The new world of regulation – October 2014 and beyond

1. The new world of regulation – October 2014 and beyond • Rachael Dodgson - Head of Adult Social Care Policy • October 2014 • 1

2. Our purpose and role • Our purpose We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve Our role We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care • 2

3. Timeline for adult social care • Oct 2013 – March 2014 • Co-production and development to shape consultation proposals • April 2014 • Consultation on regulatory approach, ratings and guidance • October: • First • ratings • April – May 2014 • Wave 1 pilot inspections • June 2014 • Evaluation; guidance and standards refined. • July – Sept 2014 • Provider guidance consultation. Wave 2 pilot inspections, initial ratings of services • Oct 2014 • New approach fully implemented and indicative ratings confirmed • March 2016 • Every adult social care service rated

4. Building a culture of co-production • Communication • 4

5. The Mum Test • Is it responsive to people’s needs? • Is it good enough for my Mum? Is it effective? Is it safe? • Is it • well-led? • Is it caring?

6. Key features of the new approach • Robust and rigorous test at registration • Intelligent monitoring information to help determine the timing and focus of inspections • Provider Information Return • Thorough inspections by specialised adult social care inspectors with experts by experience and specialist advisers • Rating services as Inadequate, Requires Improvement, Good or Outstanding • Inspection frequencies • Encouraging services to improve or holding services to account

7. The new approach • 7

8. Make judgements and build ratings • Define the questions to answer • Gather and record evidence from all sources • Write report and publish alongside ratings • New approach Outstanding Good Requires improvement Inadequate Key lines of enquiry (mandatoryplus additional KLOEs identified from information held) Intelligent monitoring and local information On-site inspection Apply consistent principles, build ratings from the recorded evidence Speak to staff and people using the service Pre- inspection information gathering • 8

9. Ratings • 9

10. Being clear about quality • 10

11. Key Question - Caring • By caring, we mean that staff involve and treat people with compassion, kindness, dignity and respect. • In residential care, this means that people, their families and carers experience care that is empowering and provided by staff who treat people with dignity, respect and compassion. • 11

12. Caring: Key Lines of Enquiry • C1 - How are positive caring relationships developed with people using the service? • C2 - How does the service support people to express their views and be actively involved in making decisions about their care, treatment and support? • C3 - How is people’s privacy and dignity respected and promoted? • C4 - How people are supported at the end of their life to have a comfortable, dignified and pain free death? • 12

13. Caring – outstanding characteristics • The service has a strong, visible person centred culture and is exceptional at helping people to express their views so they understand things from their points of view. • People value their relationships with the staff team and feel that they often go ‘the extra mile’ for them, when providing care and support. • Staff are exceptional in enabling people to remain independent and have an in-depth appreciation of people’s individual needs around privacy and dignity. • Staff will be highly motivated and inspired to offer care that is kind and compassionate and will be determined and creative in overcoming any obstacles to achieving this. • 13

14. Encouraging improvement • 14

15. Our enforcement powers • Not an escalator – more than one power can be used

16. Cracks in the pathway - Variable quality and transitions • The quality of dementia care is variable – not everyone is meeting the standards we expect • Across more than 90% of care homes and hospitals visited, we found some variable or poor care – this is unacceptable • Transitions between services should be improved • People are likely to experience poor care at some point

17. What will we do? • Find poor dementia care and take action • Appoint a new national specialist adviser for dementia care to provide advice across all relevant teams • Train inspectors across all teams to understand what good dementia care looks like so their judgments are consistent and robust • add a section to hospital inspection reports that shows how well the hospital cares for people living with dementia

18. Why does this matter? • People are at the heart of it • 18

19. Thank you • www.cqc.org.uk • enquiries@cqc.org.uk • @CareQualityComm • Rachael Dodgson • Head of Adult Social Care Policy • 19