The Great British Care Show Ian Biggs Deputy Director of Operations (South) 30 May 2012

1. The Great British Care Show Ian Biggs Deputy Director of Operations (South) 30 May 2012

2. Role of a regulator People can expect services to meet essential standards of quality, protect their safety and respect their dignity and rights, wherever care is provided and wherever they live, despite changes in the system

3. CQC – what CQC does and does not do • CQC’s role • Register – inspect – enforce – publish • CQC registers care providers then checks whether they are meeting essential standards • If not, we take action – they must put problems right or face enforcement action • We publish what we find as quickly as possible • We share what we know with our partners • We put a premium on users/ whistleblowers • We monitor the care of those detained under the MHA • What CQC does not do • Wedo not make assessments of commissioning – although we can comment on shortcomings via themed reviews and investigations • We do not assess quality above essential standards • We only promote improvement by focusing on non- compliance • Inspectors are encouraged to describe what they see, comment on good practice and reference it

4. Palette of Regulation Inspection Analysis Voices • Themed inspections • Scheduled inspections • Responsive inspections • Investigations • Themed reviews • Quality Risk Profiles • Other data sources • Whistleblowing • Safeguarding • Website feedback • Telephone or written feedback • Third party feedback

5. Scale of CQC regulated care Independent healthcare 2,500 locations Independent ambulances 300 locations Primary medical services 9,000 locations Primary dental care 10,000 locations NHS Trusts 2,500 locations Adult social care 24,500 locations Dental appointments 36.4 million Combined outpatients and inpatients 77.4 million People using adult social care services 1.75 million

6. CQC’s lifecycle – a five-year programme Phase 1 - legacy HCC, CSCI, MHAC CSA until Sept 2010 Phase 2 Design and build From April 2009 Phase 3 Registration Apr 2010-13 Phase 4 Implement and review Ongoing Phase 5 Optimising the model April 2014 onwards…

7. Unannounced We do not notify providers before we carry out inspections Timely At least once a year or once every two years depending on the provider Flexible We can use different types of inspection to respondto concerns Focused Inspections will focus on outcomes that are important to people using services New approach to inspections Principles of inspection

8. Making a difference in the South Beautiful house and garden with sea view Bored and lonely What we found What we did What was the result Not clean Staff too busy to interact or respond to requests No choices 4 warning notices Meals a social occasion, view of the sea Listening and responding Things to do Choices

9. Making a difference in the South What we found What we did What was the result Poor care planning Poor maintenance Pressure sores and tissue damage Lack of dignity 6 warning notices Notice of proposal to cancel Personalised care planning New manager Health improvements Investment in property 9

10. Making a difference in the South Woken early What we found What we did What was the result Whistlebower Lack of overnight monitoring Early to bed 5.30am inspection Compliance actions People choice about routines Calmer atmosphere Better information and plans of care 10

11. Closing comments • The public puts its faith in those who run and work in care services • There must be a culture that won’t tolerate poor quality care, neglect or abuse – and encourages people to report it • The regulator cannot be everywhere, so we need to regulate with others • We remain cost blind in checking standards 11

12. Questions • CQC – Helping make care better for people • www.cqc.org.uk • Questions?