Challenging Behaviour National Strategy Group

The shortfall between policy and practice: the role of CQC and lessons learnt from the Learning Disability Review

Dame Jo Williams, Chair Care Quality Commission

5 October 2012

• The Learning Disability Inspection Programme was launched in response to the issues found at Winterbourne View.

• An advisory group was established to provide experience and expertise to CQC

• 150 locations were inspected across NHS, independent healthcare and adult social care settings.

• We reviewed whether people experienced safe and appropriate care, treatment and support and whether they are protected from abuse.

• Inspections were carried out by CQC inspectors, professional advisors and ‘experts by experience’ both people who have used services and family carers.

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Background

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Shortfall between policy and practice

Overall care was not centred on the person –with people fitted to services rather than services fitted around them

• 48% of locations non compliant with one or more outcomes

• Care plans were not accessible to people or made in a format they could understand

• Lack of meaningful activities to promote independence

• Good quality advocacy was not always available

• People in assessment and treatment services stayed for disproportionately long lengths of time

• Staff failing to recognise abuse

• Restraint not been delivered inline with care plans

• Seclusion not recognised as a form of restraint

What can we do going forward?

Whole system response and approach required from to include: policy makers, providers, commissioners, regulators and of course relatives and carers and people who use the services.

Innovative commissioningReal person centred care planned and delivered

All people with a learning disability are people first with the right to lead their lives like any others, with the same opportunities and responsibilities, and to be treated with the same dignity and respect. They and their families and carers are entitled to the same aspirations and life chances as other citizens. (Valuing People 2001)

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Follow up inspections:

Of the 71 locations which were non compliant (including the pilot sites) we have done:

• 34 follow up inspections undertaken• 24 locations now compliant• 10 reports in draft stage

Further unannounced inspections planned

Conclusions

Leadership, Leadership, Leadership

Institutions are potentially dangerous

Culture – How does the regulator

Monitor/Evaluate?

Experts by Experience Invaluable

Role of citizen regulators and Healthwatch

Contact us

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Website: www.cqc.org.uk

Call us on via our National Customer Service Centre:Telephone: 03000 616161Fax: 03000 616171

Write to us:CQC National Customer Service CentreCitygateGallowgateNewcastle upon TyneNE1 4PA