4 Nations Thematic Activity Conference CQC - 11 November 2011

1. 4 Nations Thematic Activity Conference CQC - 11 November 2011 RQIA Thematic Activity in Northern Ireland

2. Programmes of Thematic Activity • Thematic Review Programme for Health and Social Care (HSC) Services • Thematic approaches within the Programme of Inspections for Regulated Services • Inspection Programme to fulfil RQIA responsibilities under the Mental Health Order • HSC Infection Control and Hygiene Inspections • Programme of IR(ME)R Inspections • Joint inspections of Prison Health with Criminal Justice regulators

5. Review Programme 2009-2012

7. Review Programme 2012-2015

8. Balancing the Review Programme OVERALL HEALTH & SOCIAL CARE ASSESSMENT RQIA provides independent assurance about the quality, safety and availability of health and social care services in Northern Ireland, encourages continuous improvements in those services and safeguards the rights of service users

12. Use of thematic approach in Mental Health and Learning Disability Services 1 April 2009: Assumed responsibilities under the Mental Health (NI) Order 1986

13. Core Activities Improving Care Informing the Population Safeguarding Rights Influencing Policy

14. Talking directly with service users their relatives and carers Patient Experience Reviews/ Inspection information and Intelligence Monitoring of detention and conditions of detention SAIs Early days – getting a baseline RQIA’s approach

15. Adoption of the Rights based approach • key principles of: • Protection (2011/12) • Respect • Autonomy • Fairness (2010/11) • Equality

16. Framework for regulation • Framework for regulation - Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003 • Subordinate regulations • Associated service-specific standards

17. Thematic approach to regulation • Selection of 4 standards or theme areas for each service on annual basis • Focus on outcomes for users • Themes selected by prioritisation • Introduction of regulation for improvement

18. Identifying themes • Issues identified by service users • Concerns identified by regulation team • Strategic/ political issues (currently: whistleblowing, complaints, care management) • Unresolved major concerns

19. Selecting themes • Categorisation of issues as weighted to quality or safety • Application of prioritisation criteria • Balancing tool approach • Selection for all service types agreed with Director

20. Inspection template • Possible alignment of themes with standards • Criteria (indicators) identified from standards and other sources • Correlation with regulations

21. Prioritisation factors - 1 • Regional and/or national priority for safety and/or quality • Variations in quality create a major risk for the population affected • Area of significant or developing public concern

22. Prioritisation factors - 2 • High proportion of the population is affected • Evidence of a possible variation in quality arising from existing data and/or existing reports • Recognised inequality in how health and social care services are provided

23. Proportionate approach • “Dipstick” unannounced inspections • Risk rating framework – Inspection Planning Tool • Factors from regulations – focused on safety • Individual regulation plans for each service