SECHA AGM

29 September

Louise Bushell and Janet OrtegaCompliance Managers

CQC Regulation under the Health and Social Care Act 2008

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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

Outcome-based – Regulation that assesses outcomes experienced by people who use services, rather than targets or processes

Risk-based – Responsive to the views of people who use services, using their insights alongside data to trigger regulatory action

Enforcement – Earlier identification and swifter action to follow up concerns, including enforcement action where necessary

Compliance – Increased compliance by health and adult social care providers; assurance about standards across the board

Information – Improved access to timely, relevant and reliable information about our expert judgement of the quality and safety of care

Value for money – Reduce unnecessary regulation and associated costs of demonstrating compliance; give providers value for money

Process – Improved transparency, speed, consistency and reliability of transactions

Regulatory functions –how we do our work

Reviews of compliance

Responsive

A responsive review of compliance:is triggered by specific

information that raises concern about compliance

is not a full check of compliance for all 16 outcomes (for the core 16

quality and safety standards)is targeted to the area (s) of concern

Depending on the concern, may focuson:

- the whole provider- one or more locations- one or more regulated activities- a particular service- one or more outcomesMay include a site visitAll findings will be published

Planned

A planned review of compliance:

Looks across all regulated activities at a location to assess compliance with all 16 outcomes (for the core 16 quality and safety standards)

Will take place at intervals of 3 months to no less frequent than

2 years

Will be proportionate, with additional activities focused on gaps on information

May include a site visit

All findings will be published

Site Visits

The aim of site visits is to gather evidence of compliance

We will have short, focussed unannounced site visits, rather than set piece inspections that require the provider to spend a lot of time in preparation

Site visits will primarily centre on the assessment of outcomes - the experiences people have as a result of the care they receive

Site visits will be direct checks of compliance rather than assessing compliance through the assurance systems the organisation has in place.

Therefore site visits will always include direct observation of care and we will spend time with people who use the service, their families and carers, unless not appropriate to do so. We may also talk to managers and staff. Experts by experience will join us on some site visits to help us engage with people who use services.

Site visits will take place as often as required to ensure that providers are meeting essential standards of quality and safety. This is likely to lead to more frequent site visits but shorter duration and more focused.

Judgement on Risk

Monitoring ongoing compliance

Using the Guidance about Compliance and Judgement Framework:

No concern

Minor concern

Moderate concern

Major concern

Follow up enquiries will be targeted

Regulatory Judgement

Maintain registration

Improvement actions:

Improvement letter

Enforcement actions:

Statutory warning notice

Imposition or variation of conditions

Fines

Prosecution

Suspension of registration

Cancellation of registration

Regulatory Response

Using framework:

Translates minor, moderate or major concerns into regulatory action

Takes account of the provider’s capacity to improve

Action will be proportionate

Evaluating Evidence

Essential Standards of quality and safety

Judgement Framework

Setting the bar: Monitoring of compliance

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

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Moving Forward

Pilot methodology for planned reviewNo provider compliance assessmentsOutcomes 4, 7 and 16 as a minimum

Domiciliary care pilot

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Moving Forward

Enforcement policy consultation

Judgement framework and our regulatory response

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Questions

• Any Questions?