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Care Quality Commission: ‘A New Start’ Consultation (England)

Care Quality Commission: ‘A New Start’ Consultation (England). June 2013. Full details on the CQC Consultation are available here: http ://www.cqc.org.uk/sites/default/files/media/documents/cqc_consultation_2013_tagged.pdf. Introduction.

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Care Quality Commission: ‘A New Start’ Consultation (England)

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  1. Care Quality Commission: ‘A New Start’ Consultation(England) June 2013 Full details on the CQC Consultation are available here: http://www.cqc.org.uk/sites/default/files/media/documents/cqc_consultation_2013_tagged.pdf

  2. Introduction • This slide deck presents key points and emerging issues on the consultation ‘A New Start’ from the Care Quality Commission • Please use it to share with your colleagues and feedback to leela.barham@rcn.org.uk by mid July as the RCN develops our response

  3. Background to the consultation • Prompted by: • Francis, Winterbourne View, Morecambe Bay • Implementing new strategy under new leadership of David Behan and David Prior • Widespread criticism of ‘old’ CQC (and new reports emerging all the time of problems at CQC in the past)

  4. New operating model Informed by 6 C’s Chief Inspector of Hospitals can request Monitor/TDA to take action

  5. Simplification to focus on 5 questions • When CQC inspect they will ask the following questions about care services: • Are they safe? • Are they effective? • Are they caring? • Are they responsive to people’s needs? • Are they well-led?

  6. Proposed changes and initial RCN view RCN View* ✔ ? ? ✔ ✔ ✔ ✔ ✔ *RCN based on previous consultation responses and member engagement. Subject to discussion and due process to reach final position(s)

  7. Other encouraging signs • Staffing highlighted in registration: “They must show us that they focus on the right things when they employ staff, such as their qualifications, clinical supervision and continuing professional development” (p11) • Approach inspections from the perspective of peer review • Co-ordination with existing inspections and visits e.g. Royal College visits • Inspect at night and at weekends and talk more to frontline staff • Can ask NMC to act or HSE • Will include concerns raised by staff as part of indicators looked at • Will consider avoidable morbidity

  8. Tier 1 Indicators for an Acute Trust RCN view that staffing is both an indicator for safety and a well-led organisation

  9. ‘Well led’ indicators RCN looking at indicators and exploring whether there are preferred indicators for staffing that can act as a trigger for further investigation

  10. Areas where there may be tension with RCN view • Ratings • Intention for overall rating • But devil in the detail • Setting is relevant; makes more sense for care homes than for hospitals • Further consultation later this year on the details of this • But just what will this mean for public, patients, carers, staff? • Frequency of inspection • In 2011 our members told us that they wanted annual inspections • Not sure of view about ‘earned autonomy’ which will mean an unannounced inspection once every 3 to 5 years for those rated as ‘outstanding’ • ‘Reasonable’ fundamental standards • Organisational not individual? • Complementary to code or duplicatory? • Realistic or setting up organisations to fail? CQC Examples “I will be helped to use the toilet and to wash when I need it” “There will always be enough members of staff available to keep me safe and meet my health and welfare needs”

  11. Areas we’re unsure about • How will CQC work with Monitor and others? Will it work? • Will CQC be able to staff this new model? • But intention to make work at CQC an attractive career option but concerns of workload, lack of support voiced by our members working at CQC • Sufficient focus on staffing (numbers and skill mix)?

  12. What could it mean to practicing nurses? • See CQC less often but when they do it will be for longer (6-7 days on site) and it should be more clinically credible • May be asked by public and patients and carers about their organisations’ rating • May be less work in preparing for CQC inspection • Opportunities for members to get involved: • Directly - as part of expert team • Indirectly - their comments will be looked at by CQCand as part of peer review?

  13. Timeline • Consultation response due 12th August but your thoughts by mid July please to allow for sign off • Implementing changes will take 2 years

  14. Tell us your thoughts Contact: Leela Barham leela.barham@rcn.org.uk 020 7647 3901 By mid July

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