1 Natalie Gourgaud 2 February 2016 Presentation for DLF Moving and Handling Practitioners conference

2 Our purpose and role Our purpose 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 2

3 Rebuilding trust

The scale of regulated care Care homes 565,000 residents 400,000 current residents 165,000 going into care per year 39,000 people with severe learning disabilities in residential care 18,000 in a care home or care in their own home with no kith or kin NHS hospitals 90 million outpatient appointments per year 11 million inpatients per year 18 million A&E attendances 5 million emergency admissions/year 600k maternity users 42,000 detained and treated against their will Home-care 700,000 people receiving home-care support per year General public 53 million (35 million adults) Dentists 22 million on a dentist list 15 million NHS 7 million private Private hospital 1.4 million people receive treatment in a private hospital per year GP practices 52 million registered with a GP 150m appointments per year Health & social care staff 1.7m NHS staff 1.5m in adult social care NB There is overlap between our different audiences – none are wholly distinct from the others

Adult Social Care Inspection Directorate A typical inspection team for residential or domiciliary social care would have 1-2 inspectors, an expert by experience and specialist (e.g. dementia, pharmacy), with team size depending on provider size, location and risk. Typical inspections: - Residential care 2-5 days - Domiciliary care 2-4 days A typical inspection team for residential or domiciliary social care would have 1-2 inspectors, an expert by experience and specialist (e.g. dementia, pharmacy), with team size depending on provider size, location and risk. Typical inspections: - Residential care 2-5 days - Domiciliary care 2-4 days We run the Registration service for all sectors regulated by CQC We manage the relationship with big corporate providers and provide market oversight for the social care sector ASC: What do we regulate? 17,350 residential social care homes with and without nursing; 8,110 domiciliary care services; specialist college services; community based services for people with a learning disability; extra care housing services; shared lives; supported living services; hospice services.

6 The Mum Test Is it good enough for my Mum? Is it safe? Is it caring? Is it effective? Is it responsive to people’s needs? Is it well-led?

7 The new approach

8 Five key questions Safe EffectiveCaring By caring, we mean that staff involve and treat people with compassion, kindness, dignity and respect. By safe, we mean that people are protected from abuse and avoidable harm. By effective, we mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is evidence-based where possible.

9 Five key questions Responsive Well - led By responsive, we mean that services are organised so that they meet people’s needs. By well-led we mean that the leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.

Key Lines of Enquiry Safe 2 How are risks to individuals and the service managed so that people are protected and their freedom is supported and respected? Prompts What arrangements are there for managing risk appropriately, and to make sure that people are involved in decisions about any risks they may take? Are risk management policies and procedures followed to minimise restrictions on people’s freedom, choice and control? How are the premises and equipment managed to keep people safe?

Key Lines of Enquiry Effective 1 How do people receive effective care, which is based on best practice, from staff who have the knowledge and skills they need to carry out their roles and responsibilities? Prompts Are people supported to have their assessed needs, preferences and choices met by staff with the necessary skills and knowledge? Do staff have effective support, induction, supervision, appraisal and training? Does the service have links with organisations that provide sector-specific guidance and training linked to best practice in leadership and the delivery of care? Do staff have the skills to communicate effectively so that they can carry out their roles and responsibilities?

Key Lines of Enquiry Effective 4 How are people supported to maintain good health, have access to healthcare services and receive ongoing healthcare support? Prompts How are people’s day-to-day health needs met? How does the service make sure that people have information and explanations that they understand about their healthcare and treatment options and their likely outcomes? How are people involved in regularly monitoring their health? Have any changes that may require additional support or intervention been discussed with them? Are referrals made quickly to relevant health services when people’s needs change?

Key Lines of Enquiry Responsive 1 How do people receive personalised care that is responsive to their needs? Prompts Are people’s care plans used to make sure that they receive care that is centred on them as an individual, and is the planned care provided to them when and where they need it? How does the service make sure that people have the time they need to receive their care in a person-centred way?

Key Lines of Enquiry S3: How does the service make sure that there are sufficient numbers of suitable staff to keep people safe and meet their needs? E5: How are people’s individual needs met by the adaptation, design and decoration of the service? C1: How are positive caring relationships developed with people using the service? C3: How is people’s privacy and dignity respected and promoted? W3:How does the service deliver high quality care? 14

15 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

16 First ASC inspections and ratings Outstanding Good Requires improvement Inadequate As at 26 January 2016

17 Safety and leadership

18 Adult social care

19 Why does this all matter? People are at the heart of it