1 The new world of regulation – October 2014 and beyond Rachael Dodgson - Head of Adult Social Care Policy October 2014
Dec 30, 2015
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The new world of regulation – October 2014 and beyond
Rachael Dodgson - Head of Adult Social Care PolicyOctober 2014
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Our purpose and role
Our purposeWe make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve
Our roleWe monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care
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Timeline for adult social care
Co-production and development to shape consultation proposals
Oct 2013 – March 2014
Consultation on regulatory approach, ratings and guidance
April 2014
Wave 1 pilot inspectionsApril – May 2014
Evaluation; guidance and standards refined.
July – Sept 2014
Provider guidance consultation. Wave 2 pilot inspections, initial ratings of services
June 2014
Oct 2014
New approach fully implemented and indicative ratings confirmed
March 2016
Every adult social care service rated
October:First
ratings
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Building a culture of co-production
Communication
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The Mum Test
Is it good enough for my Mum?
Is it safe?
Is it caring?
Is iteffective?
Is it responsive to people’s needs?
Is itwell-led?
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Key features of the new approach
Robust and rigorous test at registration
Intelligent monitoring information to help determine the timing and focus of inspections
Provider Information Return
Thorough inspections by specialised adult social care inspectors with experts by experience and specialist advisers
Rating services as Inadequate, Requires Improvement, Good or Outstanding
Inspection frequencies
Encouraging services to improve or holding services to account
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The new approach
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New approach
Intelligent monitoring and local information
Pre-inspection information gathering
On-site inspection
Speak to staff and
people using the
service
Key lines of enquiry
(mandatoryplus
additional KLOEs
identified from
information held)
Gather and record evidence from all
sources
Define the questions to
answer
Write report and publish alongside
ratings
Outstanding
Good
Requires improvement
Inadequate
Apply consistent principles,
build ratings from the recorded evidence
Make judgements
and build ratings
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Ratings
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Being clear about quality
High level characteristics of each rating level
Innovative, creative, constantly striving to improve, exceptional
Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong
May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong
Severe harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve
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Key Question - Caring
By caring, we mean that staff involve and treat people with compassion, kindness, dignity and respect.
In residential care, this means that people, their families and carers experience care that is empowering and provided by staff who treat people with dignity, respect and compassion.
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Caring: Key Lines of Enquiry
C1 - How are positive caring relationships developed with people using the service?
C2 - How does the service support people to express their views and be actively involved in making decisions about their care, treatment and support?
C3 - How is people’s privacy and dignity respected and promoted?
C4 - How people are supported at the end of their life to have a comfortable, dignified and pain free death?
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Caring – outstanding characteristics
• The service has a strong, visible person centred culture and is exceptional at helping people to express their views so they understand things from their points of view.
• People value their relationships with the staff team and feel that they often go ‘the extra mile’ for them, when providing care and support.
• Staff are exceptional in enabling people to remain independent and have an in-depth appreciation of people’s individual needs around privacy and dignity.
• Staff will be highly motivated and inspired to offer care that is kind and compassionate and will be determined and creative in overcoming any obstacles to achieving this.
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Encouraging improvement
Our enforcement powers
Not an escalator – more than one power can be used
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Cracks in the pathway - Variable quality and transitions
The quality of dementia care is variable – not everyone is meeting the standards we expect
Across more than 90% of care homes and hospitals visited, we found some variable or poor care – this is unacceptable
Transitions between services should be improved
People are likely to experience poor care at some point
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What will we do?
Find poor dementia care and take action
Appoint a new national specialist adviser for dementia care to provide advice across all relevant teams
Train inspectors across all teams to understand what good dementia care looks like so their judgments are consistent and robust
add a section to hospital inspection reports that shows how well the hospital cares for people living with dementia
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Why does this matter?
People are at the heart of it