Transcript now
Changing the way CQC regulates, inspects and monitors care
1
Our purpose and role
Our purpose
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve
Our role
We 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
We will be a strong, independent and expert inspectorate that is always on the side of people who use services
2
Adult social care vision
The Mum Test
Is it responsive to people’s needs?
Is it effective?
Is it well-led?
Is it safe?
Is it caring?
Is it good enough for my Mum?
3
Our new approach
4
Mental Capacity Act and Deprivation of Liberty Safeguards
Duty to monitor the use of the Deprivation of Liberty Safeguards Inspect and report on services’ approach to meeting the Mental Capacity Act code of practice In particular, we look at how and when capacity is assessed and how decisions are recorded in compliance with the Mental Capacity Act Included in our prompts and descriptions of ratings for safety, effectiveness and caring 5
Making the Mum Test Real
Communication
6
What will be different?
Now
Risk based model
Future
More targeted Caseloads Making judgements Enforcement when needed Publishing our findings Ongoing monitoring More manageable On the 5 key questions Commitment to taking firm action Clearer reports Better information 7
Timetable
Oct 2013 – March 2014
Co-production and development to shape consultation proposals
April 2014
Consultation on regulatory approach, ratings and guidance
April – May 2014
Wave 1 pilot inspections
June 2014
refined.
Oct 2014 4 June: Consultation closes
Evaluation; guidance and standards
July – Sept 2014
Wave 2 pilot inspections and initial ratings of some services New approach fully implemented and indicative ratings confirmed
March 2016
Every adult social care service rated 8
Inspection principles
9
What will be different?
Intelligent monitoring
Provider information return Questionnaires – community services Sharing information with external partners
Inspections
6 months – 2 years Tailored inspection teams Increased use of experts Experts by Experience Specialist Advisors 10
Our key questions and key lines of enquiry
We will no longer focus solely on whether providers are compliant or non-compliant with regulations Our focus is on the five key questions about services: Is it safe?
Is it effective?
Is it caring?
Is it responsive?
Is it well-led?
11
Principles for our key lines of enquiry
For each of the five key questions there are mandatory key lines of enquiry There will be additional key lines of enquiry based on: An inspector’s knowledge of the service Information available The inspectors professional judgement They support consistency of what we examine under the five key questions and focus on those areas that matter most Key lines of enquiry are supported by guidance on the ‘key things to consider’ as part of the assessment – these are called prompts 12
Safe
By safe, we mean
that people are protected from abuse and avoidable harm.
In adult social care, this means that people are supported to make choices and take risks and are protected from physical, psychological or emotional harm; abuse, discrimination and neglect.
Key line of enquiry example:
How are people protected from bullying, harassment, avoidable harm, abuse and breaches of their human rights?
13
Effective
By effective, we mean
that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence.
In adult social care, this means that people are supported to live their lives in the way they choose and experience the best possible health and quality of life outcomes.
Key line of enquiry example:
How are people’s needs and choices for care, treatment and support met?
14
Caring
By caring, we mean
that staff involve and treat people with compassion, kindness, dignity and respect.
In adult social 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.
Key line of enquiry example:
How are positive, caring relationships developed with people using the service?
15
Responsive
By responsive, we mean that
services are organised so that they meet people’s needs.
In adult social care, this means that people get the care they need, are listened to and have their rights and diverse circumstances respected.
Key line of enquiry example:
How do people receive personalised care that is responsive to their needs?
16
Well-led
By well-led, we mean that
the leadership, management and governance of the organisation assure the delivery of high-quality care, supports learning and innovation, and promotes an open and fair culture.
In adult social care, this means that people get the care they need, are listened to and have their rights and diverse circumstances respected.
Key line of enquiry example:
How does the service promote a positive culture that is person centred, open, inclusive and empowering?
17
Ratings
18
Four point scale
High level characteristics of each rating level
Innovative, creative, constantly striving to improve, open and transparent 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 19
How key lines of enquiry and evidence build towards ratings
Define the questions to answer
Key lines of enquiry (mandatory plus additional KLOEs identified from information held)
Gather and record evidence from all sources
Intelligent monitoring and local information On-site inspection Pre inspection information gathering Speak to staff and people using the service
Make judgements and build ratings
Apply consistent principles, build ratings from the recorded evidence
Write report and publish alongside ratings
Outstanding Good Requires improvement Inadequate 20
How do we decide a rating?
21
To what do we give ratings?
Services will be rated at two levels: level one - we will use our rating methodology and professional judgement to produce separate ratings for each of the five key questions level two - we will aggregate these separate ratings up to an overall location rating using ‘ratings principles’ 22
Principles
The five key questions contribute equally to the overall location rating. Overall ratings are produced using the following principles: If two or more of the key questions are rated ‘inadequate’, then the overall rating will normally be ‘inadequate’ If one of the key questions is rated ‘inadequate’, then the overall rating will normally be ‘requires improvement’ If two or more of the key questions are rated ‘requires improvement ’, then the overall rating will normally be ‘requires improvement’ At least two of the five key questions would normally need to be rated ‘outstanding’ before an overall rating of ‘outstanding’ can be awarded 23
Rating limiters
24
Other ways to share your views
Consultation: 9 April to 4 June 2014
Get involved:
Web form at
www.cqc.org.uk
@CareQualityComm
Provider online community: join at
www.cqc.org.uk
25
www.cqc.org.uk
Thank you
26