Market Oversight

Sally Warren Andrea Sutcliffe Ray James

30 October 2014 NCAS

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Andrea Sutcliffe Chief Inspector Adult Social Care

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Why market oversight?

Clear relationship between quality of care and finances 3

What can it do?

Market oversight aims to: Spot if a ‘Southern Cross’ could happen again Protect people in vulnerable circumstances Monitor finances of ‘difficult to replace’ providers Provide early warning to local authorities Assist in co-ordinating the system response if failure occurs Market oversight is not there to: Protect providers from failure Pre-empt failure through disclosure of information 4

Timelines for market oversight Sept – Dec 2014 Jan – Feb 2015 • Development of CQC approach and methodology • CQC engagement on proposed methods Identify and liaise with providers that meet the market oversight entry criteria April 2015 • Formally notify providers of their inclusion in the scheme and respond to appeals • Start to undertake financial assessments of providers in the scheme October 2015 Bring specialist providers into the scheme 5

A co-production culture

Communication

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This session Market oversight regime in detail – Sally Warren Local authority local duty to manage continuity – Ray James 7

Sally Warren Deputy Chief Inspector Adult Social Care

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Proposed model for market oversight

Step 1 2 3 4 5 6 Activity Entry to scheme Regular monitoring Further risk analysis Provider engagement on risk Regulatory action & engagement Formal notification to LAs If concerns identified and addressed Key:

Assessment of risk to financial sustainability (all provisional) no cause for concern/very low risk possible risk/medium risk likely risk/high risk risk clearly identified/very high risk 9

Step 1 - entry • Regulations set out entry criteria and reflect size, localised concentration and spread across the country • Specialist providers to be nominated via a panel • Currently expect around 50

corporate

providers to be in the scheme • These operate around 400

registered

providers which deliver services from about 4000 locations (30% of all care home beds in England) • Inclusion in scheme is a reflection of size, not a judgement of risk of failure 10

Proposed model for market oversight

Step 1 2 3 4 5 6 Activity Entry to scheme Regular monitoring Further risk analysis Provider engagement on risk Regulatory action & engagement Formal notification to LAs If concerns identified and addressed Key:

Assessment of risk to financial sustainability (all provisional) no cause for concern/very low risk possible risk/medium risk likely risk/high risk risk clearly identified/very high risk 11

Steps 2 and 3 – Intelligent Monitoring Aggregation of quality information, including ratings enforcement, information on concern

C. Quality A. Business context B. Financial

To allow CQC to understand provider structure and operation model Quarterly financial returns. Data is a prompt for further investigation and analysis 12

Proposed model for market oversight

Step 1 2 3 4 5 6 Activity Entry to scheme Regular monitoring Further risk analysis Provider engagement on risk Regulatory action & engagement Formal notification to LAs If concerns identified and addressed Key:

Assessment of risk to financial sustainability (all provisional) no cause for concern/very low risk possible risk/medium risk likely risk/high risk risk clearly identified/very high risk 13

Draft for discussion Steps 4 - 6: tools available to CQC

Activity

If elevated risks are identified from financial and quality indicators, CQC will use tools to obtain further information before assessing if failure is likely

Provider engagement on risk Regulatory action and engagement Formal notification to LAs Tools a

Risk assessment meeting

b

Additional financial information requests

c

More frequent quality inspections

d

Key stakeholder engagement

e

Independent Business Review

f

Risk Mitigation Plan

g

Notify relevant LAs

Transparency in market oversight • CQC will publish a list of providers within the scheme • Ongoing judgment of risk will not be published • LA(s) will be notified if failure is judged to be likely • Providers will be sharing commercially sensitive information and CQC will have systems to manage this appropriately 15

Ray James Vice President of ADASS

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Role of Councils • • • • Detail in Act, Guidance & planned Toolkit Duty applies for all providers not just those in Market Oversight Regime Duty

not

triggered if business has failed but service continues to be delivered (e.g. administrator running the business) Duty falls to LA where service is delivered

not

on commissioning LA 17

Temporary duty • • • • LA

must

involve the person concerned or those acting on their behalf LAs have the power to compel information from the provider that would help in this (e.g. care plans, risk assessments) Duty to cooperate Excludes NHS commissioned care 18

Insolvency situations • • Where an administrator appointed, LAs should not become involved in the commercial aspects of insolvency but should cooperate with the administrator LAs should consider the impact on the provider should they withdraw contracts but this should not be at the expense of people’s wellbeing 19

Market shaping and contingency planning • • Important that LAs have thorough understanding of local market (capacity, quality, types of service, trading conditions) Should underpin contingency planning; LAs to consider how to respond to failure of a significant provider, linking with neighbouring authorities where necessary 20

Promoting responsible behaviours • • • • • • Focus on wellbeing of those needing care • • Information Sharing – Building Trust Availability of key personal data Media Protocols Local, Regional, National Clear plan and accountabilities Communication vital – LAs should have capacity to react quickly and effectively to • minimise uncertainty and anxiety Service Users, Carers, & Staff 21

Thank you

www.cqc.org.uk

[email protected]

@CareQualityComm

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