Dignity Matters Jamie Rentoul designate Director of Regulation

Dignity Matters Jamie Rentoul, designate Director of Regulation & Strategy Care Quality Commission 25 November 2008

Ensuring better care for people

What is CQC ?

What is CQC? · We will bring together and build on the excellent work of three commissions · As a new, combined and powerful regulator across health and social care, our work will touch the lives of everyone in England at some point · People who use services, their families and carers will be at the heart of everything we do

The CQC model of quality care · Safety and safeguarding · Outcomes, including clinical outcomes · Experience of people who use services · ‘Functionality’, independence and quality of life · Access to services · Making best use of our resources

Our values · Put the people who use services first · Be independent, expert and authoritative · Champion joined-up care · Work with service providers and professions to agree definitions of quality · Be visible, open and transparent

Building on success – key functions · Registration · Provider assessment · Risk-based inspection · New enforcement powers · Commissioner assessment · Trusted, accessible information · Gatekeeping role · Knowledge to influence policy

How can CQC play its part in promoting dignity in health and adult social care?

How do people define dignity? Not being given food or help with eating/drinking Being spoken about as if they were not there I don’t believe it. !!! Being placed in a mixed sex accommodation Not seeking their consent and/or not following their wishes Not being given proper information Lack of protection of personal property including personal aids – hearing or visual Being addressed in an inappropriate manner Being subjected to abuse and violent behaviour Being left in soiled clothes Being exposed in an embarrassing manner Having to use premises that are unclean and smelly – toilet and wards Being in a noisy environment at night thus causing lack of sleep There is no standard definition of ‘dignity’. Being left in pain

How good is existing care? ‘State of social care’ – personal dignity & respect: - 74% of councils ‘good’ or ‘excellent’; - 88% of care homes meet relevant standards. Surveys of people in healthcare settings: - 78% always treated with dignity in acute hospitals; - Over 80% treated with respect & dignity in community mental health services; - 93% of those seeing a GP treated with dignity ‘all of the time’; but… - 20% of those needing help to eat did not get it; - Significant proportion still sharing accommodation when first admitted or sharing bathrooms later on; - Considerable variation between providers of care.

Dignity in care – the golden thread Dignity is an integral part of providing care in any care setting. Dignity is central to the personalisation agenda. Maintaining dignity does not always require resources, small changes can make a big difference to people. Dignity is fundamental to CQC’s human rights based approach

Caring for dignity – building blocks ØInvolving people in their care ØA culture focussed on delivering personal care in a way that ensures dignity for the person using services ØA workforce that is equipped to deliver good quality care ØStrong leadership at all levels ØSupportive environment Source: “Caring for Dignity”, Healthcare Commission 2007

Who has a role in improving quality? National Quality Board Commissioning ADASS Other Regulators Performance Management Commissioners RIEPs E&D 3 rd Sector Quality observatories JIPs Staff NPSA Audit Commission CAA LAA Quality Accounts NHS Choices Political landscape Darzi review GMC NHS Constitution NMC DH GSCC Improvement Agencies DCLG Quality Framework Personalisation PROMs NHS Litigation Authority NICE JSNA SCIE Providers Human Rights Professional accreditation

Topics for registration requirements Department of Health consultation: ØMaking sure people get the nourishment they need ØMaking sure people get care & treatment in safe, suitable places which support their independence, privacy & personal dignity ØUsing equipment that is safe & suitable for people’s care & treatment and supports people’s independence, privacy & personal dignity ØInvolving people in making informed decisions about their care & treatment ØResponding to people’s comments & complaints ØSupporting people to be independent ØRespecting people and their families & carers – people’s privacy, autonomy & dignity are safeguarded and their human rights & equality are respected. Where appropriate, people are assisted to maintain their private and family lives and social support networks

How can regulation help? ØGiving people using services & their carers a stronger voice ØEnsuring that all providers meet registration requirements ØAssessing performance of all providers ØAssessing performance of Local Authorities and Primary Care Trusts as commissioners of care ØGiving people trusted information that helps them & their carers make decisions on their care We need your help to ensure our work reflects what is important to people

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