Care Quality Matters- A compliance Masterclass

1. Care Quality Matters- A compliance Masterclass Sughra Nazir Care Excellence Partnership

2. Welcome • Introductions • Care homes or domiciliary care? • About me

3. Exercise - Your care essentials • Outcomes • Impact

4. Plan for today • Looking ahead information from CQC about proposed changes • Move onto look at specifics

5. Compliance- why it matters • CQC. New questions • Fundamentals of care • Quality ratings • Council • Links to occupancy /business development and growth • Internet • Social media

6. New CQC questions • −− Are they safe? • −− Are they effective? • −− Are they caring? • −− Are they responsive to people’s needs? • −− Are they well-led? • Internal compliance needs to answer these questions

7. CQC top ten proposed changes • More systematic use of people’s views and experiences, including complaints • Inspections by expert inspectors, with more experts by experience and specialist advisors • Tougher action in response to breaches of regulation, particularly services without a registered manager for too long • Checking providers who apply to be registered have the right values and motives, as well as ability and experience • Ratings to support people’s choice of service and drive improvement 1 2 3 4 5

8. CQC top ten proposed changes (2) • Better data and indicators to help us target our efforts • New standards and guidance to underpin the five key questions • Avoid duplication of activity with local authorities • Focus on leadership, culture and governance with a different approach for larger and smaller providers • Frequency of inspection to be informed by ratings 6 7 8 9 10

9. New inspection process Surveillance

10. Other ideas from CQCss • Better use of technology to capture people’s views and experiences • Specific guidance on our expectations for the induction and training of staff who work in adult social care services • How we might encourage services to be more open and better integrated with local communities, creating an open culture • Allowing providers to pay for additional inspections if they believe the quality of their service has improved • Finding a better way of regulating supported living schemes • Potential use of mystery shoppers and hidden cameras to monitor care

11. Developing a ratings system • One overall rating for a service, always based on inspector’s professional judgement • Four point ratings scale – outstanding; good; requires improvement; inadequate – but more work needed on the descriptions • To be outstanding, it must feel outstanding to people who use the service, their families and carers. • We are considering whether to offer providers the opportunity to pay for an additional inspection • The things we look for will develop over time as people’s needs and aspirations change

12. Timelines • Co-production and development to shape consultation proposals • Oct 2013 – March 2014 • March 2014 • Consultation on regulatory approach, ratings and guidance • March – May 2014 • Wave 1 pilot inspections • June 2014 • Evaluation; guidance and standards refined • Wave 2 pilot inspections and initial ratings of some services • July – Sept 2014 • Oct 2014 • New approach fully implemented and indicative ratings confirmed • March 2016 • Every adult social care service rated

13. So what does that all mean? How will you evidence • −− Are they safe? • −− Are they effective? • −− Are they caring? • −− Are they responsive to people’s needs? • −− Are they well-led?

14. Before lunch • Doing a care plan audit • Doing a medication audit • Doing a staff file audit • Safe, effective, caring, responsive and well-led

15. Feedback from audits • Care plan audit • Medication audit • Staff file audit

16. Complaints What to include • Timescales • Named contacts • Social services • CQC? • Ombudsman Learn lessons?? Some examples coming up

17. 2 complaints • 1) list the issues and action you would take to investigate(10 minutes) • 2) draft the letter of response (10 minutes) • 3) consider any changes needed to systems processes, policies and practice (10 minutes)

18. Feedback from complaints exercise • 1 Care home example • 2 Domiciliary care example

19. The next challenge • Paragraphs 1, 2 and 3 • What Action would you take straight away? • What would you investigate and how? • What changes need to be made and what steps will you take to make sure the changes are made and implemented?

20. Feedback • Paragraph 1 • Paragraph 2 • Paragraph 3

21. Implementation tips – behaviours • Recruitment • Induction • Supervision • Team meetings

22. Implementation tips - documentation • Care plans – are they ever really up-to-date? • Medication – the missing gap • Food and fluid charts • Consistent and good quality daily records

23. Implementation tips – checks and audits • Audits – what to do if you find a gap • Staff awareness • Timing of audits • Person who is doing the audits • Links with performance/supervision

24. Next steps • Look at draft regulations • Look at current practice • Independently audit • Sughra Nazir • Care Excellence Partnership • 07737633500 • sughra@careexcellencepartnership.co.uk

25. Questions and individual issues • Any questions? • Any individual issues?