1

Welcome

1

Margaret Willcox OBEPresident

ADASS

Good Care Bad Care: lived experiences

Sue Kelley

Expert by Experience and

Insight and Engagement Partner2

Disability and attitude

• A negative attitude held by society can disable a person just as much as a flight of steps or inaccessible information

3

Me

• I have a neurological disorder resulting in a multiple disability since 1980

• In 2006 I was diagnosed with cancer (4a) and have lived with its activity and remissions since

4

Poor care

• Poor Care in my experience amounted from:• Ignorance: my own and that of the

professionals• Stereotyping: ‘Does she take sugar

syndrome?’ • Arrogance: ‘Because the doctor

thought or implied so”• Fear of retribution

5

Good care

• My experience of good care:

• December 2015 my mother diagnosed with advanced pancreatic cancer

• Move from hospice to home

• Finding an appropriate domiciliary care agency

• Personal care and social interaction

6

Why is poor care out there?

• I know that good care can be provided to meet individual needs….

• ….so why is poor care and support still to be found in large numbers throughout the system?

7

8

Andrea Sutcliffe

Chief Inspector Adult Social Care

NCAS

12 October 2017

Quality in

adult social

care: where

are we now?

State of Care

8

Our purpose

The Care Quality Commission is

the independent regulator of

health and adult social care in

England

We make sure health and

social care services provide

people with safe, effective,

compassionate, high-quality

care and we encourage care

services to improve

9

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?

10

The Mum (or anyone you love) Test

Published this week:

10 October 2017

12

Health and care services are at full

stretch – which impacts upon people

Increased complexity of demand = new challenges

Providers must change to meet complexity and challenges

Future quality of care is precarious

• Providers struggling to cope with more complex demand

• People waiting over four hours at A&E

• More planned operations cancelled and people waiting longer

• Increasing demand for mental health services, affecting

waiting time

• Fewer nursing home beds

• Adult social care providers handing back contracts

• One in eight older people are not receiving help they need

13

Are adult social care services closer to

the tipping point?

14

Variation and the tipping point

Some areas closer to the tipping point, others further away

Factors affecting the tipping point vary geographically – ratings

variation is one aspect

Percentage of

good and outstanding

Top 20%

Upper 20-40%

Middle 20%

Lower 20-40%

Bottom 20%

ADULT SOCIAL

CARE RATINGS

BY LOCAL

AUTHORITY

Sourc

e: C

QC

ratin

gs d

ata

, 31 J

uly

2017

Adult social care findings 1/2

15

• 78% rated good, but 19% rated requires

improvement and 1% (303 locations) inadequate

• Community services rated best. Nursing homes

biggest concern with 28% requires improvement and

3% inadequate, affecting c6,300 people

• Caring rated best – 92% good and 3% outstanding.

Safe and well-led poorest – 22% requires

improvement and 2% inadequate

Adult social care findings 2/2

16

• High-performing services have strong leaders –

innovative registered managers known to staff,

people using the service, carers and families

had a positive impact

• High-quality services are person-centred – staff get to

know people as people, understanding their interests,

likes and dislikes

• Most enforcement for poor care relates to

governance, safety, staffing and person-centred care

• Quality matters joint commitment developed

Local collaboration and joined-up care

• People first – personalised care

• Shared vision and strong leadership

• All staff to share that vision and deliver

• Work together as part of a system

17

Complexity + challenges = collaboration

Golden thread connecting vision to delivery

Challenges

18

• Improve planning,

delivery and experience

for mental health –

Mental Health Act and

the Green Paper

• Long-term sustainable

solution for adult social

care needed

• Services in all sectors

must collaborate locally

State of

Care

available on

stand A32

19

What can we do about it?

Quality matters: a shared commitment to high quality, person-centred adult social care

Margaret Willcox OBE, ADASS President

20

21

What is Quality matters?

Co-produced with:

• People who use services, their families and carers

• Professionals and staff

• Providers

• Commissioners

• National bodies that oversee and support adult social care

A shared commitment for everyone using, working and supporting adult social care.

22

Why is this important?

The quality and sustainability of adult social care is at risk:

• More people with complex needs

• The cost of care is rising

• More people paying for their own care

• Serious challenges in recruiting and retaining staff

• No shared view of what quality means

23

Our principles

• Promote quality through everything we do

• Support and encourage improvement

• Coordinate action

24

How do we improve quality in adult social care?

• A shared understanding of high-quality care

• Effective and aligned support

• Joined-up action

25

Quality matters: a collective effort

People who use services, families, carers – giving feedback

Staff – capable, confident and supported

Providers – culture, organisation, expectations

Commissioners and funders – expectations of quality

Regulators – monitor, inspect, rate, take action, celebrate

Our single shared view of quality

26

27

Our single shared view of quality

28

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:

Our action plan priorities

1. Acting on feedback, concerns and compliments

2. Measuring, collecting and using data more effectively

3. Commissioning for better outcomes

4. Better support for improvement

5. Shared focus areas for improvement

6. Improving the profile of adult social care

29

What people told us they wanted

30

www.penmendonca.com

31

Get involved

• What commitments can you or your organisation make towards improving quality?

• Share your work on Twitter and join in the Quality matters conversation by using the hashtag #QualityMatters

32

This is a Q & A to you!

32

Person-centred co-ordinated

high quality care for all

What do commissioners need, in terms of their own processes, to commission good quality care?

33

This is a Q & A to you!

33

Person-centred co-ordinated

high quality care for all

What good practice examples do you have in your local area on

working with providers to drive quality improvement?

34

It is worth it!

34

Person-centred co-ordinated

high quality care for all

35

Thank you

35

#Qualitymatters

#StateofCare

Andrea Sutcliffe

Chief Inspector of Adult

Social Care

@CrouchEndTiger7

@CQCProf

Margaret Willcox OBE

ADASS President

@1adass

Sue Kelley

Expert by Experience

#NASC17

@LGAcomms