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Care Quality Commission: ‘A New Start’ Consultation(England)
June 2013
Full details on the CQC Consultation are available here: http://www.cqc.org.uk/sites/default/files/media/documents/cqc_consultation_2013_tagged.pdf
Introduction
This slide deck presents key points and emerging issues on the consultation ‘A New Start’ from the Care Quality Commission
Please use it to share with your colleagues and feedback to [email protected] by mid July as the RCN develops our response
Background to the consultation Prompted by:
Francis, Winterbourne View, Morecambe Bay
Implementing new strategy under new leadership of David Behan and David Prior
Widespread criticism of ‘old’ CQC (and new reports emerging all the time of problems at CQC in the past)
New operating model
Informed by 6 C’s Chief Inspector of Hospitals can
request Monitor/TDA to
take action
Simplification to focus on 5 questions When CQC inspect they will ask the
following questions about care services: Are they safe? Are they effective? Are they caring? Are they responsive to people’s needs? Are they well-led?
Proposed changes and initial RCN view
✔
✔
✔
✔
✔
✔
RCN View*
?
?
*RCN based on previous consultation responses and member engagement. Subject to discussion and due process to reach final position(s)
Other encouraging signs
Staffing highlighted in registration:“They must show us that they focus on the right things when they employ staff, such as their
qualifications, clinical supervision and continuing professional development” (p11)
Approach inspections from the perspective of peer review Co-ordination with existing inspections and visits e.g. Royal
College visits Inspect at night and at weekends and talk more to frontline staff Can ask NMC to act or HSE Will include concerns raised by staff as part of indicators looked
at Will consider avoidable morbidity
Tier 1 Indicators for an Acute Trust
RCN view that staffing is both an indicator for safety and a well-led organisation
‘Well led’ indicators
RCN looking at indicators and exploring whether there are preferred indicators for staffing that can act as a trigger for further investigation
Areas where there may be tension with RCN view Ratings
Intention for overall rating But devil in the detail Setting is relevant; makes more sense for care homes than for hospitals Further consultation later this year on the details of this But just what will this mean for public, patients, carers, staff?
Frequency of inspection In 2011 our members told us that they wanted annual inspections Not sure of view about ‘earned autonomy’ which will mean an unannounced
inspection once every 3 to 5 years for those rated as ‘outstanding’ ‘Reasonable’ fundamental standards
Organisational not individual? Complementary to code or duplicatory? Realistic or setting up organisations to fail?
CQC Examples“I will be helped to use the toilet and to wash when I need it”“There will always be enough members of staff available to keep me safe and meet my health and welfare needs”
Areas we’re unsure about
How will CQC work with Monitor and others? Will it work?
Will CQC be able to staff this new model? But intention to make work at CQC an attractive
career option but concerns of workload, lack of support voiced by our members working at CQC
Sufficient focus on staffing (numbers and skill mix)?
What could it mean to practicing nurses? See CQC less often but when they do it will be for
longer (6-7 days on site) and it should be more clinically credible
May be asked by public and patients and carers about their organisations’ rating
May be less work in preparing for CQC inspection Opportunities for members to get involved:
Directly - as part of expert team Indirectly - their comments will be looked at by CQC and as
part of peer review?
Timeline
Consultation response due 12th August but your thoughts by mid July please to allow for sign off
Implementing changes will take 2 years
Tell us your thoughts
Contact: Leela Barham
020 7647 3901
By mid July