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CQC – An

Update

Deanna WestwoodLeeds Care Conference

20 June 2019

Is it good enough for my Mum?

Is it

safe?

Is it

caring?

Is it

effective?

Is it responsive to

people’s needs?

Is it

well-led?

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Ambition for social care: The Mum Test (or Anyone You Love test)

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Regulation to inspire improvement

What we do:

Set clear expectations

Monitor and inspect

Publish and rate

Celebrate success

Tackle failure

Signpost help

Influence debate

Work in partnership

Ambition

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Our ambition:

A more targeted, responsive and collaborative approach to

regulation, so more people get high-quality care

1. Encourage improvement, innovation and sustainability in care

2. Deliver an intelligence-driven approach to regulation

3. Promote a single shared view of quality

4. Improve our efficiency and effectiveness

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Four priorities to achieve our strategic ambition

A more targeted, collaborative and responsive approach

• The majority of people are receiving good

quality care. This is something to celebrate.

• Over 80% of inadequate services improve on

re-inspection but for services that require

improvement nearly 40% don’t improve and

5% get worse

• We are focusing on encouraging improvement

in services rated RI

• We will do this flexibly and proportionately,

using inspector judgement and existing risk

and enforcement frameworks

• We will monitor these services more closely to

identify changes in quality (up or down) and

respond more quickly, as required

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Our single shared view of quality

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Our single shared view of quality

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What does quality mean to people?

“I feel in control

and safe”

“I have the

information I need

when I need it”

“I have access to a

range of support that

helps me live my life”

“I am in control

of my support, in

my own way”

“I have considerate

support delivered by

competent staff”

“I can decide the

kind of support I

need”

By following these principles and encouraging others to

do the same, we enable people using services to say:

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Staff in adult social care: What does Quality matters mean for me?

• It will set out what high-quality care and support should look like

• Help define what well-led means

• Asking employers to support and empower you to deliver high quality care

• How you can help to improve adult social care for everyone

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Providers of adult social care: What does Quality matters mean for me?

• It will set out what high-quality care and support should look like

• Empowering you to drive quality for people using services, their families and staff

• Highlights the critical role you play in improving adult social care• Celebrating good practice

• Highlighting areas for improvement

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Commissioners and funders: What does Quality matters mean for me?

• It will set out what high-quality care and support should look like

• Empowering you to work with providers in your area to drive quality

• Highlights the critical role you play in improving adult social care• Commissioning for high quality outcomes

• Funding new services and placements only if they offer high-quality care

Beyond Barriers: What did we find?

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• A system designed in 1948 can no longer effectively

meet 2018 needs

• Living longer – but with more complex health

problems

• Increasingly, our care must be delivered by more

than one person or organisation

• In 2018, we expect care to be personalised to

people’s individual circumstances

• A fragmented health and care system designed

in 1948 can not meet the needs of today’s

population or operating environment

• We must remove the barriers to collaboration at a local and

national level and create an environment that drives people and

organisations to work together

What we found

• People experience the best care when people and organisations work together to overcome a fragmented system

• Dedicated staff regularly going beyond the call of duty

• There were examples of good practice in every local system we looked at

• Where local leaders share a clear vision, it provides a shared purpose for people and organisations across the local health and social care system

• But in a fragmented health and social care system there are barriers to collaboration at a local and national level

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1. An agreed joint plan that sets out how older people are to be supported and helped which in turn, guides joint commissioning decisions over a multi-year period

2. A single framework for measuring the performance of how agencies collectively deliver improved outcomes for older people

3. The development of joint workforce plans with more flexible and collaborative approaches to staff recruitment, retention and development

4. New legislation to allow CQC to regulate systems and hold them to account for how they work together to support and care for older people

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Recommendations to local and national leaders, and government

What did we find in Leeds

A number of recommendations:

• The workforce strategy for Leeds should be developed at pace, pulling together the different strands of activity to develop deliverables and timescales which include the independent social care sector.

• There should be improved engagement with GPs and adult social care providers in the development of the strategy and delivery of services in Leeds.

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Social Care Services in Leeds

Inadequate RI Good Outstanding

Nursing Sep-18 1 16 29 0

Mar-19 1 19 24 1

Residential Sep-18 2 11 86 0

Mar-19 0 15 85 1

Domiciliary

care Sep-18 0 23 62 0

Mar-19 0 20 70 0

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Driving improvement across health and social care

• Report series features

providers that have increased

their quality rating considerably

• Similar themes for all reports

• What themes stand out?

• Leadership

• Culture

• Person centred care

• Staffing & support

• Outward looking

• Happy staff means better care

What does it take to raise standards in adult social care settings?

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• Reaction to CQC report

• Leadership

• Cultural change

• Person-centred care

• Staffing

• Working with partners

• Building a community

For committed staff, the inspection report can come as a relief..

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• Using the report as a

roadmap to success

• Creating action plans

• CQC are here to help; using

our inspection teams as

support and guidance

• Having a ‘we will get this right’

attitude

• Key first steps to

improvement

• Strong, focused leadership to

drive change

Leadership and culture, go hand in hand

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• Involving staff, people who use services and their

families, giving them a voice

• Shaping the culture of the organisation

• Staff feeling valued and given a voice

• Develop good teams to be even better, valuing training

and development

• Empowering staff to ‘steer the ship’

“There’s a saying that to be a good leader you’ve got to have

good followers. No. To be a leader you’ve got to breed more

leaders.”Jamie Stubbs, Senior General Manager

Ottley House Nursing Home

Ensuring people are at the heart of what we do

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• Comprehensive care plans truly reflecting what the

person wants and needs

• Appreciating their life story

• Processes to support

access to and ease of

updating, care plans

• Using care plan as a tool

to assess environment

• Learning from things that

do not suit the person,

adapting and changing

• Incorporating activities!

Consistent, compassionate workforce

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• Great consistency of staffing makes

a massive difference

• Limited or structured use of agency

staff

• Empowered staff willing to speak out

and suggest changes

• No blame culture, learning culture

• Taking people on the improvement

journey

• Regular supervision and training

• Robust recruitment and induction process, management

providing bespoke training

“Having the same

staff means that they

know the little things

that make a

difference to Jean,

like making sure she

has a tissue in her

sleeve, or seeing if

she’d like to spray

some of her favourite

perfume”

David Eadie, wife uses the

service

Working with partners fosters an improvement culture

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• Being honest and asking for

support

• Commissioners being part of

the improvement journey

• Building a relationship with your

CQC inspector

• Working with other healthcare

professionals in your local

community

• Sharing good practice

corporately or wider social care

community

Bring the community into your home

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• A commitment to being part

of the wider community

• Making your home a hub of

activity and energy

• Bringing the community into

your home

• Local groups

• Working with schools

• Taking people out into

the community to shop

or have breakfast

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How good and outstanding providers meet The Mum Test

‘Outstanding’ can be achieved

"We didn't think we were outstanding. And perhaps

that's why we were – I think it's because we see

every single person as an individual. It is our

privilege to support them to live the last years of

their life with as

much happiness,

love and security as

we can give them."

Suzanne, Prince of Wales

House, Ipswich

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Influencers of quality

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The public - who use services

Professionals - all undertake a personal commitment to deliver safe high quality care when they register

Providers – from the Board to the front line

Commissioners – what they do and how they do it

Regulators - this includes quality regulators, system regulators but also professional regulators

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Maya Angelou

“People will forget what you said, people

will forget what you did, but people will

never forget how you made them feel”

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A wise woman once said…

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