1. RNHA
What CQC expect
16 October 2014
Nick Kerswell 1 1

2. Our purpose and role Our purpose Our role
We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve
Our role
We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care
We will be a strong, independent, expert inspectorate that is always on the side of people who use services 2

3. What kind of regulator? Independent of politics and the system
Covers all sectors
Clinically driven with expert teams, no guarantees
Evidence-based judgement, not regulatory compliance
Highlight excellence and expose poor care with transparent ratings
Always on the side of people who use services
Critical friend
Consistent and fair 3

4. Is it safe? Is it effective? Is it responsive? Is it caring?
Our new approach
We ask these questions of all services:
Is it safe?
Is it effective?
Is it responsive?
Is it caring?
Is it well-led? 4

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

6. Our new approach 6

7. What are we doing differently?
Larger inspection teams including specialist inspectors, clinical experts, and Experts by Experience
Intelligent monitoring to decide when, where and what to inspect
Inspections will focus on five key questions about services
We have developed services/groups and pathways that we focus on in each sector
KLOEs (key lines of enquiry) form the overall framework for a consistent and comprehensive approach
Ratings compare services and highlight where care is outstanding, good, requires improvement or inadequate

8. Our new approach 8

9. Formulating judgements and ratings
Intelligent monitoring and local information
Pre-
inspection information gathering
On-site
inspection
Speak to staff and people using the service
Key lines of enquiry (mandatory plus additional KLOEs identified from information held)
Gather and record evidence from all sources
Define the questions to answer
Write report and publish alongside ratings
Outstanding
Good
Requires improvement
Inadequate
Apply consistent principles, build ratings from the recorded evidence
Make judgements and build ratings 9

10. Four point scale High level characteristics of each rating level
Innovative, creative, constantly striving to improve, open and transparent
Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong
May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong
Severe harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve
Following each inspection, we will judge whether services are outstanding, good, requires improvement or are inadequate.
We have developed characteristics to describe what each of these ratings looks like (which we’ll take a closer look at in our next table session). 10

11. The importance of leadership: being well-led drives up quality
  “It’s the leaders in organisations who really make a difference to the cultures of organisations – by what they attend to; what they value; what they monitor and what they model in their behaviours. The challenge for us is how can we ensure we have leadership, which ensures that there is a focus on the vision of providing high-quality, continually improving, and compassionate care at every level of the organisation? Not just in the vision or mission statements but in the behaviours throughout the organisation.”
Michael West, The King’s Fund

12. CQCchanges.tellus@cqc.org.uk @CareQualityComm www.cqc.org.uk
Get involved
@CareQualityComm

13. Thank you 13