2 Our purpose Our role Our purpose and role We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improveOur roleWe 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 careOur purpose and role, as set out in our new strategy ‘Raising standards, putting people first’, published in April 2013, is clear.2
3 Underpinning our approach Our judgements will be independent of the health and social care system; and politicsWe will always be on the side of people who use servicesOur relationship with providers will be constructive not adversarialPatients and other users will be at the heart of the regulatory processProviders and clinicians remain responsible for safety and qualityNo 100% guaranteesThe values underpinning our new approach are important.We are independent of the NHS and social care systems, and government and operate under our own legistlation.We are on the side of people who use services – patients, carers, families – and seek to be constructive with service providers, but we will have a zero tolerance approach where they break the rules.Providers, clinicians and those we regulate are ultimately responsible for quality and safety. And we cannot offer a 100% guarantee that poor care will not happen again.33
4 Five things we will look at We will tackle the following five questions about services:Are they safe?Are they effective?Are they caring?Are they well led?Are they responsive to people’s needs?Our new approach sees a move to regulate around these five questions.People have a right to expect safe, effective, compassionate, high-quality care. We play a vital role in making sure that care services meet those expectations.4
5 Things we will do differently Appoint chief inspectors of hospitals, adult social care and support, and primary and integrated careDevelop fundamental standardsSpecialist inspectors leading expert teams, including clinical and other experts, including experts by experienceNHS hospitals: national teams with expertise to carry out in depth reviews of hospitals with significant problemsOur new strategy, published in April 2013, and our consultation document, ‘A New Start’, published in June 2013, outline key changes that we plan to make.The next 3 slides outline these.5
6 Things we will do differently NHS hospitals: a clear programme for failing trusts that makes sure immediate action is taken to protect people and deal with failurePredict, identify and respond more quickly to services that are failing, or likely to fail, by using information and evidence in a more focused and open way – including people’s views and experiencesImprove understanding of how well different care services work togetherWork more closely with our partners in the health and social care system to improve the quality and safety of care6
7 Things we will do differently Publish better information for the public, including ratings of servicesA more thorough test for organisations applying to provide care services, making sure named directors, managers, and leaders commit to meeting standards which is testedStrengthen the protection of people whose rights are restricted under the Mental Health ActBuild a high performing organisation that is well run and well led, has an open culture that supports its staff and is focused on delivering its purpose7
8 What we will continue to do A programme of unannounced inspections and reporting across the sectors we regulateInspections at any time in response to concernsInspections and reviews on particular areas of careRegulatory and enforcement actionHowever, some things remain. Most inspections continue to be unannounced, we continue to take longer looks at certain themes of care eg. Dementia, maternity.8
9 Next steps Changes for 2013/14 set out in our Business Plan We will deliver:New fundamental standardsNew hospital inspection methodsHospital ratingsBegin to develop changes for other sectorsContinued involvement of staff, providers, stakeholders, public in the development of our workWe are formulating our business plan and awaiting the results of our consultation which closes on 12 August 2013.While involving all of our stakeholders, staff and the public in our consultation and beyond, we will deliver new fundamental standards, new methods of inspecting hospitals (longer, with clinical and patient involvement, more in-depth), and hospital ratings will begin by the end of Changes will begin to develop for other sectors into 2014.9
10 Consultation launch date – Monday 17 June Closing commentsPeople have a right to know that care is safe, effective, compassionate and high qualityWe are changing the way we inspect and regulate to play a vital role in making sure that care meets those expectationsConsultation launch date – Monday 17 JuneConsultation closes on 12 August Please give comments through our website –101010
11 Regulated care in the London Primary medical services1550 locationsIndependent healthcare234 locationsIndependent ambulances51 locationsNHS Trusts217 locationsAdult social care2,381 locationsPrimary dental care1,004 locations5491locations
12 673 locations Regulated care in Team 1 184 locations 35 locations Primary medical services184 locationsIndependent healthcare35 locationsIndependent ambulances3 locationsNHS Trusts9 locationsAdult social care271 locationsPrimary dental care161 locations103 care homes without nursing (older people LD and MH), 51 nursing homes, domiciliary agencies 105 and some supported living facilities, care homes for people who require treatment for substance misuse673locations
13 The law says that health and social care services must meet essential standards. This is so that people know what to expect from health and social care services.We, the Care Quality Commission, have made rules about what people can expect when services are meeting the essential standards.
14 How we checked Rainbow House How we checked Rainbow House We asked people for their views.We asked staff and managers for their views.We looked at policies, records and care plans.
15 We watched to see how staff treated people using the service. We watched to see how staff treated people using the service. We thought about what we learnt. We decided what Rainbow House was doing right and what it was not doing well.
16 What they were doing right at Rainbow House What they were doing right at Rainbow HouseBefore a person moves into Rainbow House their needs are checked.
17 The person and people important to them are asked what they think. The person and people important to them are asked what they think.Rainbow House gives people information about what it is like to live there in a way they understand.
18 Activities took place regularly inside the home and outside. People were usually able to choose what activities they would like to do.Activities took place regularly inside the home and outside.People got the right care and support in a safe way.Staff helped make people feel safe.
19 There were enough staff to care for people. There were enough staff to care for people.More staff worked in the home when they were needed.Staff got training to make sure they meet people’s needs in the best way.
20 The owner checked all staff and supported them to do their work. The owner often checked Rainbow House to make sure care was good and people were safe.The owner checked all staff and supported them to do their work.
21 What Rainbow House was not doing well What Rainbow House was not doing wellThe owner did not always make sure bedrooms were warm and safe, and the home well decorated.
22 People’s records when they saw doctors and other professionals were not available.What happens next?We have asked the owner to tell us how and when they will make things better. We will check they have done this.