Registering the care sector – next steps Dr Linda Hutchinson Director, Care Quality Commission

1. Registering the care sector – next steps Dr Linda Hutchinson Director, Care Quality Commission National Care Association Conference, 21 October 2010

2. People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights, wherever care is provided, wherever they live

3. The difference registration will make • All adult social care and health 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 adult social care and health care; people receive safe and quality care no matter which part of the care system they experience and where

4. Registration timeline NHS trusts April 2010 Adult social care Independent healthcare Oct 2010 Primary dental care (dental practices) Independent ambulance services April 2011 Primary medical services (GP practices and out of hours) April 2012

5. The registration cycle Registration application Information capture Judgement on risk Application made Information analysis Application assessed Judgement published Judgement made Regulatory judgement Regulatory response Monitoring of compliance

6. How the system is different after registration

7. Where we receive our information from New information can come from a variety of sources People who use services, families and carers Providers Quality and risk profile Other regulatory bodies and Information Centre Staff and other professionals Other bodies eg. Ombudsman, commissioners CQC assessors and inspectors

8. Provider profiles • Clearly laid out to give information to people who use services • Shows our judgement and how and when it was made • Flexible – updated when we make a new judgement • Testing with people who use services to make sure it helps them make informed decisions about their care options

9. How we will 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 • Taking swift action to follow up concerns

10. Reviews of compliance May include a site visit All findings published • All reviews: • There are two types of reviews: • Responsive review • - Triggered when information, or an information gap raises concern about compliance • - Targeted to the area of concern • Planned review • - Scheduled check of all core 16 quality and safety outcomes • - Will take place no less frequently than two years

11. Regulatory response Types of regulatory response • Maintain registration –no further action • Improvement actions • Compliance actions • Enforcement actions: • Statutory warning notice • Imposition or variation of conditions • Fines • Prosecution • Suspension of registration • Cancellation of registration 1 2 3 4

12. Ensuring compliance • Key questions: • Have I focused on people’s experience of care, and the quality of the treatment and support that they receive? • If asked, could I produce relevant evidence to show compliance with the essential standards of quality and safety?

13. Provider compliance assessment Provider compliance assessment • Designed to help providers understand if they are compliant • Focused on evidence of outcomes – the experience of care and the treatment people receive • ‘Live’ documents and updated on a continual basis • Designed to look at each regulation and outcome area In compliance monitoring, providers must be able to supply evidence of compliance at any time

14. Monitoring your compliance with the essential standards • Self assessment will be triangulated with other evidence wherever appropriate • We will talk to partner organisations, other regulators, providers, commissioners, user representative groups etc Triangulate evidence

15. Our aims for a new information scheme on quality • We are designing a new information scheme on adult social care quality, which we aim to begin in spring 2011 • Our aim is to provide information about the quality of services to help people who use and commission them to make choices and decisions • We also hope to: • Motivate providers to improve the quality of care to give people using services the best possible outcomes and experiences • Reinforce the need for compliance with essential standards at all times • Recognise and reward services that are providing care of a higher quality 15

16. How might the new scheme look? • The views of people using services and those of their carers will be important evidence used in the new information system • Part of the scheme will provide information on the provider’s record of compliance with essential standards – so registration, compliance and the quality information scheme will work together to form an overall picture of performance • Beyond this, we will also recognise ‘excellent’ care • We have started talking with stakeholders and will launch a formal 12-week consultation on our proposals this winter 16

17. Getting involved and finding out more • We will also soon be consulting on a single, long-term system of fees to for all providers from April 2011 • We will be engaging with the adult social care sector during next year – I encourage you to get involved • You can join our Provider Reference Group – where we collect opinions and request feedback on our ideas and draft documents. To join, email cqc@nunwood.com • Also, subscribe to our monthly newsletter – go to ‘news and events’ section of CQC website • For questions, call our contact centre on 03000 61 61 61 or email enquiries@cqc.org.uk 17