1. Trade Associations meeting
Adult social care
Trade Associations meeting
14 September 2016 1 1

2. Agenda No. Agenda item Lead Time Welcome and introductions Sue Howard
Welcome and introductions
Sue Howard
10.00
2. 
Minutes and actions from last meeting
Arti Luther
10.05
3. 
Ratings and updates
10.10
4. 
Issues raised by Trade Associations
10.20
5. 
Mental Health Update
Emily Weston
10.45
7. 
Single shared view of quality
Charles Rendell
11.05 8.
AOB
11.25 2

3. Welcome and introductions

4. Minutes and actions from last meeting

5. Ratings and updates

6. Current ratings overall and by key question for active locations
Current ratings up to
8 September 2016
Note: Figures in chart are percentages
Source: CQC ratings data

7. Current overall ratings by service type
Source: CQC ratings data

8. Current overall ratings by size of care home
Small = 1-10 beds, Medium = 11-49, Large = 50+
Source: CQC ratings data

9. Current overall ratings by size of domiciliary care agency
The above chart presents data we have for DCA locations that have been rated and the number of people using the service. There is a trend suggesting that locations providing care to a smaller number of people are performing better than larger services. This analysis is based upon 2,214 rated DCA locations.
Source: CQC ratings data and CQC community PIR data from May 2016

10. Overall ratings by publication quarter – Residential social care
Residential social care ratings, by publication quarter
Calendar quarter
Inadequate
Requires improvement
Good
Outstanding
2015 Q1
186
666
1,050 7
2015 Q2
191
898
1,306 4
2015 Q3
174
928
1,277 15
2015 Q4
163
877
1,515 13
2016 Q1
181
978
1,813 18
2016 Q2
170
999
1,850 29
2016 Q3
151
714
1,238 26
Source: CQC ratings data

11. Overall ratings by publication quarter – Community social care
Community social care ratings, by publication quarter
Calendar quarter
Inadequate
Requires improvement
Good
Outstanding
2015 Q1 19 63
186 5
2015 Q2 27
153
313
2015 Q3
389 3
2015 Q4 28
183
469 2
2016 Q1
224
728 13
2016 Q2 37
280
869
2016 Q3 30
200
624 12
Source: CQC ratings data

12. Overall ratings by region (rated locations)
Figures in chart are percentages of rated locations
Source: CQC ratings data

13. Overall ratings by region (all locations)
Figures in chart are percentages of all locations with the grey % being location not yet rated
Source: CQC ratings data

14. Hospital discharge needs assessment

15. Mental Heath Update

16. Inspection of mental health services – who does what?
Hospitals Directorate
Adult Social Care Directorate
Primary Medical Services Directorate
Mental Health Trusts – inpatient and community
Independent mental health services – inpatient and community
Substance misuse services where treatment is carried out (medical or psychosocial)
Housing with care for people with mental health or substance misuse issues
Domiciliary Care Agencies
Care homes
Care homes with nursing
GPs – Mental health care looked at alongside other healthcare provision

17. Substance misuse services
Regulated activity determines inspection type
Regulated activities are listed in Schedule 1 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014
Hospital inspection
Adult social care inspection
Accommodation for persons who require treatment for substance misuse
Accommodation for persons who require nursing or personal care
Treatment of disease, disorder or injury
Personal care
Assessment or medical treatment for persons detained under the Mental Health Act 1983
Diagnostic and screening procedures
Nursing care

18. Update on adult social care mental health registration and inspection (1)
Adapting to new models of care – registration and inspection
Single inspections where possible
Revision of approach to inspecting combined providers
Risk enablement v. risk avoidance
Greater focus on role of leadership at provider/corporate level
Simplification of registration system and queries
Development of risk-based registration (set out in strategy)
Role of relationship management – review across all sectors
Improved understanding for inspectors on mental health provision, new emergent models and risk enablement at all levels
Development of specialisms for inspectors
“What good looks like in…” guidance
Improved training on issues such as assessing medicines management
Simplifying system of registration and queries so that it is more relationship based by area or provider
Reviewing role of relationship management across all sectors
Looking to develop risk-based registration (set out in strategy)
Inspection report and feedback standards
Format of reports being looked at for next phase
Improved factual accuracy process
Single inspections where possible
Revise approach to inspecting combined providers
Greater focus on role of leadership at provider/corporate level
Next phase approach needs to be flexible enough to cope with new models of care – registration and inspection

19. Update on adult social care mental health registration and inspection (2)
Enhancing inspector skills and knowledge about mental health
Inspection report and feedback standards
Revision of report format for next phase of inspection
Improved factual accuracy process
Improved understanding for inspectors on mental health provision, new emergent models and risk enablement at all levels
Development of specialisms for inspectors
“What good looks like in…” guidance
Improved training on issues such as assessing medicines management
Simplifying system of registration and queries so that it is more relationship based by area or provider
Reviewing role of relationship management across all sectors
Looking to develop risk-based registration (set out in strategy)
Inspection report and feedback standards
Format of reports being looked at for next phase
Improved factual accuracy process
Single inspections where possible
Revise approach to inspecting combined providers
Greater focus on role of leadership at provider/corporate level
Next phase approach needs to be flexible enough to cope with new models of care – registration and inspection

20. Single shared view of quality

21. We promote a single shared view of quality
The challenges facing our health, public health and social care system require a joined-up approach and increased partnership between national bodies.
We are working with our partners, providers and the public to agree a definition of quality and how this should be measured based on the five key questions.
Strategy 2016 set out our commitment to a shared view of quality.
What that means is:
Greater alignment – eg so that we use the same language, definitions, expectation and measures as other organisations that regulate and oversee care quality.
Reduced duplication – eg so that there aren’t multiple different agencies asking for the same information in different ways and at different times.
We know we can’t do any of this alone – we must work with people who use services, providers, and other partners locally, regionally and nationally.

22. We’re making a shared commitment to quality with other national bodies
We will work together more effectively to safeguard quality and encouraging improvement in quality, by:
Supporting commissioners, providers and professionals with the tools, information and capability they need to pursue quality improvement;
Reducing the administrative requirements of oversight and regulation, to free up time to focus on quality improvement; and
Championing quality, with and for people who use services, as a shared goal that requires all of us to commit and to act.
Just one of the ways in which we’re working to promote a shared view of quality is through the National Quality Board.
The National Quality Board brings together the national oversight bodies for health, public health and social care. CQC’s Chief Inspector of Hospitals co-chairs the board.
Through the board, and with input and challenge from our partners (eg LGA, NHS Confed, NHS CC, SCIE), we’re about to launch a shared commitment to quality.
This is just a document – but it makes clear that we will work together more effectively to support commissioners, providers and professionals to maintain and improve quality.

23. Turning our commitment into concrete action
Thinking about how the national bodies work together with providers, professionals and commissioners to maintain and improve quality:
What would it look like it we were really effective at maintaining and improving quality together? What would the national bodies be doing and saying?
What do we currently do that doesn’t help to maintain and improve quality together?
What one change would have the greatest impact on maintaining and improving quality?
To turn our commitment into concrete action, we want to know what matters most to you.

24. AOBs