Helping to make care better

Cynthia Bower, CEO National Care Association Conference

11 November 2009

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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

Timeline for Adult Social Care and Independent Healthcare

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 From December, subject to legislation

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

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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