CQC Inspections: seeking assurance of good practice Prof. Ursula Gallagher, Deputy Chief Inspector of General Practice (London) Janice Waters, National Advisor - Safeguarding Children and Adults University of East Anglia 15th September 2017 1 1

Our role 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 Strategy Slides - 24 May 2016 - MASTER

Monitor, inspect and rate Our current model of regulation Register Monitor, inspect and rate Enforce Independent voice We register those who apply to CQC to provide health and adult social care services We monitor services, carry out expert inspections, and judge each service, usually to give an overall rating, and conduct thematic reviews Where we find poor care, we ask providers to improve and can enforce this if necessary We provide an independent voice on the state of health and adult social care in England on issues that matter to the public, providers and stakeholders

A changing environment Why a new strategy? A changing environment Use and delivery of regulated services is changing CQC must deliver its purpose with fewer resources Adapt and improve We want to become more efficient and effective to stay relevant and sustainable for the future The public, and organisations that deliver care, have told us we have improved but we know there is more to do Strategy Slides - 24 May 2016 - MASTER

It's fundamental to high-quality health and social care. Safeguarding means protecting people's health, wellbeing and human rights, and enabling them to live free from harm, abuse and neglect. It's fundamental to high-quality health and social care.

What is our role in safeguarding? Ensuring providers have effective systems and processes Using intelligent monitoring to assess risk Making sure the right people act at the right time to keep people safe Raising safeguarding issues we discover during inspections and alerting local authorities/police if necessary Holding providers to account and taking regulatory action Publishing our findings Regulation 13

State of Care 2015/16 What we have found Safeguarding practice Safeguarding reporting 7

Safeguarding incidents by sector *Please Note: Sector is based on primary inspection category. Due to S3 moving into Hospital on the 1st April 2017, incidents at S3 locations are counted as ASC for the purposes of this analysis

Consultations on our proposed changes to inspections Closed 8 Aug 17 20 December 2016 – 14 February 2017 New care models and complex providers Cross sector changes to assessment frameworks Updated guidance for registration of learning disability services Changes to Hospitals inspection methodology 12 June – 8 August 2017 Changes to Adult Social Care regulation Changes to Primary Medical Services regulation Clarifying how we define registered providers and improving the structure of registration Updating guidance on Fit and Proper Person Requirements Closed Winter 2017 Changes to Independent Acute inspection methodology A joint consultation on Use of Resources with NHS Improvement is expected in Winter 2017

Safeguarding adults in prisons or approved premises Discussion Safeguarding adults in prisons or approved premises

Safeguarding adults in prisons or approved premises Care Act 2014: Sections 42 and 47 (safeguarding: enquiry by local authority and protection of property) do not apply in the case of an adult who is— (a) detained in prison, or (b) residing in approved premises  

Safeguarding adults in prisons or approved premises Potential legislative impact – reduced assurance: National prison service guidance (PSI 16/2015) is subject to local interpretation and implementation is variable, including information sharing and engagement with local SABs Health and social care providers can no longer rely on support from local safeguarding teams/boards Absence of independent scrutiny of the prison management and investigation of safeguarding concerns (outside periodic inspection by HMI Prisons and CQC) CQC cannot require prisons to investigate concerns or share the outcome of their investigation with us.

Our roles and responsibilities for safeguarding adults and children More information Our roles and responsibilities for safeguarding adults and children Information about joint inspections The fundamental standards www.cqc.org.uk/content/safeguarding-people In depth information about regulation 13 http://www.cqc.org.uk/content/regulation-13-safeguarding-service-users-abuse-and-improper-treatment#full-regulation

Deputy Chief Inspector of General Practice (London) Thank you www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm Prof. Ursula Gallagher Deputy Chief Inspector of General Practice (London) Generic Acute Deck - October 2015