Bournemouth Poole Safeguarding Adults Board Sally Newell and
Bournemouth & Poole Safeguarding Adults Board Sally Newell and Nicky Simpson 26 January 2017
About CQC: our purpose The Care Quality Commission is the independent regulator of health and adult social care in England. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. 2
About CQC: our role • We register health and adult social care providers • We monitor and inspect services to see whether they are safe, effective, caring, responsive and well-led, and we publish what we find, including quality ratings • We use our legal powers to take action where we identify poor care • We speak independently, publishing regional and national views of the major quality issues in health and social care, and encouraging improvement by highlighting good practice 3
Scope of CQC’s remit Care homes and domiciliary care 12, 500 providers 25, 500 care homes Hospitals and clinics Ambulances 245 NHS trusts 250 independents 1, 500 independents Primary dental care Primary medical services 8, 000 providers 9, 000 providers England’s population is 53 m 10 NHS trusts • 1. 75 million people use adult social care • 11 million NHS and 1. 6 million independent inpatients • 22 million dental patients per year (15 m NHS, 7 m private)
Ambition for social care: The Mum Test (or Anyone You Love test) Is it effective? Is it responsive to people’s needs? Is it safe? Is it well-led? Is it caring? Is it good enough for my Mum? 5
Our 5 key questions 6
What do the overall ratings mean? Outstanding The service is performing exceptionally well. Good The service is performing well and meeting our expectations. Requires improvement The service isn't performing as well as it should and we have told the service how it must improve. Inadequate The service is performing badly and we've taken action against the person or organisation that runs it. 7
So far we have found. . 100 (75%) 50 (22%) (1%) 0 Inadequate Source: CQC – 11 January 2017 Requires improvement Good Outstanding 8
…and by key question Safe 4 Effective 2 Caring 1 Responsiv e 2 Well-led 29 24 89 19 0% Source: CQC – 5 September 2016 <0. 5 73 8 4 <0. 5 67 2 2 78 26 20% 1 69 40% 60% 80% 100% 9
How do CQC determine the rating? There are characteristics for each rating, with separate characteristics for residential and community services. Is the service responsive? Good rating • • People describe the service as good. People receive consistent, personalised care, treatment and support. People are involved in developing their care and support plans. Care is focused on people’s whole life, including their goals, skills and how they wish to be supported. • People are protected from the risks of social isolation and supported to keep relationships with people who matter to them.
How do CQC determine the rating? • Is the service responsive? Outstanding rating There additional characteristics that make the service exceptional and distinctive. People describe the service in these terms. • People tell us staff have outstanding skills and excellent understanding of their social, cultural, values and beliefs and how this may influence how they wish to receive support. • People’s care and support is planned proactively in partnership with them. Staff use innovative and individual ways of involving people. • Professionals tell us the service achieves exceptional results. • Staff find creative ways to enable people to live as full a life as possible. • The service takes a key role in the local community. People are supported to attend events outside of the service.
Themes from services with an overall rating of Outstanding • People are at the centre and staff want to give them a life not just a service • Good leadership extends beyond the manager and those values are cascaded to inspire staff • Open culture – people who use services/ staff/ relatives shared views and issues • Strong links with local community • 75% have registered manager in post • A can do, will do attitude – staff dedication • Safe care actively promoted – effective oversight of care and staff communication 12
Passion Excellence Integrity Cooperation Common themes from ‘well-led’: Outstanding “This place is brilliant, management care so much, as do the staff, everybody knows their role and the atmosphere is amazing. ” “I’m made to feel important, I’m constantly encouraged to always better myself. ” CQC Published reports – sampled for data on well-led. Sample size 177, 50 services with outstanding ratings (all outstanding ratings for well-led when the sample was extracted) for and 127 for services with inadequate ratings for well-led. 13
Prince of Wales House, Ipswich innovative and creative commitment by managers to continually improve ‘My Story’ booklets give detailed biography of a person – with the clear message that their lives do not stop when they move into care vibrant and friendly environment staff are motivated by a strong culture of inclusivity care is person-centred considers individuals and their views and preferences management inspire confidence and lead by example strong and visible leadership
Themes from Well-Led– Inadequate • Unawareness of best practice and notifications not being made to CQC • Lack of supervision and training opportunities • Ineffective systems to identify and manage risks / no process to assess lessons learned • Regular management changes / no registered manager • Poor care planning / lack of personalised care • Closed culture – views not listened to or acted on • Underdeveloped partnership working and community links CQC Published reports – sampled for data on well-led. Sample size 177, 50 services with outstanding ratings (all outstanding ratings for well-led when the sample was extracted) for and 127 for services with inadequate ratings for well-led.
Duty of Candour Being open Transparent Providing reasonable support Informing people about the incident Providing truthful information An Apology when things go wrong When things go wrong with care and treatment 16
When things go wrong Death Severe / moderate harm Psychological harm 17
Guidance for providers to display ratings 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 18
Display of ratings A Provider Why? Public able to see rating of service quickly and easily Where? Providers should display in prominent area in public view and on website CQC will send a template for completion and display CQC will check this during inspections 19
Why do we place a service in special measures? Service is rated inadequate Inspection Service is placed in special measures Service is rated inadequate for one of 5 key questions Service is given up to 6 months to improve Second inspection Service has improved and is rated requires improvement or above Service has not demonstrated sufficient improvement Service is placed in special measures 20
Our enforcement powers • Requirements (formerly known as compliance actions) • Warning notices • S. 28 warning notices Severity Protect people who use services by requiring improvement Civil enforcement powers • Impose, vary or remove conditions of registration • Suspension of registration • Cancellation of registration • Urgent procedures Failing services • Immediate action to protect from harm • Time-limited ‘final chance’ • Coordination with other oversight bodies Protect people who use services by requiring improvement Criminal powers • Penalty notices • Simple cautions • Prosecutions Holding individuals to account • Fit and proper person requirement • Prosecution of individuals Hold providers to account for failure 21
Ambition Our ambition for the next five years: A more targeted, responsive and collaborative approach to regulation, so more people get high-quality care 22 22
Four priorities to achieve our strategic ambition 1. Encourage improvement, innovation and sustainability in care 2. Deliver an intelligence-driven approach to regulation 3. Promote a single shared view of quality 4. Improve our efficiency and effectiveness 23
Remember why we do this…… Copyright: Community Care 24
Reviews of care 2015/16 25
Reviews of care 2015/16 More to come…. • Integrated urgent care 26
Thank you To keep up-to-date with developments: Subscribe to receive our monthly bulletin: http: //www. cqc. org. uk/content/get-our-newsletter Follow us on Twitter: @CQCProf Join our provider online community to share your views: www. cqc. org. uk/organisations-we-regulate/getinvolved/join-our-online-communities-providers 27
Thank you www. cqc. org. uk enquiries@cqc. org. uk @Care. Quality. Comm Sally Newell Inspection Manager 28
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