1. David James – CQC Policy Team

2. Technology and regulation
Dave James
Head of Adult Social Care Policy, Care Quality Commission 2
Generic ASC deck (June Final) 2

3. Purpose of this session
To describe CQC’s approach to assessing outcomes and how this applies to technology in care
To prompt a discussion on our approach, future challenges and how we can all work together to ensure technology can be used to underpin high quality care

4. A quick show of hands
Do you think CQC is a barrier to technological innovation in adult social care?

5. 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
Register
Monitor and inspect
Use legal powers
Speak independently
Encourage improvement
People have a right to expect safe, good care from their health and social care services
Strategy Slides - 24 May MASTER

6. Is it responsive to people’s needs? Is it good enough for my Mum?
Ambition for social care: The Mum Test (or Anyone You Love test)
Is it responsive to people’s needs?
Is it good enough for my Mum?
Is it
effective?
Is it safe?
Is it
well-led?
Is it caring?
Generic ASC deck (June Final)

7. Ratings based on outcomes
Outstanding The service is performing exceptionally well.
Good The service is performing well and above minimum legal requirements.
Requires improvement The service isn't performing and may be in breach of legal requirements.
Inadequate The service is performing badly, is in breach and we've taken action.

8. the service is consistently well-managed and led
The Characteristics of Good and Outstanding care
SAFE
People protected from avoidable harm and abuse
Supported to keep themselves and belongings safe and secure
EFFECTIVE
People’s outcomes and feedback are consistently good
Outcomes are consistently better than other similar services
CARING
people supported, treated with dignity and respect and involved as partners in their care
RESPONSIVE
Needs met through way services organised & delivered
Meet needs of individual and ensure flexibility, choice and continuity of care
WELL-LED
the service is consistently well-managed and led
the leadership, governance and culture drive high-quality, person-centre care
More detail sits at KLOE level – this is an illustration at KQ level
Use of tech doesn’t change these

9. Technology in care
Technology is changing how care is provided & the benefits can be significant – technology can;
give people more control over their health, safety and wellbeing
Increase independence, decrease isolation
link to services which are important to people
enhance the effectiveness of care or treatment
help people communicate with families, professionals and staff
help staff to prioritise and focus their attention on people who need it most
capture and compare data, and share good practice with peers.
But technology and other innovations should never come at the expense of high-quality, person-centred care - the interests of the person using the service must be at the heart of any decision to use technology

10. Technology in care
Some questions that will help you prepare if you’re thinking about using technology to deliver care – CQC will want to know the answers too!
Involving people
Who will the technology affect and how?
How will you involve them in your plans?
What do they need to know to make an informed choice? Do they fully understand the implications of the new technology?
How have you involved your staff? What information and training do they need so they can be confident and competent?
Clarity of ambition
What outcome do you want to achieve? How will you measure it?
Safety and legal considerations
What are the practical and legal issues you need to think about before you introduce new technology?
What are the risks and how will you manage them, particularly during transition & early implementation? How will you keep people safe?

11. respects the needs and preferences of the person using the service
The (draft!) areas of focus…
Person Centred
respects the needs and preferences of the person using the service
promotes good outcomes for people including independence whilst supporting them to stay safe
Drives Improvement
positive impact on outcomes
clear how tech improves service & evaluation
Privacy and Dignity
impact on privacy and dignity fully considered e.g. minimising intrusion
Open and Transparent
people who use, visit or work at the service are aware of purpose and impacts
Appropriate and Proportionate
best way to meet need or intended purpose
Confident Staff
staff understand and confident with tech including how to raise concerns or changes in need
System Security and Data Protection
operated and maintained legally, in a way that keeps people’s information safe
contingency plans in place
Managing Risk
promotes safety – in line with safeguarding processes
risks assessed and plans to manage them in place
Capacity and Consent
people can express views, actively involved in decisions
supported to give informed consent & free to withdraw at any time.
consent sought in line with MCA
The questions on the previous slide translate to some key themes or “areas of focus”
The areas of focus are based on our key lines of enquiry, picking out the specific areas that are most relevant for technology or innovation used to support care. They are also mapped to the regulations if you are considering there is a breach. They are intended to assist as a tool to help assess, make a judgement and consider ratings, when technology or innovation plays a significant part in delivering care.

12. the service is consistently well-managed and led
Mapping to the Characteristics of Ratings
SAFE
People protected from avoidable harm and abuse
Supported to keep themselves and belongings safe and secure
Confident Staff
System Security and Data Protection
Managing risk
EFFECTIVE
People’s outcomes and feedback are consistently good
Outcomes are consistently better than other similar services
Capacity and Consent
Open and Transparent
CARING
people supported, treated with dignity and respect and involved as partners in their care
Privacy and dignity
RESPONSIVE
Needs met through way services organised & delivered
Meet needs of individual and ensure flexibility, choice and continuity of care
Person centred
Appropriate and Proportionate
WELL-LED
the service is consistently well-managed and led
the leadership, governance and culture drive high-quality, person-centre care
Driving improvement
…which in turn map to the existing Characteristics

13. An example of what this looks like in practice
Confident Staff
Staff understand how to use the technology or apply the innovation and are confident to do so. They have completed any relevant training and understand their responsibilities, including how to raise concerns or changes in need.
S3: How does the service make sure that there are sufficient numbers of suitable staff to support people to stay safe and meet their needs?
S3.1: What arrangements are there, including within the rotas, for making sure that staff have the right mix of skills, competencies, qualifications, experience and knowledge, to meet people’s individual needs?
Regulation 12: safe care and treatment
Regulation 18: Staffing
Regulation 19: Fit and proper persons employed
S3.2: How is safety promoted in recruitment practices, arrangements to support staff, training arrangements, disciplinary procedures, and ongoing checks?
S3.3: Do staff receive effective training in safety systems, processes and practices?

14. Closing thoughts
Risk that sole focus on outcomes might not always be enough – e.g. AI making clinical decisions
How we do assess the safety of the algorithms?
What is our role and what is the role of other agencies?
How do we stay on top of current developments?
Need to continue to engage and learn, asking;
“Is it new?”
“How does it affect quality?”
“Does it affect CQC’s methodology or scope of regulation?”
Answers will determine whether CQC will apply ‘Regulatory Sandboxing’ where implementation of technology can be tested against the regulations in a controlled way, to ensure that regulation achieves the best outcome for people using services.
See for more info
CQC was recently awarded funding to test new ways of engaging with innovative providers. The grant from the Department for Business Energy and Industrial Strategy (BEIS) could help CQC examine ‘regulatory sandboxing’, where implementation of technology can be tested against the regulations in a controlled way, to ensure that regulation achieves the best outcome for people using services.

15. A quick show of hands
Do you think CQC is a barrier to technological innovation in adult social care?

16. Any questions or comments?