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Excellence in Homecare
7th October 2011
Alan RosenbachSpecial Policy Lead to CEO
2
Background
Regulator for health and social care – created in April 2009
Putting people, their families and carers at the centre of everything we do
Weaving equality and human rights into our work
Doing things differently – by being firm on performance and using information to target poor provision
About us
We listen to the voice of people using services (and staff) This is the most important feature of CQC’s approach
We are outcome focused
We carry out unannounced on-site inspections
We use local networks and intelligence
We work in partnership
We act swiftly
We have learnt from Healthcare Commission, CSCI and MHAC
We need time for the new system to bed in
CQC in a changing environment
The public puts its faith in those who run and work in care services - but sometimes care fails or presents too much riskCQC must act swiftly when it sees signs of poor care and take strong action when things go wrong in care servicesRegulation is not the only answer - quality and safety is everyone’s business
There must be greater integration between health and social care – this will improve outcomes and improved efficiencies
CQC in a changing environment
– continuedWe have had a critical 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 are seeking additional funds from government
Scale of CQC regulated care
Primary medical services
9,000 locations
NHS Trusts
2800 locations
Independent healthcare
2,500 locations
Adult social care
24,000 locations
Independent ambulances
350 locations
Primary dental care
10,000 locations
Combined outpatients and inpatients
77.4 million
People using adult social care services
1.75 million
Dental appointments
36.4 million
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 responsive – taking swift action to follow up concerns
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
HealthWatch England
HealthWatch England
Consumer champion’ for health and adult social care services in England
Independent body within CQC
Leadership, advice and support to Local HealthWatch, and advice to Monitor, NHS Commissioning Board and Secretary of State
Structures and systems set up during 2011/12 – official launch October 2012
Different players in a changing system – economic / provider/ professional – must work in tandem
Refining our regulatory model
Since April 2010 CQC have registered providers of NHS, independent health and adult social care, against new essential standards We have listened to challenges to our regulatory modelWe seek to strengthen and simplify our regulatory model to improve how we inspect and take actionOur 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 on September 19 2011
CQC intends to inspect all adult social care services, independent health care services, NHS acute hospitals and ambulance trusts at least once a year – this is our scheduled inspection programme Scheduled inspections will focus on key standards; the choice of standards will depend on:
The type of care provided The amount of information we hold on the provider
Scheduled inspections
Refining our regulatory model
Simplifying the bar – compliant or non-complaint CQC plans not to issue minor, moderate or major concerns – providers will be either compliant or non-compliant
Information for those who choose services
a summary of CQC’s judgement of compliance with essential standards and a provider’s compliance historyan update on improvements against compliance conditions or CQC’s recommendationsinformation from people who have used the service
From autumn, the CQC website will provide improved, accessible, useful, up-to-date information for the public, including:
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Changes to Domiciliary Care regulation
Project to look at domiciliary care regulation
What are the most effective methods for regulating domiciliary care services?
What are the best mechanisms for capturing user voice?
What has a round of inspections focused on specific outcomes told us about the quality and safety of those providers?
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Next steps
First meeting of reference group
Refine tools and methods
Identify the providers in scope of the pilot
Project plan
Pilot begins October 2011
Senior management to consider way forward
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The Department of Health asked CQC to develop an excellence scheme for adult social care The intention of the scheme was to motivate providers to improve the quality of care so that people using services receive the best possible outcomes and experiences
Following consultation, although the need to incentivise quality still stands, the proposed scheme is not the answer
Politicians, CQC and providers of adult social care need discuss to the best way forward
Adult Social Care Excellence Scheme
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How it will look
Homepage
• 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
Using the search results
Our search results will allow visitors to compare and choose services.
We use a simple key of ticks and crosses to show whether or not a service is currently meeting essential government standards.
On the profile page
Every provider and location has a profile page showing our latest judgments about the care provided.
The 16 essential standards are grouped under five chapters (as they are in the Guidance about Compliance) – listed 1 to 5 on the site. When visitors click on a chapter they can read more detailed information about that service.
The chapter judgement is determined by the worst judged standard within that chapter (see next slide).
For example, if one standard within chapter 2 is judged with a grey cross, then that whole chapter cannot be judged any higher than a grey cross overall.
There are also links to all inspection
reports relating to that location.
Sharing experiences of care
At CQC we encourage people to share information with us about care services.
Visitors to our site can tell us about their experiences of care by using the form on our website.
We use this important information in our work.
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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