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CQC Thematic Activity Emma Steel Bernadette Hanney. What we will cover. Our regulatory model and the context for thematic activity Thematic reviews Themed inspection programmes. Legislation and standards. Parliament. Dept of Health. CQC.

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CQC Thematic Activity Emma Steel Bernadette Hanney


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    Presentation Transcript
    1. CQC Thematic Activity Emma Steel Bernadette Hanney

    2. What we will cover • Our regulatory model and the context for thematic activity • Thematic reviews • Themed inspection programmes

    3. Legislation and standards Parliament Dept of Health CQC Care Quality Commission (Registration) Regulations 2009 Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 Single system of registration Single set of standards Strengthened and extended enforcement powers

    4. 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 don’t 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

    5. Forms of regulation 5

    6. 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

    7. Priorities in action

    8. Our Regulatory Compilation Inspection Analysis Voices • Themed inspections • Scheduled inspections • Responsive inspections • Investigations • Thematic reviews • Quality Risk Profiles • Surveillance • Other data sources • Website feedback • Telephone or written feedback • Third party feedback • Whistleblowing • Safeguarding

    9. Thematic Reviews & Themed Inspections • Applicable to all inspectors • Where information can provide assurance and increase efficacy • Promotes consistency in follow up of concerns • increase confidence in Operations' interpretation of data • Can be precursor to a themed inspection, directing areas to examine • A sub set of inspectors • Where data is not available or cannot provide sufficient assurance • Where supported and coordinated inspection is preferred methodology • Random set of providers inspected • Can test the risk model and provide feedback THEMATICREVIEWS • Service level • Risk driven • Proportionate THEMED INSPECTIONS

    10. Proposed topics so far • Maternity: staffing and outcomes • Physical health needs of people with a learning disability • Pressure sores • End of life care for people in care homes • Deprivation of liberty safeguards • Hospital discharge arrangements • Medicines management • Care of people with mental health needs in A&E

    11. Type 1 Thematic Review • Suitability: a prescriptive commission to identify trusts at high risk of non-compliance within a specific topic area • Purpose: to maximise the use of existing data for risk based activity • Output: a hybrid of data analysis (RAG status at provider level) and expert prompts • Example: maternity: staffing and outcomes thematic review

    12. Maternity review provider report

    13. Maternity review provider report Individual scores are presented here Click on these questions to find out more about the results including links to outcomes and national standards. Click here to check the data period and weight of the data item If data is presented graphically or there is important additional information, you can click here to reveal the graph

    14. Regulatory response Total number of maternity providers = 144

    15. Type 2 Thematic Review • Suitability: collating all available datato create a comprehensive picture; alternative presentation of existing data • Purpose: to present a picture which adds value through correlation or triangulation with other sources • Output: a complete, current data set as a baseline report with limited policy interpretation • Example: Deprivation of Liberty Safeguards thematic review

    16. Deprivation of Liberty provider report

    17. Deprivation of Liberty provider report

    18. 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

    19. CQC Thematic Inspection Programme 2011/12 • NHS Dignity & Nutrition Spring/Summer 2011 • Learning Disability Services Autumn/Winter 2011 • Phase 2 Dignity & Nutrition Winter/Spring 2012 19

    20. Why do a learning disability inspection programme? • Serious abuse identified in a service for people with learning disabilities: • Winterbourne View 2011 • History of abuse in learning disability services: • Ely 1967 • Cornwall 2005/06 • Sutton and Merton 2006/07 20

    21. What does the inspection programme comprise of? • Care Quality Commission is undertaking inspections of 150 locations where assessment and treament and rehabilitation is provided. • A second phase will take the learning from phase one and look at alternative models of care. 21

    22. Inspection teams • Lead compliance inspector for this LD review • Compliance inspector portfolio holder • Experts by Experience: • person who has used services • family carer • Professional advisor 22

    23. Phase one Aims • To reassure people who use services, relatives, the public and CQC that the risk of such abuse occurring in any other unit is minimised. • To take appropriate action if concerns arise • To provide information for wider review of LD services. Actions Use existing methodology to inspect: • Outcome 4 (regulation 9) Care and welfare of service users • Outcome 7 (regulation 11) Safeguarding service users from abuse • We will report on our findings on every location and produce a national report

    24. Background to the inspection programme This review will directly support CQCs two strategic priorities: • We focus on quality and act swiftly to eliminate poor quality care; • We make sure care is centred on people’s needs and protects their rights • If we judge during this review that services are not meeting essential standards we will use our regulatory powers to ensure necessary improvements are made • If we judge during this review that people using a service are at risk, we take swift, proportionate action to protect people 24

    25. Questions • CQC – Helping make care better for people • Questions? 25