Dignity Matters

1. Dignity Matters Jamie Rentoul, designate Director of Regulation & Strategy Care Quality Commission 25 November 2008

2. Ensuring better care for people

3. What is CQC ?

4. What is CQC? • We will bring together and build on the excellent work of three commissions • As a new, combined and powerful regulator across health and social care, our work will touch the lives of everyone in England at some point • People who use services, their families and carers will be at the heart of everything we do

5. The CQC model of quality care • Safety and safeguarding • Outcomes, including clinical outcomes • Experience of people who use services • ‘Functionality’, independence and quality of life • Access to services • Making best use of our resources

6. Our values • Put the people who use services first • Be independent, expert and authoritative • Champion joined-up care • Work with service providers and professions to agree definitions of quality • Be visible, open and transparent

7. Building on success – key functions • Registration • Provider assessment • Risk-based inspection • New enforcement powers • Commissioner assessment • Trusted, accessible information • Gatekeeping role • Knowledge to influence policy

8. How can CQC play its part in promoting dignity in health and adult social care?

9. How do people define dignity? Not being given food or help with eating/drinking I don’t believe it.!!! Being spoken about as if they were not there Being placed in a mixed sex accommodation Not seeking their consent and/or not following their wishes Not being given proper information Lack of protection of personal property including personal aids – hearing or visual Being addressed in an inappropriate manner Being subjected to abuse and violent behaviour Being left in soiled clothes Being in a noisy environment at night thus causing lack of sleep Being left in pain Being exposed in an embarrassing manner Having to use premises that are unclean and smelly – toilet and wards There is no standard definition of ‘dignity’.

10. How good is existing care? • ‘State of social care’ – personal dignity & respect: • 74% of councils ‘good’ or ‘excellent’; • 88% of care homes meet relevant standards. • Surveys of people in healthcare settings: • 78% always treated with dignity in acute hospitals; • Over 80% treated with respect & dignity in community mental health services; • 93% of those seeing a GP treated with dignity ‘all of the time’; but… • 20% of those needing help to eat did not get it; • Significant proportion still sharing accommodation when first admitted or sharing bathrooms later on; • Considerable variation between providers of care.

11. Dignity in care – the golden thread • Dignity is an integral part of providing care in any care setting. • Dignity is central to the personalisation agenda. • Maintaining dignity does not always require resources, small changes can make a big difference to people. • Dignity is fundamental to CQC’s human rights based • approach

12. Caring for dignity –building blocks • Involving people in their care • A culture focussed on delivering personal care in a way that ensures dignity for the person using services • A workforce that is equipped to deliver good quality care • Strong leadership at all levels • Supportive environment • Source: “Caring for Dignity”, Healthcare Commission 2007

13. Who has a role in improving quality? PROMs National Quality Board NHS Litigation Authority Commissioning ADASS Other Regulators Performance Management Commissioners GMC Staff Darzi review NPSA RIEPs 3rd Sector NHS Constitution NMC GSCC E&D Audit Commission DH LAA Improvement Agencies Quality observatories DCLG CAA Quality Framework SCIE NICE Quality Accounts JSNA Human Rights JIPs Providers NHS Choices Personalisation Professional accreditation Political landscape

14. Topics for registration requirements • Department of Health consultation: • Making sure people get the nourishment they need • Making sure people get care & treatment in safe, suitable places which support their independence, privacy & personal dignity • Using equipment that is safe & suitable for people’s care & treatment and supports people’s independence, privacy & personal dignity • Involving people in making informed decisions about their care & treatment • Responding to people’s comments & complaints • Supporting people to be independent • Respecting people and their families & carers – people’s privacy, autonomy & dignity are safeguarded and their human rights & equality are respected. Where appropriate, people are assisted to maintain their private and family lives and social support networks

15. How can regulation help? • Giving people using services & their carers a stronger voice • Ensuring that all providers meet registration requirements • Assessing performance of all providers • Assessing performance of Local Authorities and Primary Care Trusts as commissioners of care • Giving people trusted information that helps them & their carers make decisions on their care • We need your help to ensure our work reflects what is important to people

16. ? • Your questions