Elaine Wright Head of Quality Compliance The Princess Alexandra NHS Trust

The Care Quality Commission:A New ApproachElaine WrightHead of Quality ComplianceThe Princess Alexandra NHS Trust

Who are the CQC?

Why a new approach?

Reports: Cavendish July 2013, Berwick August 2013, Clywd-Hart October 2013

Fundamental Care Standards Person centred care Dignity and respect Need for consent Safe care and treatment Safeguarding Nutrition and hydration needs Premises and equipment Receiving and acting on complaints Good governance Staffing Fit and proper persons employed Duty of Candour

CQC 5 Domains Safe: protecting people from abuse and avoidable

harm. Effective: care, treatment and support achieves

good outcomes, promotes a good quality of life and is based on the best available evidence.

Caring: Staff involve and treat people with compassion, kindness, dignity and respect.

Responsive: Services are organised so that they meet people’s needs.

Well-led: Leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.

What is the service track record on safety? Have we learned when things went wrong? Have we improved safety from reviewing

incidents and complaints? Are our risks assessed and appropriately

managed? Are people who use the service treated with

kindness, dignity, respect and compassion?

Key Lines of Enquiry

What does good look like? Care, treatment and support achieve good outcomes Care is patient-centered and holistically assessed. National and international evidence-based best practice Staff are appropriately qualified, competent with good

inductions, appraisal and performance management Multi-disciplinary approach to care and treatment Discharge, transfers etc. are planned in advance and

involve the holistic assessment of peoples needs Staff practices comply with health legislation for the area

Core services inspected Urgent and emergency services Medical care (including older people’s care) Surgery Critical care Maternity and gynaecology Services for children and young people

◦ Transition services child to adult End of life care Outpatients and diagnostic imaging

Gathering evidence Checking essential equipment (resus) Pathway tracking people through their care

◦ Referral to treatment times Interviewing staff Reviewing records Reviewing policies, procedures and PGD’s Interviewing service users and their carers Checking prescriptions and talking to the pharmacists Attending and observing a MDT Maintenance of equipment Local rules IR(ME)R 2000 Waiting times Acute kidney injury, Contrast Induced Nephropathy WHO checklist NatSSIPs Local Safety Standards for invasive

procedures

Managing the inspection process Communication, information,

support and engagement CEO sets the scene Be prepared for visits in and out of

hours (do staff know what to do? Gathering evidence Focus groups Initial feedback Draft report Final report Ratings advertised Future inspection process yearly

D Day

National and Local Safety Standards for invasive procedures (7th Sept 2015)◦ Making a cut or a hole to gain access to the inside

of the patients body. Standardise procedural care and patient

pathway Ownership of local standards Patient user involvement Documentation Audit & review

OPD and Diagnostics Future inspection process

The role of NatSSIPs

What’s happening locally? MDT, patient user involvement Steering group What’s in place, SOP’s Human factors training by the team Policies, procedures in place Staffing/finance implications

What do we need to consider?

Human Factors

Any questions?

http://www.england.nhs.uk/2015/09/07/natssips/

http://www.england.nhs.uk/ourwork/patientsafety/never-events/

http://www.legislation.gov.uk/ukdsi/2014/9780111117613

http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf

http://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-interventional-procedures-guidance

References