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How to avoid a warning notice 4 December 2012 Jennifer Pattinson Compliance Manager. Background. Regulator for health and social care – created in April 2009 Putting people, their families and carers at the centre of everything we do

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How to avoid a warning notice

4 December 2012

Jennifer Pattinson

Compliance Manager


  • 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


Who are we
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


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



Priorities in action
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

About us
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


Cqc in a changing environment
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

Cqc in a changing environment continued
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

The regulation system
The regulation system

Single system of registration


Single set of standards – the essential standards of quality and safety


Strong enforcement powers



Adult social care



Innovative use of information


health care


Reduced overall cost

Scale of cqc regulated care
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

Cqc registration and standards
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

How we gather evidence to monitor compliance
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

So what does safe mean for cqc
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.


So what does safe mean for cqc1
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……


Ensuring compliance
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?.

Refining our regulatory model
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

  • New approach to inspection
    New approach to inspection


    CQC do not notify providers before we carry-out inspections

    Principles of



    At least once a year or once every two years depending on the provider


    CQC can use different types of inspection to respondto concerns


    Inspections will focus on outcomes that are important to people using services

    Changes to how cqc takes action
    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


    • CQC – Helping make care better for people

    • Questions?

    • Jennifer Pattinson, Compliance Manager

    • [email protected]