Priorities for regulating and inspecting dementia services Alison Murray, Head of Inspection Westminster Health Forum 30 January 2017 1
Our purpose The Care Quality Commission is the independent regulator of health and adult social care in England. We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve. 2
The Mum (or anyone you love) Test Is it responsive to people’s needs? Is it Is it effective? safe? Is it Is it well-led? caring? Is it good enough for my Mum? 3
State of Care 2016 • Published 13 October 2016 4
State of Care 2016: Adult social care The good news • Many services are providing good quality care – over 70% • More than three-quarters of re- inspected inadequate locations improved • 84% of community social care locations, including 92% Shared Lives services, Good or Outstanding • Caring achieves highest scores – 90% Good, 2% Outstanding 5
Great care The provider and staff supported people in a number of creative ways to lead a fulfilling life with a commitment and determination to promote people's quality of life. Innovative ways of involving people were used so people were at the heart of everything. People were listened to and their comments acted on. A person who liked heavy metal had a CD player and headphones. Another person liked birds – they had their own budgies and love birds to look after. Relatives told us they were amazed and moved by the changes they saw in their family member when they used their iPads. 6
State of Care 2016: Adult social care The worrying news • 26% services Require Improvement and 2% are Inadequate • Poorer performance for safety and leadership • Nearly a quarter of re-inspected inadequate services did not improve • Half of services rated requires improvement did not improve on re- inspection – 8% became inadequate • Services for older people fare worse than those for people with a learning disability 7
Poor care The home was not clean. Bins outside the home were over-flowing and household rubbish was kept in the garden which could encourage pest infestation. There has been inconsistent People were not leadership at the receiving medicines home, with safely and the One member of management temperature for staff when asked changes and storing medicines about MCA “I periods of was too high to probably have management ensure medicines had training, I absence. were effective. can’t think what it is off hand, is it when people are Staff employed at the home did not have the skills too ga ga?” and knowledge required to support people safely. 8
Dementia care • Care providers: • Help people living with dementia maintain independence for as long as possible • Enable people living with dementia to live life to the full • Make sure families and carers feel cared for and supported • Ensure end of life care is the best it can be • See the person not the diagnosis 9
State of Care 2016: approaching a tipping point? • Age UK estimated in 2015 over a million older people have unmet social care needs, up 800,000 from 2010 • 26% fewer older people receive LA funded care – 81% of councils reduced spending on social care • Five-year increase in nursing home beds now stalled • Some providers resigning contracts, councils warn of more • Recruitment and retention of staff a challenge Source: CQC – State of Care 2015/16 10
Quality matters: a collective effort The public – people who use services, families and carers Staff – capable, confident and supported Providers – culture, organisation, expectations Commissioners and funders – expectations of quality Regulators – monitor, inspect, rate, take action, celebrate 11
Our next phase of regulation: a more targeted, responsive and collaborative approach
The purpose of the consultations How we propose to update our approach and our assessment framework to reflect the changing provider landscape closer working more targeted more greater and approach that integrated emphasis on alignment focuses on approach that leadership , with NHS areas of enables us to including at Improvement greatest be flexible the level of and other concern , and and overall partners so where there responsive to accountability that providers have been changes in for quality of experience improvements care provision care less in quality duplication There will be two consultations on these changes: one in Winter 2016/17, and another in Spring 2017
Consultations on our proposed changes to inspections 20 December 2016 – 14 February 2017 New care models and complex providers Spring 2017 (TBC) Cross sector changes to assessment Changes to Adult Social frameworks Care inspection methodology Updated guidance for registration of learning disability services Changes to Primary Medical Services Changes to Hospitals inspection inspection methodology methodology Changes to registration Developing quality ratings for NHS trusts and other complex providers NHS Improvement consultation on Use of Resources and ‘well-led’ scheduled for December
Changes to our assessment framework • Reducing the number KLOEs sets from 11 to two; one for healthcare and one for ASC • Majority of the KLOEs and prompts relevant to all health or adult social care sectors • Continue to provide additional sector-specific materials • Also informs evidence when registering providers To be made available primarily as online information
Strengthen and simplify We are not proposing a significant shift in what we already ask of providers; rather, our proposals for change represent an evolution of our framework. Strengthen Simplify • Aligning the questions we ask of • Based on learning over the past three years and changes in the different sectors sectors • Promote a single shared view of • Not ‘raising the bar’ for providers quality • Providers to be able to demonstrate • A simpler process to reduce regulatory burden on providers how they are developing and adapting
Get involved Respond to the first consultation on our next phase of inspections until 14 February 2016 • www.cqc.org.uk/nextphase • nextphase@cqc.org.uk • @CareQualityComm using #CQCnextphase To respond to the NHS Improvement joint consultation on Use of Resources and the ‘well-led’ domain, please follow the link on the above web page.
Thank you www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm 18 18
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