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Debbie IvanovaSouth West Long Term Care Conference18 October 2017
An update from CQC: State of Care 2016/17
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Our purpose
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• We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve
• Register• Monitor and inspect• Use legal powers• Speak independently• Encourage
improvement
• People have a right to expect safe, good care from their health and social care services
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• Full picture of the quality of health and social care in England, with ratings for all sectors and a baseline from which to draw conclusions about quality and safety of care and what influences this
• 21,256 adult social care services• 152 NHS acute hospital trusts• 197 independent acute hospitals• 18 NHS community health trusts• 54 NHS mental health trusts• 226 independent mental health locations• 10 NHS ambulance trusts• 7,028 primary medical care services
• Increasingly, CQC will report on quality of areas and coordination across services – for care fit for the 21st century
• Is it safe? • Is it effective? • Is it caring? • Is it responsive? • Is it well-led?
Unique oversight of health and care
Source: State of health and adult social care in England 2016/17, CQC
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Increased complexity of demand = new challengesProviders must change to meet complexity and challengesFuture quality of care is precarious
• Providers struggling to cope with more complex demand• People waiting over four hours at A&E• More planned operations cancelled and people waiting longer• Increasing demand for mental health services, affecting
waiting time• Fewer nursing home beds• Adult social care providers handing back contracts• One in eight older people are not receiving help they need
Health and care services are at full stretch – which impacts upon people
Source: State of health and adult social care in England 2016/17, CQC
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Are adult social services at a tipping point?
Source: State of health and adult social care in England 2016/17, CQC
• 78% rated good, but 19% rated requires improvement and 1% (303 locations) inadequate
• Caring rated best – 92% good and 3% outstanding. Safe and well-led poorest – 22% requires improvement and 2% inadequate
• High-performing services have strong leaders – innovative registered managers known to staff, people using the service, carers and families had a positive impact
• High-quality services are person-centred – staff get to know people as people, understanding their interests, likes and dislikes
• Most enforcement for poor care relates to governance, safety, staffing and person-centred care
• Quality matters joint commitment developed
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Our findings on adult social care
Source: State of health and adult social care in England 2016/17, CQC
Quality matters: a shared commitment to high quality, person-centred adult social care
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Quality matters: a collective effort
People who use services, families, carers – giving feedback
Staff – capable, confident and supported
Providers – culture, organisation, expectations
Commissioners and funders – expectations of quality
Regulators – monitor, inspect, rate, take action, celebrate
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Our action plan priorities
1. Acting on feedback, concerns and compliments
2. Measuring, collecting and using data more effectively
3. Commissioning for better outcomes
4. Better support for improvement
5. Shared focus areas for improvement
6. Improving the profile of adult social care
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Additional funding for adult social care announced in the BudgetDH asked CQC to undertake a programme of targeted reviews in local authority areas
Reviews will answer the question:• How well do people move through
the health and social care system, with a particular focus on the interface between the two, and what improvements could be made?
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CQC Local systems review: background and objectives
By asking:• What is currently happening and
what are the outcomes for people?
• What is the maturity of the local area to manage the interface between health and social care moving forward?
• What else needs to happen?The reviews will look at the over 65s and the interface with general primary care, social care, acute and community services. Mental health and specialised commissioning are out of scope.
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CQC Local systems reviews: questions
Our next phase: Changes to registration
• Outlines the principles for registering providers at the level of greatest accountability
• Provider-level assessments for all sectors to help encourage improvement
• Changes to how the register will record the services that providers are registered to deliver
• Describes what this means for new models and complex providers
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Our next phase: Changes to adult social care inspection methodology
• Focus on how we will encourage improvement in services that are repeatedly rated as Requires Improvement
• Improved processes for inspecting services providing care to people in their own homes
• Our effectiveness and consistency of how we use our enforcement powers
• Promoting a single shared view of quality by developing our PIR requests
• New assessment framework November 2017
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A&E?
GP practice?
I am 78 I have hip and
knee problemsSometimes I
have difficulty remembering
I live alone and I want to stay independent
What happens if I have a fall?
Source: State of health and adult social care in England 2016/17, CQC
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What it is all about
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Person-centred co-ordinated
high quality care for all