Rachael Dodgson Interim Head of Regulatory Design Regulating for better outcomes

1. Rachael Dodgson Interim Head of Regulatory Design Regulating for better outcomes

2. This presentation is about… • Essential standards of quality and safety • The regulatory model • The Quality and Risk Profile • Our work with people with learning disabilities

3. Registration • All health and adult social care providers are meeting a single set of essential standards of quality and safety • Standards are focused on what is needed to make sure people who use services have a positive experience- a direct result of what people said they wanted • A single regulatory framework across health and adult social care; people receive safe and quality care no matter which part of the care system they experience and where

4. What’s changed? A single way of judging quality Organisations Standards/ requirements Enforcement Providers of adult social care (ASC) registered National Minimum Standards (ASC and PVH) - different regulation and NMS for each setting Care Standards Act enforcement action limited to statutory notices and closures Private and voluntary healthcare (PVH) providers registered Old system Standards for Better Health considered as part of annual health check Limited enforcement powers for NHS providers NHS providers were not registered (HCAI in 2009) All providers of health and adult social care registered with CQC Single set of essential standards of quality and safety for all settings Strengthened and extended range of enforcement powers for providers from all sectors New system

5. Legislation and standards Parliament Dept of Health CQC Care Quality Commission (Registration) Regulations 2009 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Single system of registration Single set of standards Strengthened and extended enforcement powers

6. Example of an OUTCOME Respecting and involving people who use services Plain English • People who use services: • Understand the care, treatment and support choices available to them. • Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support • Have their privacy, dignity and independence respected. • Have their views and experiences taken into account in the way the service is provided and delivered People focused Outcome based

7. Registration: the cycle Registration application Information capture Judgement on risk Application made Information analysis Application assessed Judgement published Judgement made Regulatory judgement Regulatory response Ongoing monitoring of compliance

8. Information analysis and judgement about risk Quality and Risk Profile Additional Information Capture • The QRP is a prompt not a judgement: • Gathers all we know about an organisation • Builds over time • Organises information into relevant classification system • Manages flows • Applies risk model to calculate risk and present findings in a way frontline staff can use • Depending on the nature of the possible • concern, the type of provider and the service, • or if there are gaps in information, • inspectors will seek further information from: • People who use services, their families and carers • Other regulators, commissioners and others • The provider themselves • A site visit Judgement about Risk • Using the QRP: • Inspectors will interpret the information and decide whether further action is needed • Using the Judgement framework • - Stage 1: Is there enough evidence?

9. Regulatory judgement and response Judgement framework Regulatory response • Stage 2: Does the evidence show compliance? • Stage 3: What is the impact on people who use services and the likelihood of this happening? Is there: • No concern • Minor concern • Moderate concern • Major concern Stage 4: Validation • Maintain registration - no further action • Improvement actions: • eg improvement letter • Enforcement actions: • Statutory warning notice • Imposition or variation of conditions • Fines • Prosecution • Suspension of registration • Cancellation of registration Regulatory judgement • Judgement of compliance or concerns • Translates minor, moderate or major concerns into regulatory judgement • Takes account of the provider’s capability to improve • Action will be proportionate

10. Quality and Risk Profile process

11. Information analysis and judgement –judgement about risk

12. QRP judgement

13. Regulating for better outcomes for people with a learning disability • 'Meeting the physical health needs of people with learning disabilities‘ • Review of healthcare for people in care homes • Learning disability action plan • Learning disability advisory board • Experts by experience • Other indicators/data sets to help judge performance?

14. And finally… • To contact us : • National Contact Centre • Telephone: 03000 616161 • enquiries@cqc.org.uk Website: www.cqc.org.uk