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

1. Excellence in Homecare 7th October 2011 Alan Rosenbach Special 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 2

3. 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

4. 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 risk • CQC must act swiftly when it sees signs of poor care and take strong action when things go wrong in care services • Regulation is not the only answer - quality and safety is everyone’s business • There must be greater integrationbetween health and social care – this will improve outcomes and improved efficiencies

5. CQC in a changing environment– continued • We 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

6. Scale of CQC regulated care Independent healthcare 2,500 locations Independent ambulances 350 locations Primary medical services 9,000 locations Primary dental care 10,000 locations NHS Trusts 2800 locations Adult social care 24,000 locations Dental appointments 36.4 million Combined outpatients and inpatients 77.4 million People using adult social care services 1.75 million

7. 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

8. 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

9. 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

10. 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 model • We seek to strengthen and simplify our regulatory model to improve how we inspect and take action • Our 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

11. 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 Scheduled inspections • 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

12. Information for those who choose services From autumn, the CQC website will provide improved, accessible, useful, up-to-date information for the public, including: • a summary of CQC’s judgement of compliance with essential standards and a provider’s compliance history • an update on improvements against compliance conditions or CQC’s recommendations • information from people who have used the service

13. 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? 13

14. 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 14

15. Adult Social Care Excellence Scheme 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 careso 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 15

16. 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 16

17. 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.

18. 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.

19. 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.

20. 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 20

21. Questions • CQC – Helping make care better for people • Questions? • alan.rosenbach@cqc.org.uk 21