essential standards drive improvement?
Concern
As part of CQC’s Dignity and Nutrition Inspection programme our inspectors judged the respective trust as being non-compliant :
Outcome 1 - respecting and involving people
Outcome 5 - meeting nutritional needs Outcome
CQC’s inspection prompted the trust to address concerns and take a broader look at the care they provided
They said, "it (CQC’s inspection) really helped us think very differently about how we make sure our patients are receiving the care they should.”
The state of health and social care in England: an overview of key themes in care in 2010/11
How can meeting essential standards drive improvement?
Concern
Last November, friends and relatives of several older people with dementia contacted CQC to share their experience of poor quality care at a care home.
CQC found 8 of the16 essentials standards were not being met, including:
Outcome 4 – Care and welfare of people who use services
Outcome 9 – Management of medicines Outcome
A new manager was employed by the home to address the various issues identified.
On our return to the home two months later, our inspectors found that the
situation has significantly improved.
The state of health and social care in England: an overview of key themes in care in 2010/11
Enforcement
It is the duty of health and social care providers to ensure compliance at all times
Should a provider not be compliant with the standards required, CQC can:
give a warning notice
impose conditions
suspend registration of some services
issue a fine
prosecute
close services by cancelling registration
CQC is cost blind
New CQC website
New site developed with the help of our inspection staff, the public and providers – launched October 2011
Improved, accessible information for the public, the site features a dedicated section for organisations we regulate
Every provider and location has a profile page where we publish our reports, latest judgments about the care provided and latest regulatory activity
People visiting the site have access to detailed information on services including full reports by inspectors and information from people who have used a service
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How it looks
• Consumer focused
• Clear about what we do/can offer the public
• Focused on ability to look up location level reports/see major action we’re taking
• Information for providers and corporate information clearly signposted
Health and Social Care Bill 2011, ALB review 2010
CQC well placed in Bill – joint licensing with Monitor; working with Clinical Commissioning Groups, NHS Commissioning Board, NICE, ADASS and other major players
Creation of HealthWatch England – ‘Consumer champion’ within CQC for health and adult social care services in England. Independent body within the regulator. Start date 1 October 2012
Arm’s Length Bodies review – taking on new responsibilities:
Human Fertilisation and Embryology Authority
Human Tissue Authority
HealthWatch
Local Government Information Board
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Closing comments
The public puts its faith in those who run and work in care services
There must be a culture that won’t tolerate poor quality care, neglect or abuse – and encourages people to report it
The regulator cannot be everywhere, so we need to regulate with others
We remain cost blind in checking standards
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Questions
CQC – Helping make care better for people
www.cqc.org.uk
Questions?