1. The social care market today and for the future – ensuring quality and sustainability
Debbie Westhead, Interim Chief Inspector Adult Social Care
ADASS Spring Seminar
1 May 2019 1

2. Our role and purpose
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

3. The Mum (or anyone you love) Test
Is it responsive to people’s needs?
Is it
effective?
Is it safe?
Is it
well-led?
Is it caring?
Is it good enough for my Mum or Dad?

4. State of Care: what have we found?
Access to good care is increasingly dependent on where people live and how well local systems work together
It’s an ‘integration lottery’
Ineffective co-ordination of services has led to fragmented care in some areas
Current funding mechanisms for health and care services have led to a focus on individual organisations performance rather than joined-up care
We can only change the way services work together, by changing the way services are funded 4

5. Local system reviews: Beyond Barriers: first 20 reviews
20 site visits
Final report July 2018
20 local system reports
Interim report December 2017 5

6. Local system reviews: Beyond Barriers: What did we find?
Living longer – but with more complex needs
Care must be delivered by more than one person or organisation
In 2018, we expect care to be personalised
A fragmented health and care system designed in 1948 can’t meet today’s needs
We must remove the barriers to collaboration at a local and national level and create an environment that drives people and organisations to work together

7. What we found 1/2
People experience the best care when people and organisations work together to overcome a fragmented system
Dedicated staff regularly going beyond the call of duty
There were examples of good practice in every local system we looked at
Where local leaders share a clear vision, it provides a shared purpose for people and organisations across the local health and social care system
But in a fragmented health and social care system there are barriers to collaboration at a local and national level

8. What we found 2/2
Funding: Health and social care organisations are limited in how far they can pool resources and use their budgets flexibly across prevention, social care and healthcare Managing performance: Organisations are held to account for their own performance, not the performance of the system as a whole Workforce: Services do not always have the right staff, in the right place, at the right time – the health workforce and social care workforce are seen as separate entities Oversight: Regulation usually looks at quality of care in individual providers, rather than across a system as a whole

9. Additional work beyond the report
Three additional visits after the July 2018 report
Reading
Staffordshire
Leeds
Findings mirrored first 20 reviews
Three follow up reviews where some improvement was found in each e.g. improved relationships, more collaborative culture, delayed transfers addressed
Stoke
Oxfordshire
York
Monitoring shows improvements in other parts of the country 9

10. Influencers of quality – commissioning well is important
The public - who use services
Professionals - all undertake a personal commitment to deliver safe high quality care when they register
Providers – from leaders to the front line
Commissioners – what they do and how they do it
Regulators - this includes quality regulators, system regulators but also professional regulators

11. Know your patch: area-level exploration map
New map-based tool with multi-sector organisation information and links to:
existing intelligence products
current rating
insight profile
relationship owner
inspection team

12. How can you improve and collaborate?
OFFICIAL SENSITIVE
How can you improve and collaborate?
Adult social care is underserved by improvement resources
How can you and providers in your area collaborate? Can you form alliances across your local system?

13. Driving improvement across health and social care
Report series features providers that have increased their quality rating considerably
Similar themes for all reports
What themes stand out?
Leadership
Culture
Person centred care
Staffing & support
Outward looking
Happy staff means better care

14. Leadership and culture, go hand in hand
Involving staff, people who use services and their families, giving them a voice
Shaping the culture of the organisation
Staff feeling valued and given a voice
Develop good teams to be even better, valuing training and development
Empowering staff to ‘steer the ship’
“There’s a saying that to be a good leader you’ve got to have good followers. No. To be a leader you’ve got to breed more leaders.”
Jamie Stubbs, Senior General Manager
Ottley House Nursing Home

15. Quality matters

16. A look to the future and in conclusion
We await the Green Paper with interest
Long Term NHS plan – only one sentence refers to social care…
Great quality exists, but... we can’t stand still
Flexible positive response to change
Challenge the status quo
One size does not fit all
It’s a collective effort
Don’t forget the Mum test! 16

17. Interim Chief Inspector Adult Social Care
@CareQualityComm
Debbie Westhead
Interim Chief Inspector Adult Social Care 17 17