1. CQC activity in Coventry Coventry Cares Learning Network 1 March 2013

2. 2 Coventry and Solihull team Compliance Manager: Lesley Ward Compliance Inspectors: Brenda SmartMartin Brown Michelle McCarthyErica Davies Fiona StephensonRachael Ratcliffe Sara GibsonSandra Wade Keith Briant

3. 3 Regulated Locations in Coventry Social Care Organisations 162 Independent Health Care 7 Dentists 45 GP’s (so far) 65 NHS 2 University Hospital Coventry and Warwickshire and St Cross (Coventry and Warwickshire Partnership Trust is covered by the Warwickshire team). We also cover 221 locations in Solihull and 2 large NHS trusts: Birmingham and Solihull Mental Health Foundation Trust and Heart of England Foundation Trust.

4. 4 What have we been doing? Planned inspections of all social care organisations and independent health care organisations (registered on 1 April 2012). Responsive inspections in response to concerns. Inspections of all acute NHS hospitals. 50% of dentists this year. Following up on compliance actions. Working with partner agencies – safeguarding and information sharing.

5. 5 Compliance Most locations are compliant. Well done to everyone who has had a fully compliant inspection. Based in inspections to 15/2/13 in Coventry: Social care organisations: 111 locations inspected. 25 had one or more compliance actions. 77% fully compliant. 23% work to do. Independent healthcare: 5 locations inspected. 1 location had compliance actions. 80% fully compliant. 20% work to do.

6. 6 Compliance Dentists: 13 locations inspected. One location with compliance actions. 92% fully compliant. 8% work to do. NHS: 2 locations inspected. UHCW and St Cross. Both compliant in the areas we inspected.

7. 7 What is not compliant? Social care organisations: Personal Care (DCA’s): Compliance actions made: Outcome 4: Care and welfare (3) Outcome 9: Management of medicines (1) Outcome 13: Staffing (2) Outcome 14: Supporting workers (2) Outcome 16: Assessing and monitoring quality (2) Outcome 20: Notification of other incidents (1)

8. 8 What is not compliant Care and nursing homes: Outcome 1: Respecting and involving (5) Outcome 2: Consent (1) Outcome 4: Care and welfare (9) Outcome 5: Meeting nutritional needs (1) Outcome 7: Safeguarding (3) Outcome 8: Cleanliness and infection control (3) Outcome 9 Management of medicines (3) Outcome 10: Safety and suitability of premises 91)

9. 9 What is not compliant Outcome 12: Requirements relating to workers (3) Outcome 13: Staffing (3) Outcome 14: Supporting workers (4) Outcome 16: Assessing and monitoring quality (4) Outcome 17: Complaints (1) Outcome 21: Records (6)

10. 10 Key to compliance? From our experience the key to compliance is: Leadership, good managers and well supported, trained and committed staff (outcomes 12, 13 and 14). Providers who really know what is going on in their service and act on what they know (outcome 16) Focusing on people’s individual care and welfare needs (outcome 4). If these are right, in most instances so will everything else be.

11. 11 Assessing compliance? We base this on: Regulations / outcomes. What you say you are doing (statement of purpose). What we see on the day – care plans, interactions, environment etc. What people tell us – people using services, relatives, staff, external sources. What we know about your service: notifications, safeguarding, intelligence via website, comparison with similar services nationally. Corroboration: Evidence from more than one source. So what? What does it mean for people using the service.

12. 12 Example: Outcome 4: Care and welfare Care and treatment was planned and delivered in a way that was intended to ensure people’s safety and welfare. (Evidence) - The records included an assessment of the risks of people getting sore skin and how staff should support them to minimise this risk. (Corroboration) - We saw that all of the people living there had special mattresses on their bed that helped to reduce the risks of this and they had pressure relieving cushions on their wheelchairs. Staff we spoke told us how they supported each person to reduce the risk of getting sore skin. (So what) This meant that people were supported appropriately to minimise the risk of them getting sore skin.

13. 13 Example: Outcome 14: Supporting workers (Evidence) The service had an up to date training plan that include an analysis of training completed and needed. We saw training records, supervision and appraisals records on staff files. (Corroboration) Staff told us that they received regular training that helped them to do their jobs better. One member of staff told us that recent training on safeguarding vulnerable adults had helped her to identify a concern, which she had then reported to her manager. Staff told us that they had regular supervision with their manager and an annual appraisal. Staff told us that these sessions had helped them to think about the care they were giving and to identify training needs. They told us that the manager always had an open door and was readily available if they had any questions and concerns. People using the service told us that staff always explained what they were doing and helped them in ways that met their individual needs. We saw staff putting their training into practice during our visit. Examples included helping people with their mobility and reassuring a person who was confused. (So what?) People were having their health and welfare needs met by competent staff.

14. 14 Summary - what we look for Intelligence helps us to prioritise, guide and focus inspections. Records provide direction and a framework, information and an audit trail. They are important but they are not the main focus of our inspection. What we see, what you / staff tell us and what people who use tell us are crucial. How well (or not) these elements corroborate each other forms the basis for a compliant / not compliant judgement.

15. 15 What will we be doing in 2013/14? Inspecting all social care organisations and most independent health care organisations. Dentists who have not already been inspected. Pilot inspections of GP practices have started and these will be rolled out once the methodology has been confirmed. Developing our work with the NHS further. Working with partner agencies.

16. 16 Questions? Email: Enquiries@cqc.org.ukEnquiries@cqc.org.uk Phone :03000 616161 On line feedback : www.cqc.org.uk