Raising standards, putting people first Our strategy for 2013 to 2016 April 2013 1 1

Compliance Inspector Team 11(Brent 7 Harrow) , Care Quality Commission Andreas Schwarz Compliance Inspector Team 11(Brent 7 Harrow) , Care Quality Commission 2 2

Views, comments and recommendations CQC public consultation Sept - Dec 2012 Francis Report recommendations and the Government’s response Winterbourne View Serious Case Review Health Select Committee report Review of our regulatory model by Kieran Walshe Review of our investigations by Deloitte Health and social care ratings review by the Nuffield Trust In developing our strategy we have looked closely at how we carry out our role, listening to what people who use health and social care services, providers of those services and others tell us to make sure we focus on what matters to them. Our consultation and engagement - Over 1,000 people attended 70 events + online engagement; 400 formal consultation responses – broad support for our strategic direction; debates over the ‘how’. Robert Francis published his report into the Public Inquiry into Mid Staffordshire NHS FT on 6th March. His main criticism was that services did not focus on patients or their safety. Francis made 290 recommendations designed to change the culture to one that “puts patients where they are entitled to be – the first and foremost consideration of the system and everyone who works in it.” Francis identified 5 things that need to happen to develop a patient centred culture: No tolerance of non compliance with fundamental standards Openness and transparency Candour to patients Strong cultural leadership and caring, compassionate nursing Useful and accurate information about services As a response to the scrutiny CQC received and the development of our strategic review, an evaluation of our regulatory model was commissioned in summer 2012. This review was sponsored by our Board member Professor Martin Marshall and led by Professor Kieran Walshe a regulatory academic at Manchester Business School. The purpose of this work was to help develop a strategic framework to guide CQC’s programme of evaluation. Some conclusions present us with some challenging issues, however our strategic review has, in many ways, already acknowledged these.  In addition Deloitte were commissioned to look at the use of our investigations methodology. Again the conclusions have presented us with challenges, however these have also been considered and taken account of in our proposals. We have also taken account of the Department of Healths report - Transforming care: A National response to Winterbourne View Hospital - that sets out steps to respond to the failings that led to the abuse of patients at Winterbourne View. These include tightening up the accountability of management and corporate boards for what goes on in their organisations. There are 15 recommendations specific to CQC that we have taken account of. HSC annual report published – January 2013 Jennifer Dixon to made recommendations to the secretary of state about aggregated assessments / ratings in March 2013 3 3

Our purpose and direction 4 4

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 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 Thousands of people - members of the public, our staff, providers, professionals and others – have given their views during CQC’s consultation on its strategy for the next three years 5

Underpinning our approach Our judgements will be independent of the health and social care system We will always be on the side of people who use services 6 6

Five influences on quality Commissioners Professionals Providers Regulators People who use services 7 7

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? 8

Things we will do differently Appoint a Chief Inspector of Hospitals, and a Chief Inspector of Adult Social Care and Support, and consider the appointment of a chief inspector for primary and integrated care Develop fundamental standards Specialist inspectors leading expert teams, including clinical and other experts, and experts by experience NHS hospitals: national teams with expertise to carry out in-depth reviews of hospitals with significant problems 9

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 failure Predict, 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 experiences Improve understanding of how well different care services work together Work more closely with our partners in the health and social care system to improve the quality and safety of care 10

Things we will do differently Publish better information for the public, including ratings of services A more thorough test for organisations applying to provide care services, making sure named directors, managers and leaders commit to meeting standards, which is tested at registration Strengthen the protection of people whose rights are restricted under the Mental Health Act Build 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 purpose 11

What we will continue to do A programme of unannounced inspections and reporting across the sectors we regulate Inspections at any time in response to concerns Inspections and reviews on particular areas of care Regulatory and enforcement action 12

Next steps Changes for 2013/14 set out in our Business Plan We will deliver: New fundamental standards New hospital inspection methods Hospital ratings Begin to develop changes for other sectors Continued involvement of staff, providers, stakeholders and public in the development of our work 13

Consultation Consultation on changes to the way we inspect, regulate and monitor care services Closing Date: 12 August 2013 Link: http://www.cqc.org.uk/public/sharing-your- experience/consultations/consultation-changes-way-we-inspect- regulate-and-monito

Questions? 15 15

Thank you for your contribution 16 16