Learning Disability Providers Network Meeting10th May 2013

The changes we are making:

•Appoint Chief Inspectors of Hospitals, and of Social Care and Support, and consider a chief inspector for primary and integrated care.

•Ask the following five questions of services:

1.Are they safe?2.Are they effective?3.Are they caring?4.Are they well led?5.Are they responsive to people’s needs?

• Develop new fundamental standards that focus on those five areas, working with the public, people who use services, providers, professionals and our partners to do so.

• Make sure inspectors specialise in particular areas of care and lead teams that include clinical and other experts, and people with experience of care

who we call experts by experience.

• In NHS hospitals, introduce national teams with specialist expertise to carry out in depth reviews of hospitals, particularly those with significant or long-standing problems and trusts applying to be foundation trusts.

• In NHS hospitals, introduce a clear programme for failing trusts that makes sure immediate action is taken to protect people.

• Predict, identify and respond more quickly to services that are failing, or likely to fail, by using information and evidence in a more focused and open way, including listening better to people’s views and experiences of care.

• Improve our understanding of how well different care services work together by listening to people’s experiences of care when they move between different care services.

• Work more closely with our partners in the health and social care system to improve the quality and safety of care and coordinate our work better.

• Publish better information for the public, including ratings of services.

• Introduce a more thorough test for organisations applying to provide care services including making sure that named directors, managers and leaders commit to meeting our standards and are tested on their ability to do so.

• Strengthen the protection of people whose rights are restricted under theMental Health Act.

• Build a high performing organisation that is well run and well led, has an openculture that supports its staff, and is focused on delivering our purpose.

When?The changes will come into effect in NHS hospitals and mental health trusts first because we recognise there is an urgent need for more effective inspection and regulation of these services.

We will extend and adapt our approach to other sectors in 2014 and 2015.

Business PlanOur main priorities for 2013/14

Priority 1: Appointing Chief InspectorsPriority 2: Changing the way we inspect NHS hospitals and mental health trustsPriority 3: Respond more quickly to services that are failingPriority 4: Improve our understanding of how well different care services work togetherPriority 5: Work better with other regulators and partners to improve the quality and safety of carePriority 6: Publish ratings of services to improve transparencyPriority 7: Introduce a more rigorous test for organisations that are applying to provide care servicesPriority 8: Build a high-performing organisation

Priority 4: Improve our understanding of how well different care services work togetherWe will begin to carry out two themed inspections.

The themed inspections will look at dementia care and people’s experiences of moving between different services. We will also carry out a ‘thematic probe’ into inductions for health care assistants and care assistants.

Priority 6: Publish ratings of services to improve transparency In 2013/14, we will begin to develop a ratings system of NHS hospitals and will consult on this in quarter 2.

This takes forward the recommendations of the Nuffield Review, developing information for the public in partnership with others and helps the public to make choices on the care they receive.

Priority 7: Introduce a more rigorous test for organisations that are applying to provide care servicesThis priority will include making sure that named directors and managers commit to meeting the standards and are tested on their ability to do so.

We will first introduce this approach to organisations that provide learning disability services, before rolling it out to all organisations that apply to provide new care services. (More frequent inspections promised)

The CQC expects: Providers and commissioners of services for vulnerable adults must improve their understanding of the Mental Capacity Act and the Safeguards, requiring: •Improved training in the Act and the Safeguards •Improved use of care plans, recording of incidents, and gathering of feedback from staff, people who use services and their relatives •Practice needs to show an understanding of when and how to explore a person’s capacity to make a specific decision, and of best interests decision-making •Stronger links between managing authorities and local Independent Mental Capacity Advocate services may be one way of improving staff knowledge

Skills for Care has developed an Awareness of the Mental Capacity Act 2005 qualification. http://www.skillsforcare.org.uk/qualifications_and_training/adultsocialcarequalifications/AwarenessoftheMentalCapacityAct2005.aspx

EnforcementThe Care Quality Commission's assessment of registered providers' staffing and training will include how far staff are compliant with the code and minimum training standards. The Health and Care Professions Council is also developing a proposal for a "negative register", which could see staff found to have made significant breaches of the code barred from working in the sector.

Welfare Reform Timetable

2013 APRIL Council tax benefit replaced by Local Council Tax Support

    Social Fund Community Care Grants and Crisis Loans replaced by Local Welfare Assistance.

    ‘Bedroom tax’ applied to tenants in social housing.

  JUNE New claims for Personal Independence Payment. No more claims taken for DLA.

  JULY Benefit cap on households starts to roll out nationally

  SEPTEMBER Roll out of benefit cap completed

  OCTOBER First phase of DLA cases to be reassessed for PIP. No new claims for DLA.

    First new claims for Universal Credit taken

2014 APRIL Extension of new Universal Credit claims

2015 OCTOBER Second main phase of DLA cases to be reassessed for PIP

2017 OCTOBER Universal Credit transfer completed

    Disability Living Allowance transfer to PIP completed

Sector Update:

Queens Speech – main social care implications:New legislation this year based on the draft Care and Support Billnew duties on local authorities to:•commission preventive services and information and advice;•promote a market of diverse and high-quality services;•assess adult carers and provide support for those who meet eligible needs;•comply with a new national minimum threshold for care and support;•ensure continuity of support for people who move between local authority areas;•make enquiries into suspected abuse or neglect of adults with care and support needs;•establish safeguarding adults boards to oversee local safeguarding arrangements;•meet the care costs of people whose historic care costs have exceeded £72,000.

The legislation would also tighten regulation for providers by introducing newquality ratings for social care providers

introduce a system of financial oversight of large providers to guard againstadverse consequences for service users if they go bust.

Context – almost 20% cut from social care budgets last 2 years