How to avoid a warning notice 4 December 2012 Jennifer Pattinson Compliance Manager

1. How to avoid a warning notice 4 December 2012 Jennifer Pattinson Compliance Manager

2. 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 2

3. Who are we? We make sure people get better care Who are we improving care for ? People who use services, carers and families People in more vulnerable circumstances Public and taxpayers Our priorities Focus on quality, and acting swiftly to help eliminate poor quality care Making sure care is centred on people’s need and reflects their rights What we will do to achieve our priorities Registration and ongoing monitoring Special reviews and studies Regular reviews of performance Mental Health Act visits Publishing information Enforcement 3

4. 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

5. 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 5

6. 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 risk • CQC must act swiftly when it sees signs of poor care and take strong action when things go wrong in care services • Regulation is not the only answer - quality and safety is everyone’s business • Must be greater integrationbetween health and social care – this will improve outcomes and improved efficiencies

7. 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

8. The regulation system Single system of registration 1 Single set of standards – the essential standards of quality and safety 2 Strong enforcement powers 3 4 Adult social care Regulation NHS Innovative use of information Independent health care 5 Reduced overall cost

9. Scale of CQC regulated care Independent healthcare 2,500 locations Independent ambulances 350 locations Primary medical services 9,000 locations Primary dental care 10,000 locations NHS Trusts 2800 locations Adult social care 24,000 locations Dental appointments 36.4 million Combined outpatients and inpatients 77.4 million People using adult social care services 1.75 million

10. CQC registration and standards • 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 Our focus: People focused Outcome based Plain English

11. Compliance monitoring

12. 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

13. 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. 13

14. 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…… 14

15. 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?.

16. Refining our regulatory model • 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

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

18. 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

19. Questions • CQC – Helping make care better for people • Questions? • Jennifer Pattinson, Compliance Manager • jennifer.pattinson@cqc.org.uk 19