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CQC – An
Update
Deanna WestwoodLeeds Care Conference
20 June 2019
Is it good enough for my Mum?
Is it
safe?
Is it
caring?
Is it
effective?
Is it responsive to
people’s needs?
Is it
well-led?
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Ambition for social care: The Mum Test (or Anyone You Love test)
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Regulation to inspire improvement
What we do:
Set clear expectations
Monitor and inspect
Publish and rate
Celebrate success
Tackle failure
Signpost help
Influence debate
Work in partnership
Ambition
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Our ambition:
A more targeted, responsive and collaborative approach to
regulation, so more people get high-quality care
1. Encourage improvement, innovation and sustainability in care
2. Deliver an intelligence-driven approach to regulation
3. Promote a single shared view of quality
4. Improve our efficiency and effectiveness
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Four priorities to achieve our strategic ambition
A more targeted, collaborative and responsive approach
• The majority of people are receiving good
quality care. This is something to celebrate.
• Over 80% of inadequate services improve on
re-inspection but for services that require
improvement nearly 40% don’t improve and
5% get worse
• We are focusing on encouraging improvement
in services rated RI
• We will do this flexibly and proportionately,
using inspector judgement and existing risk
and enforcement frameworks
• We will monitor these services more closely to
identify changes in quality (up or down) and
respond more quickly, as required
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Our single shared view of quality
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Our single shared view of quality
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What does quality mean to people?
“I feel in control
and safe”
“I have the
information I need
when I need it”
“I have access to a
range of support that
helps me live my life”
“I am in control
of my support, in
my own way”
“I have considerate
support delivered by
competent staff”
“I can decide the
kind of support I
need”
By following these principles and encouraging others to
do the same, we enable people using services to say:
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Staff in adult social care: What does Quality matters mean for me?
• It will set out what high-quality care and support should look like
• Help define what well-led means
• Asking employers to support and empower you to deliver high quality care
• How you can help to improve adult social care for everyone
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Providers of adult social care: What does Quality matters mean for me?
• It will set out what high-quality care and support should look like
• Empowering you to drive quality for people using services, their families and staff
• Highlights the critical role you play in improving adult social care• Celebrating good practice
• Highlighting areas for improvement
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Commissioners and funders: What does Quality matters mean for me?
• It will set out what high-quality care and support should look like
• Empowering you to work with providers in your area to drive quality
• Highlights the critical role you play in improving adult social care• Commissioning for high quality outcomes
• Funding new services and placements only if they offer high-quality care
Beyond Barriers: What did we find?
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• A system designed in 1948 can no longer effectively
meet 2018 needs
• Living longer – but with more complex health
problems
• Increasingly, our care must be delivered by more
than one person or organisation
• In 2018, we expect care to be personalised to
people’s individual circumstances
• A fragmented health and care system designed
in 1948 can not meet the needs of today’s
population or operating environment
• 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
What we found
• 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
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1. An agreed joint plan that sets out how older people are to be supported and helped which in turn, guides joint commissioning decisions over a multi-year period
2. A single framework for measuring the performance of how agencies collectively deliver improved outcomes for older people
3. The development of joint workforce plans with more flexible and collaborative approaches to staff recruitment, retention and development
4. New legislation to allow CQC to regulate systems and hold them to account for how they work together to support and care for older people
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Recommendations to local and national leaders, and government
What did we find in Leeds
A number of recommendations:
• The workforce strategy for Leeds should be developed at pace, pulling together the different strands of activity to develop deliverables and timescales which include the independent social care sector.
• There should be improved engagement with GPs and adult social care providers in the development of the strategy and delivery of services in Leeds.
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Social Care Services in Leeds
Inadequate RI Good Outstanding
Nursing Sep-18 1 16 29 0
Mar-19 1 19 24 1
Residential Sep-18 2 11 86 0
Mar-19 0 15 85 1
Domiciliary
care Sep-18 0 23 62 0
Mar-19 0 20 70 0
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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
What does it take to raise standards in adult social care settings?
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• Reaction to CQC report
• Leadership
• Cultural change
• Person-centred care
• Staffing
• Working with partners
• Building a community
For committed staff, the inspection report can come as a relief..
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• Using the report as a
roadmap to success
• Creating action plans
• CQC are here to help; using
our inspection teams as
support and guidance
• Having a ‘we will get this right’
attitude
• Key first steps to
improvement
• Strong, focused leadership to
drive change
Leadership and culture, go hand in hand
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• 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
Ensuring people are at the heart of what we do
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• Comprehensive care plans truly reflecting what the
person wants and needs
• Appreciating their life story
• Processes to support
access to and ease of
updating, care plans
• Using care plan as a tool
to assess environment
• Learning from things that
do not suit the person,
adapting and changing
• Incorporating activities!
Consistent, compassionate workforce
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• Great consistency of staffing makes
a massive difference
• Limited or structured use of agency
staff
• Empowered staff willing to speak out
and suggest changes
• No blame culture, learning culture
• Taking people on the improvement
journey
• Regular supervision and training
• Robust recruitment and induction process, management
providing bespoke training
“Having the same
staff means that they
know the little things
that make a
difference to Jean,
like making sure she
has a tissue in her
sleeve, or seeing if
she’d like to spray
some of her favourite
perfume”
David Eadie, wife uses the
service
Working with partners fosters an improvement culture
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• Being honest and asking for
support
• Commissioners being part of
the improvement journey
• Building a relationship with your
CQC inspector
• Working with other healthcare
professionals in your local
community
• Sharing good practice
corporately or wider social care
community
Bring the community into your home
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• A commitment to being part
of the wider community
• Making your home a hub of
activity and energy
• Bringing the community into
your home
• Local groups
• Working with schools
• Taking people out into
the community to shop
or have breakfast
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How good and outstanding providers meet The Mum Test
‘Outstanding’ can be achieved
"We didn't think we were outstanding. And perhaps
that's why we were – I think it's because we see
every single person as an individual. It is our
privilege to support them to live the last years of
their life with as
much happiness,
love and security as
we can give them."
Suzanne, Prince of Wales
House, Ipswich
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Influencers of quality
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The public - who use services
Professionals - all undertake a personal commitment to deliver safe high quality care when they register
Providers – from the Board to the front line
Commissioners – what they do and how they do it
Regulators - this includes quality regulators, system regulators but also professional regulators
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Maya Angelou
“People will forget what you said, people
will forget what you did, but people will
never forget how you made them feel”
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A wise woman once said…
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