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Helping to make care better
Cynthia Bower, CEO National Care Association Conference
11 November 2009
2
Our Role
We make sure people get better care
Who are we improving care for ?
People who use services, carers and families People in more vulnerable circumstances
Operating principles
• Involve users to focus on what is important to them
• Expertise and independence
• Promote equality, diversity and human rights
• Engage with those providing and commissioning care
• Ensure regulation is proportionate, targeted, consistent, evidence-based, transparent and accountable
What we will do to achieve our priorities
Public and taxpayers
Our priorities
Ensuring care is centred on
people’s needs
Acting swiftly to help
eliminate poor quality care
Championing joined up care
Promoting high quality care
Regulating effectively in partnership
Registration and ongoing monitoring
Regular reviews of performance
Enforcement Special reviews and studies
Mental Health Act visits
Publishing information
Influencing the future of social care
We are actively contributing to the current debates on social care:
We gave written evidence to the Health Select Committee Inquiry on the future of social care, including personalisation and more effective, consistent and user-friendly services
We responded to the Department of Health consultation on eligibility criteria, to achieve more fairness and consistency for people seeking support
We contributed views to the Green Paper Shaping the Future of Care Together consultation about the future provision, arrangement and funding of social care, including the proposed establishment of a National Care Service
What did we say?
Personalisation still has a long way to go – people still need to be put first
Note the impact of the recession on quality
Funding should be fair, simple and sustainable
Support universality: information, advocacy, national assessment
Need clarity about care and support for all people, not just people aged 65 and over
Our new registration system: standards, dignity, rights
Registration -what’s changing? A single way of judging quality
Private and voluntary healthcare (PVH) providers registered
Providers of adult social care (ASC) registered
NHS providers are not registered
All providers of health and adult social care registered with CQC
National Minimum Standards (ASC and PVH) - different regulation and NMS for each setting
Standards for Better Health considered as part of annual health check
Single set of essential standards of quality and safety for all settings
Care Standards Act 2000 enforcement action limited to statutory notices and closures
Limited enforcement powers for NHS providers
Strengthened and extended range of enforcement powers for providers from all sectors
Old
sys
tem
New
sys
tem
OrganisationsStandards/ requirements Enforcement
The difference registration will make
All health and adult social care providers are meeting a wide range of essential standards of quality and safety
Standards are focused on outcomes - what is needed to make sure people who use services have a quality experience - a direct result of what people said they wanted
A single regulatory framework across health and adult social care, making it easier to compare one provider with another
Registration timeline
Subject to legislation
January 2010January 2010 NHS trusts (incl PCT provider trusts) apply to be registered
April 2010April 2010 NHS trusts are registered
April 2010 Adult social care (CSA-registered); Private & Voluntary healthcare (CSA-registered) apply to be registered
October 2010 Adult social care (CSA-reg); Private & Voluntary healthcare CSA-reg) are registered
April 2011April 2011 Private ambulance services, prison health services, independent midwifery, dental practices are registered
April 2012April 2012 Primary medical services are registered
Preparing for registration – what you can do now
• Check your own internal reporting and audit systems
• Consider what evidence you already hold and what you need to create
• Consider evidence on outcomes
• Be aware of activities in other sectors as they come into new registration system
11
We monitor compliance continuously
Quality & Risk Profile
Pre application
Application Received
Judgement Made
Judgement Published
Analyse Information
Judgement on Risk
Regulatory Judgement
Regulatory Response
Application Assessed
Completing registrationRegistration
goes live Ongoing Monitoring of CompliancePrepare for registration
Information Capture
The published Register of Providers will be accompanied by a process of Ongoing Monitoring of Compliance. This is now in the planning stages.CQC plans to maintain an up-to-date profile on each registered providerNew information can be uploaded to their profile at any timeInformation can reach us from a number of external sources e.g.
- people who use services, their families and carers- partner organisations such as the Ombudsman, commissioners- statutory notifications- staff & other professionals
Fees
oAdequacy, Fairness, Simplicity and Evolution
oWe are now consulting on our proposed fee structure for NHS trusts for the first year of registration
oIn early 2010 we will consult on fees for Adult Social Care and Independent Healthcare for the period Oct 2010-March 2011
oIn late 2010 we will consult on a long term system of fees to come into effect for all providers including all dental practices and primary medical care
Acting swiftly
Analysing risk
Our assessors will regularly review provider profiles
They will use the guidance about compliance to assess any risks
We will take action swiftly when we need to
Making judgements
We will take proportionate action
We will take account of the provider’s capacity to improve and work with the provider to achieve this end
If non-compliance is more serious, then we may take enforcement action
Conclusion
We all share the benefits of registration that
Is more dynamic and responsive
Identifies sooner causes of concern
Protects and promotes equality, diversity and human rights
Makes use of relevant information from other organisations and people who use services
Reduces unnecessary regulatory burdens and costs
Increases compliance
Increases credibility