Care Quality Matters- A compliance Masterclass

Sughra Nazir Care Excellence Partnership

Introductions

Care homes or domiciliary care?

About me

Welcome

Outcomes

Impact

Exercise - Your care essentials

Looking ahead information from CQC about proposed changes

Move onto look at specifics

Plan for today

CQC. New questions ◦ Fundamentals of care◦ Quality ratings

Council Links to occupancy /business development

and growth

Internet Social media

Compliance- why it matters

−− Are they safe? −− Are they effective? −− Are they caring? −− Are they responsive to people’s needs? −− Are they well-led?

Internal compliance needs to answer these questions

New CQC questions

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CQC top ten proposed changes

More systematic use of people’s views and experiences, including complaints

Inspections by expert inspectors, with more experts by experience and specialist advisors

Tougher action in response to breaches of regulation, particularly services without a registered manager for too long

Checking providers who apply to be registered have the right values and motives, as well as ability and experience

Ratings to support people’s choice of service and drive improvement

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CQC top ten proposed changes (2)

Better data and indicators to help us target our efforts

New standards and guidance to underpin the five key questions

Avoid duplication of activity with local authorities

Focus on leadership, culture and governance with a different approach for larger and smaller providers

Frequency of inspection to be informed by ratings

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New inspection process

Surveillance

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Better use of technology to capture people’s views and experiences

Specific guidance on our expectations for the induction and training of staff who work in adult social care services

How we might encourage services to be more open and better integrated with local communities, creating an open culture

Allowing providers to pay for additional inspections if they believe the quality of their service has improved

Finding a better way of regulating supported living schemes

Potential use of mystery shoppers and hidden cameras to monitor care

Other ideas from CQCss

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Developing a ratings system

One overall rating for a service, always based on inspector’s professional judgement

Four point ratings scale – outstanding; good; requires improvement; inadequate – but more work needed on the descriptions

To be outstanding, it must feel outstanding to people who use the service, their families and carers.

We are considering whether to offer providers the opportunity to pay for an additional inspection

The things we look for will develop over time as people’s needs and aspirations change

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Timelines

Co-production and development to shape consultation proposals

Oct 2013 – March 2014

Consultation on regulatory approach, ratings and guidance

March 2014

Wave 1 pilot inspectionsMarch –

May 2014 Evaluation; guidance

and standards refined

July – Sept 2014

Wave 2 pilot inspections and initial ratings of some services

June 2014

Oct 2014

New approach fully implemented and indicative ratings confirmed

March 2016

Every adult social care service rated

How will you evidence

−− Are they safe? −− Are they effective? −− Are they caring? −− Are they responsive to people’s needs? −− Are they well-led?

So what does that all mean?

Doing a care plan audit

Doing a medication audit

Doing a staff file audit

Safe, effective, caring, responsive and well-led

Before lunch

Care plan audit

Medication audit

Staff file audit

Feedback from audits

What to include Timescales Named contacts Social services CQC? Ombudsman

Complaints

Learn lessons??

Some examples coming up

1) list the issues and action you would take to investigate (10 minutes)

2) draft the letter of response (10 minutes)

3) consider any changes needed to systems processes, policies and practice (10 minutes)

2 complaints

1 Care home example

2 Domiciliary care example

Feedback from complaints exercise

Paragraphs 1, 2 and 3

What Action would you take straight away?

What would you investigate and how?

What changes need to be made and what steps will you take to make sure the changes are made and implemented?

The next challenge

Paragraph 1

Paragraph 2

Paragraph 3

Feedback

Recruitment

Induction

Supervision

Team meetings

Implementation tips – behaviours

Care plans – are they ever really up-to-date?

Medication – the missing gap

Food and fluid charts

Consistent and good quality daily records

Implementation tips - documentation

Audits – what to do if you find a gap

Staff awareness

Timing of audits

Person who is doing the audits

Links with performance/supervision

Implementation tips – checks and audits

Look at draft regulations Look at current practice Independently audit

Sughra Nazir Care Excellence Partnership 07737633500 sughra@careexcellencepartnership.co.uk

Next steps

Any questions?

Any individual issues?

Questions and individual issues