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Scrutiny and regulation working
together




 Matthew Trainer
 Sandy Patrick
 Lucy Hamer
 11th February 2013
The background…

Single, integrated regulator for      Parliament
health and social care
Responsible for assuring safety and
quality
Setting clear standards for care
providers via registration
Inspection-led model, informed by
information about risk
Clear focus on outcomes via patient
experience
Enforcement powers – including
closure

                                                   2
Size of the challenge…


 Primary medical    Independent             Independent
 services           healthcare              ambulances
 10,000 locations   2,500 locations         300 locations


 NHS Trusts         Adult social           Primary dental
                    care                   care
 2,300 locations    25,000 locations       10,000 locations

Outpatient          People using adult     Dental treatment –
                                           courses of treatment in 2011/12
appointments        social care services

70 million          1 million              10 million
Inspections
  We inspect all care homes, home care agencies and
  hospitals at least once a year
  Inspections are targeted and almost always unannounced
  They focus on quality and safety as experienced by people
  who use services - we report on what we see and hear
  A site visit includes:
        talking to people who use the service (and their
      families and carers)
         talking to staff and managers
         observation
         examination of records
Common concerns for both CQC and
scrutiny

• The safety of people in most vulnerable circumstances
• Quality of staffing in a range of services
• Cooperation between providers – as people move
  between hospital and social care, including discharge
• Care for people with complex health and care needs –
  such as dementia, people with learning disabilities
• Range of quality issues in domiciliary care services
• Dignity and respect for people – eg, when eating and
  drinking
• Medicines management - in and out of care homes
                                                          5
We want Overview and Scrutiny
 Committees to:

• Know who we are and what we do
• Have contact with local Care Quality Commission
staff to share information
• Know what we have done with any information you
give us
• Know about our inspections and where we have
concerns about services
• Work with us more closely as we monitor services

                                                     6
Working together


• We published guides for scrutiny committees and local
  councillors (September 2011)
• Scrutiny committees are now sent regular updates on
  inspection reports published, national reports and local
  press releases
• You can expect regular contact between CQC staff,
  your chair and lead officer
• We are working with CfPS regional advocates to help
  connect scrutiny committees and CQC local teams
Current national work with scrutiny
committees and elected members

• Developing protocols and further case studies of
  working together – with a group of scrutiny committees
• A pilot project with some district councils to explore
  how we could exchange information with district
  councillors involved in health/social care issues
• Working with Department of Health and the new
  guidance on scrutiny – how regulation and scrutiny
  can work together
• Exploring how we share our findings across your local
  authority and provide updates to councillors


                                                           8
Participating authorities in the
national projects

Developing protocols for     Pilot project with district
   CQC and scrutiny                 councillors
      committees
   •   Swindon
                                   •   Chesterfield
   •   Surrey
                                   •   Northampton
   •   Tower Hamlets
                                   •   Warwick
   •   Lewisham
                                   •   Dacorum
   •   Warwickshire
                                   •   Test Valley
   •   Bury
   •   Hertfordshire
Further information

• Visit our website at www.cqc.org.uk
• Guide for Overview and Scrutiny Committees for
  health and social care: How your committee can work
  with the Care Quality Commission (September 2011)
• A guide for local councillors: Working with the Care
  Quality Commission (September 2011)
• Contact your CfPS regional advocate
• Further copies of the guides are available to download
  or order from www.cqc.org.uk.
• Email involvement.edhr@cqc.org.uk about our
  national work with scrutiny committees
                                                           10

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CQC presentation to London Scrutiny Network

  • 1. Scrutiny and regulation working together Matthew Trainer Sandy Patrick Lucy Hamer 11th February 2013
  • 2. The background… Single, integrated regulator for Parliament health and social care Responsible for assuring safety and quality Setting clear standards for care providers via registration Inspection-led model, informed by information about risk Clear focus on outcomes via patient experience Enforcement powers – including closure 2
  • 3. Size of the challenge… Primary medical Independent Independent services healthcare ambulances 10,000 locations 2,500 locations 300 locations NHS Trusts Adult social Primary dental care care 2,300 locations 25,000 locations 10,000 locations Outpatient People using adult Dental treatment – courses of treatment in 2011/12 appointments social care services 70 million 1 million 10 million
  • 4. Inspections We inspect all care homes, home care agencies and hospitals at least once a year Inspections are targeted and almost always unannounced They focus on quality and safety as experienced by people who use services - we report on what we see and hear A site visit includes: talking to people who use the service (and their families and carers) talking to staff and managers observation examination of records
  • 5. Common concerns for both CQC and scrutiny • The safety of people in most vulnerable circumstances • Quality of staffing in a range of services • Cooperation between providers – as people move between hospital and social care, including discharge • Care for people with complex health and care needs – such as dementia, people with learning disabilities • Range of quality issues in domiciliary care services • Dignity and respect for people – eg, when eating and drinking • Medicines management - in and out of care homes 5
  • 6. We want Overview and Scrutiny Committees to: • Know who we are and what we do • Have contact with local Care Quality Commission staff to share information • Know what we have done with any information you give us • Know about our inspections and where we have concerns about services • Work with us more closely as we monitor services 6
  • 7. Working together • We published guides for scrutiny committees and local councillors (September 2011) • Scrutiny committees are now sent regular updates on inspection reports published, national reports and local press releases • You can expect regular contact between CQC staff, your chair and lead officer • We are working with CfPS regional advocates to help connect scrutiny committees and CQC local teams
  • 8. Current national work with scrutiny committees and elected members • Developing protocols and further case studies of working together – with a group of scrutiny committees • A pilot project with some district councils to explore how we could exchange information with district councillors involved in health/social care issues • Working with Department of Health and the new guidance on scrutiny – how regulation and scrutiny can work together • Exploring how we share our findings across your local authority and provide updates to councillors 8
  • 9. Participating authorities in the national projects Developing protocols for Pilot project with district CQC and scrutiny councillors committees • Swindon • Chesterfield • Surrey • Northampton • Tower Hamlets • Warwick • Lewisham • Dacorum • Warwickshire • Test Valley • Bury • Hertfordshire
  • 10. Further information • Visit our website at www.cqc.org.uk • Guide for Overview and Scrutiny Committees for health and social care: How your committee can work with the Care Quality Commission (September 2011) • A guide for local councillors: Working with the Care Quality Commission (September 2011) • Contact your CfPS regional advocate • Further copies of the guides are available to download or order from www.cqc.org.uk. • Email involvement.edhr@cqc.org.uk about our national work with scrutiny committees 10

Editor's Notes

  1. Regulation – simply put, a regulation is a rule, or standard. A regulator is there to make sure that the rules are met. The reasons for state regulation are various, but typically you regulate a sector to cause things to happen that otherwise wouldn’t – or prevent things from happening that otherwise would. Regulators can try to ensure more efficient market operation, to set standards for professional conduct, to protect people from unseen harm, to deliver a public good – there are plenty of reasons. Regulators are a way to implement policy – so if a government believes a sector should behave in a certain way for a public good, a statutory regulator is one answer. In CQC’s case, our regulations are legal standards of quality and safety. The Health and Social Care Act 2008 and associated regulations sets in law the standards of quality and safety that health and social care providers must meet – and it’s the responsibility of care providers in the NHS, ASC etc. to ensure the services they offer meet these standards. Our job is to check whether services registered with us are meeting those standards. It’s not to deliver care that meets these standards. It is to check whether providers are meeting the standards and use our powers to take action where they are not. As a regulator, we must be independent, accountable – and our work must be of a certain quality. We are taxpayer funded and must explain what benefit we provide.
  2. Here’s a brief idea of scale. With around 900 inspectors in England, we are responsible for regulating around 50,000 different places where care is delivered. At the moment, CQC inspectors carry out around 800 inspections a week. We’re currently delivering three times as many inspections a week as when we were set up. There are around 580 NHS providers registered across England, delivering care at more than 2,300 places, and our latest inspection data suggests one in five was not meeting more than one of our standards – so four in five were. This is a higher level of compliance than social care, lower than independent health and dental care.