Helping to make care better Cynthia Bower, CEO National Care Association Conference

1. Helping to make care better Cynthia Bower, CEO National Care Association Conference 11 November 2009

2. Our Role We make sure people get better care Who are we improving care for ? People who use services, carers and families People in more vulnerable circumstances Public and taxpayers Our priorities Ensuring care is centred on people’s needs Championing joined up care Acting swiftly to help eliminate poor quality care Promoting high quality care Regulating effectively in partnership What we will do to achieve our priorities Publishing information Registration and ongoing monitoring Enforcement Regular reviews of performance Special reviews and studies Mental Health Act visits Operating principles • Involve users to focus on what is important to them • Expertise and independence • Ensure regulation is proportionate, targeted, consistent, evidence-based, transparent and accountable • Promote equality, diversity and human rights • Engage with those providing and commissioning care 2

3. Influencing the future of social care • We are actively contributing to the current debates on social care: • We gave written evidence to the Health Select Committee Inquiry on the future of social care, including personalisation and more effective, consistent and user-friendly services • We responded to the Department of Health consultation on eligibility criteria, to achieve more fairness and consistency for people seeking support • We contributed views to the Green Paper Shaping the Future of Care Together consultation about the future provision, arrangement and funding of social care, including the proposed establishment of a National Care Service

4. What did we say? • Personalisation still has a long way to go – people still need to be put first • Note the impact of the recession on quality • Funding should be fair, simple and sustainable • Support universality: information, advocacy, national assessment • Need clarity about care and support for all people, not just people aged 65 and over • Our new registration system: standards, dignity, rights

5. Registration -what’s changing? A single way of judging quality Standards/ requirements Organisations Enforcement Care Standards Act 2000 enforcement action limited to statutory notices and closures Providers of adult social care (ASC) registered National Minimum Standards (ASC and PVH) - different regulation and NMS for each setting Old system Private and voluntary healthcare (PVH) providers registered Standards for Better Health considered as part of annual health check Limited enforcement powers for NHS providers NHS providers are not registered All providers of health and adult social care registered with CQC Strengthened and extended range of enforcement powers for providers from all sectors Single set of essential standards of quality and safety for all settings New system

6. The difference registration will make All health and adult social care providers are meeting a wide range of essential standards of quality and safety Standards are focused on outcomes - what is needed to make sure people who use services have a quality experience- a direct result of what people said they wanted A single regulatory framework across health and adult social care, making it easier to compare one provider with another

7. Timeline for Adult Social Care and Independent Healthcare

8. Registration timeline Subject to legislation

9. Preparing for Registration From December, subject to legislation

10. Preparing for registration – what you can do now • Check your own internal reporting and audit systems • Consider what evidence you already hold and what you need to create • Consider evidence on outcomes • Be aware of activities in other sectors as they come into new registration system

11. Ongoing Monitoring of Compliance Completing registration Prepare for registration Registration goes live Quality & Risk Profile Pre application Application Received Judgement Made Judgement Published Information Capture Analyse Information Judgement on Risk Application Assessed Regulatory Judgement Regulatory Response We monitor compliance continuously • The published Register of Providers will be accompanied by a process of Ongoing Monitoring of Compliance. This is now in the planning stages. • CQC plans to maintain an up-to-date profile on each registered provider • New information can be uploaded to their profile at any time • Information can reach us from a number of external sources e.g. • - people who use services, their families and carers • - partner organisations such as the Ombudsman, commissioners • - statutory notifications • - staff & other professionals 11

12. Fees • Adequacy, Fairness, Simplicity and Evolution • We are now consulting on our proposed fee structure for NHS trusts for the first year of registration • In early 2010 we will consult on fees for Adult Social Care and Independent Healthcare for the period Oct 2010-March 2011 • In late 2010 we will consult on a long term system of fees to come into effect for all providers including all dental practices and primary medical care

13. Analysing risk Our assessors will regularly review provider profiles They will use the guidance about compliance to assess any risks We will take action swiftly when we need to Making judgements We will take proportionate action We will take account of the provider’s capacity to improve and work with the provider to achieve this end If non-compliance is more serious, then we may take enforcement action Acting swiftly

14. Conclusion • We all share the benefits of registration that • Is more dynamic and responsive • Identifies sooner causes of concern • Protects and promotes equality, diversity and human rights • Makes use of relevant information from other organisations and people who use services • Reduces unnecessary regulatory burdens and costs • Increases compliance • Increases credibility