Excellence in Homecare 7 th October 2011 Alan Rosenbach Special Policy Lead to CEO

Excellence in Homecare

7th October 2011

Alan RosenbachSpecial Policy Lead to CEO

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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

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Questions

CQC – Helping make care better for people

Questions?

[email protected]