how to avoid a warning notice 4 december 2012 jennifer pattinson compliance manager
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How to avoid a warning notice
4 December 2012
Jennifer Pattinson
Compliance Manager
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Background
Regulator for health and social care – created in April 2009
Putting people, their families and carers at the centre of everything we do
Doing things differently – by using information to target poor provision
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We make sure people get better care
Who are we improving care for ?
People who use services,carers and families
People in more vulnerablecircumstances
What we will do to achieve our priorities
Public and taxpayers
Focus on quality, and acting swiftly to help eliminate poor quality care
Our priorities
Making sure care is centred on people’s need and reflects
their rights
Who are we?
Registration and ongoing monitoring
Regular reviews of
performance Enforcement
Special reviews
and studies
Mental Health Act
visits
Publishing information
Priorities in action
Making sure that care is centred on people’s needs and protects their rights
Focus on quality, and acting swiftly to help eliminate poor quality care
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About us
We listen to the voice of people using services (and staff) This is the most important feature of CQC’s approach
We are outcome focused
We carry out unannounced on-site inspections
We use local networks and intelligence
We work in partnership
We act swiftly
We have learnt from Healthcare Commission, CSCI and MHAC
CQC in a changing environment
The public puts its faith in those who run and work in care services - but sometimes care fails or presents too much riskCQC must act swiftly when it sees signs of poor care and take strong action when things go wrong in care servicesRegulation is not the only answer - quality and safety is everyone’s business
Must be greater integration between health and social care – this will improve outcomes and improved efficiencies
CQC in a changing environment – continued
We have had a critical external environment – but we are acknowledging mistakes and adapting to changing circumstances
CQC was set up as a risk-based regulator – but the public and providers want regular inspection across the board
We have committed to review and evaluate our model and are seeking additional funds from government
The regulation system
Regulation
Adult social care
NHS
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Innovative use of information
Reduced overall cost
Single system of registration
Single set of standards – the essential standards of quality and safety
Strong enforcement powers
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4Independent
health care
Scale of CQC regulated care
Primary medical services
9,000 locations
NHS Trusts
2800 locations
Independent healthcare
2,500 locations
Adult social care
24,000 locations
Independent ambulances
350 locations
Primary dental care
10,000 locations
Combined outpatients and inpatients
77.4 million
People using adult social care services
1.75 million
Dental appointments
36.4 million
CQC registration and standards
Our focus:
People focused
Outcome based
Plain English
The standards are mapped to six outcomes:
Involvement and information
Personalised care, treatment and support
Safeguarding and safety
Suitability of staffing
Quality and management
Suitability of management
Compliance monitoring
How we 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
Being targeted and responsive – taking swift action to follow up concerns
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So what does safe mean for CQC?
We listen to what people say about care and look at what data tells us in order to identify possible risks.
We deal with failure by responding to poor outcomes in order to reduce the likelihood of people being harmed.
When we identify risks, we review and inspect services to see what’s behind them – risk-based regulation.
We mitigate against risk by measuring systems and processes – this is not an annual cycle, this is real-time.
Where necessary, we seek improvements against clear timescales or take enforcement action (and follow up).
We listen, we look; and we take strong action when something goes wrong. But we don’t predict. We are cost blind.
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So what does safe mean for CQC?
CQC understands ‘safe care’ to be care delivered by a provider
who is compliant with our essential standards.
Non-compliance does not mean unsafe – it means an increasing
risk of care being unsafe. The more ‘non-compliant’ a provider is,
the greater the risk – but non-compliant is not an absolute
judgement on the quality of care on offer.
Quality above ‘compliance’ is not CQC’s responsibility. This lies
with providers and commissioners of care – Boards, managers,
clinicians, commissioners, professionals……
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 that my team was compliant with the essential standards of quality and safety?.
We seek to strengthen and simplify our regulatory model to improve how we inspect and take action
Our approach will continue to be outcome-focused, responsive and risk-based but in addition we want to:
inspect most providers more often
focus our inspections on the relevant standards
take swift regulatory action to tackle non-compliance
Consultation on our proposals began in September
Refining our regulatory model
Principles of inspection
New approach to inspection
Timely
At least once a year or once every two years depending on the provider
Focused
Inspections will focus on outcomes that are
important to people using services
Flexible
CQC can use different types of inspection to respond to concerns
Unannounced
CQC do not notify providers before we carry-out inspections
Changes to how CQC takes action
Simplifying the bar – compliant or non-complaint
Providers of health and social care services are responsible for ensuring
that their services meet our essential standards
Providers are either compliant or non-compliant
Non-compliance means that providers are failing to meet one or more of the
essential standards following inspection
We will take swift actions where we find concerns
The action we take will match the level of concern
CQC has enforcement powers that we use to hold providers to account
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Questions
CQC – Helping make care better for people
Questions?
Jennifer Pattinson, Compliance Manager
jennifer.pattinson@cqc.org.uk
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