What are CQC looking at & for?

1. What are CQC looking at & for? Rosamunde Willis-Read CQC/NCC

2. About CQC The CQC is the independent regulator of health & adult social care services in England. We also protect the interests of people whose rights are restricted under the Mental Health Act.

3. CQC mission We do this by: ● Driving improvement across health & adult social care. ● Putting people first & championing their rights. ● Acting swiftly to remedy bad practice. ● Gathering and using knowledge and expertise, & working with others.

4. Statutory role CQC has statutory role is to check whether providers comply with the essential standards of quality and safety (HSCA 2008 & associated regulations) Check all health and adult social care services in England run by: ● the NHS ● local councils ● private companies ● voluntary groups.

5. What does that mean? • Care in hospitals, care homes, people’s own homes, dental & GP practices, & other services against the National standards, & publish our findings on our website and in our inspection reports. • Inspect most hospitals, care homes & domiciliary care services at least once a year, & we inspect dental services at least once every 2 years. • Also re-inspect services not meeting standards & will inspect services more often if we think they are providing poor care that might be putting people at risk. • Unannounced

6. Service specific areas • Older people • People with mental health problems • People with learning disabilities • People with physical disabilities • People with long term health conditions

7. Regulated activities • Accommodation for people who require nursing or personal care • Accommodation for people who require treatment for substance misuse • Accommodation and nursing or personal care in the further education sector • Treatment of disease, disorder or injury • Assessment or medical treatment for persons detained under the MHA 1983 • Diagnostic and screening procedures and many more…

8. CQC inspection During inspections we: • ask people about their experiences of receiving care. • talk with care staff. • check that the right systems and processes are in place. • look for evidence that the service isn’t meeting national standards. Use of experts by experience We judge services against the national standards which are the standards that people can expect when receiving health or social care.

9. Type of inspections We carry out three types of inspections. • Scheduled: these are unannounced inspections that focus on a minimum of five of the national standards, & they’re also tailored to the type of care that is provided at the service. • Responsive: these are unannounced inspections that are carried out where there are concerns about poor care. • Themed: these inspections focus on specific standards of care or care services.

10. Essential standards – Guidance against compliance Why guidance produced? The 28 outcomes are grouped into six key areas: ● Involvement & information ● Personalised care, treatment & support ● Safeguarding & safety ● Suitability of staffing ● Quality & management ● Suitability of management 16 that relate most directly to quality & safety of care across provider types

11. Guidance about compliance Part 1 contains a section for each area, containing: ● A summary of the area and the regulations that it includes ● For each regulation: – the text of the regulation – what CQC think people who use services should experience when providers comply with the regulation (the definition of the outcome).This is what we will focus on checking that providers are meeting essential standards.

12. Judgement Framework Evidence to make a judgement about compliance? • Current, reliable, relevant, sufficient? • Does itdemonstratequality of outcomes and/or experiences of people who use services? • Does it demonstrate what controls (processes) the provider has in place? • Is specialist input (e.g. pharmacy) required? Impact on people who use services? • Minor • Moderate • Major

13. However- CQC review • Are they safe? • Are they effective? • Are they caring? • Are they well led? • Are they responsive to people’s needs? Will publish more information about the fundamental standards soon. First review is Hospital inspections, then primary Medical services and then Adult Social care

14. Safeguarding CQC help to safeguard people by: • Using information received to monitor & report on care services’ compliance with Essential Standards • Referring concerns to local councils &/or the police for further investigation. • Working with partners such as the police, local councils, health agencies, other regulators & government departments. • Report our findings about safeguarding issues. • Contributing to national safeguarding policies and making recommendations. • Involved in multi-agency children’s safeguarding inspections • Consulting people about their views & experiences of care

15. Enforcing standards • If not meeting the standards, CQC take action. • Can require providers to deliver an improvement plan or use enforcement powers. These include: • issuing a warning notice requiring improvements within a short period of time. • restricting the services that the provider can offer. • stopping admissions into the care service. • issuing fixed penalty notices. • suspending or cancelling the service’s registration. • prosecution.

16. Partnership working CQC also works with various bodies to enforce the standards. Depending on the service & the circumstances, can work with local authorities, CCGs, regulatory bodies & agencies, & the police to ensure that action is taken. • Information sharing • Serious concerns meetings • Safeguarding strategy meetings • Serious case reviews • Safeguarding adults board attendance

17. Care Bill • Inspections review • New powers- financial viability, independent business reviews & sharing with LAs. • NHS: Single failure regime • Health and social care ratings • Closure of s19 loophole • Unitary Board • False or misleading information

18. Any questions? Thanks for listening Rosamunde.Willis-Read@nottscc.gov.uk 07917156000