Market
Oversight
Sally Warren
Andrea Sutcliffe
Ray James
30 October 2014
NCAS
1
Andrea Sutcliffe
Chief Inspector
Adult Social Care
2
Why market oversight?
Clear relationship between quality of care and finances
3
What can it do?
Market oversight aims to:
Spot if a ‘Southern Cross’ could happen again
Protect people in vulnerable circumstances
Monitor finances of ‘difficult to replace’ providers
Provide early warning to local authorities
Assist in co-ordinating the system response if failure occurs
Market oversight is not there to:
Protect providers from failure
Pre-empt failure through disclosure of information
4
Timelines for market oversight
• Development of CQC approach and
methodology
• CQC engagement on proposed methods
Sept – Dec
2014
Jan – Feb
2015
April
2015
Identify and liaise with providers that
meet the market oversight entry criteria
• Formally notify providers of their
inclusion in the scheme and respond
to appeals
• Start to undertake financial
assessments of providers in the
scheme
October
2015
Bring specialist providers into the
scheme
5
A co-production culture
Communication
6
This session
Market oversight
regime in detail
– Sally Warren
Local authority
local duty to
manage continuity
– Ray James
7
Sally Warren
Deputy Chief
Inspector
Adult Social Care
8
Proposed model for market oversight
Step
1
Activity
Entry to
scheme
2
Regular
monitoring
3
4
Further risk
analysis
Provider
engagement
on risk
5
Regulatory
action &
engagement
6
Formal
notification
to LAs
If concerns
identified and
addressed
Key: Assessment of risk to financial sustainability
(all provisional)
no cause for concern/very low risk
possible risk/medium risk
likely risk/high risk
risk clearly identified/very high risk
9
Step 1 - entry
• Regulations set out entry criteria and reflect size,
localised concentration and spread across the country
• Specialist providers to be nominated via a panel
• Currently expect around 50 corporate providers to be
in the scheme
• These operate around 400 registered providers which
deliver services from about 4000 locations (30% of all
care home beds in England)
• Inclusion in scheme is a reflection of size, not a
judgement of risk of failure
10
Proposed model for market oversight
Step
1
Activity
Entry to
scheme
2
Regular
monitoring
3
4
Further risk
analysis
Provider
engagement
on risk
5
Regulatory
action &
engagement
6
Formal
notification
to LAs
If concerns
identified and
addressed
Key: Assessment of risk to financial sustainability
(all provisional)
no cause for concern/very low risk
possible risk/medium risk
likely risk/high risk
risk clearly identified/very high risk
11
Steps 2 and 3 – Intelligent
Monitoring
Aggregation
of quality
information,
including
ratings
enforcement,
information on
concern
A.
Business
context
C.
Quality
To allow CQC
to understand
provider
structure and
operation
model
B.
Financial
Quarterly
financial
returns.
Data is a
prompt for
further
investigation
and analysis
12
Proposed model for market oversight
Step
1
Activity
Entry to
scheme
2
Regular
monitoring
3
4
Further risk
analysis
Provider
engagement
on risk
5
Regulatory
action &
engagement
6
Formal
notification
to LAs
If concerns
identified and
addressed
Key: Assessment of risk to financial sustainability
(all provisional)
no cause for concern/very low risk
possible risk/medium risk
likely risk/high risk
risk clearly identified/very high risk
13
Draft for discussion
Steps 4 - 6: tools available to CQC
If elevated risks are identified from financial and
quality indicators, CQC will use tools to obtain further
information before assessing if failure is likely
Provider
engagement on risk
Activity
Tools
a
Risk
assessment
meeting
b
Regulatory action and
engagement
Additional
financial
information
requests
c
More frequent quality
inspections
d
Key stakeholder
engagement
e
Independent
Business Review
f
Risk Mitigation
Plan
Formal
notification
to LAs
g
Notify
relevant LAs
14
Transparency in market oversight
• CQC will publish a list of providers within
the scheme
• Ongoing judgment of risk will not be
published
• LA(s) will be notified if failure is judged to
be likely
• Providers will be sharing commercially
sensitive information and CQC will have
systems to manage this appropriately
15
Ray James
Vice President
of ADASS
16
Role of Councils
• Detail in Act, Guidance & planned Toolkit
• Duty applies for all providers not just those in
Market Oversight Regime
• Duty not triggered if business has failed but
service continues to be delivered (e.g.
administrator running the business)
• Duty falls to LA where service is delivered not
on commissioning LA
17
Temporary duty
• LA must involve the person concerned or those
acting on their behalf
• LAs have the power to compel information from
the provider that would help in this (e.g. care
plans, risk assessments)
• Duty to cooperate
• Excludes NHS commissioned care
18
Insolvency situations
• Where an administrator appointed, LAs should
not become involved in the commercial
aspects of insolvency but should cooperate
with the administrator
• LAs should consider the impact on the
provider should they withdraw contracts but
this should not be at the expense of people’s
wellbeing
19
Market shaping and contingency
planning
• Important that LAs have thorough
understanding of local market (capacity,
quality, types of service, trading conditions)
• Should underpin contingency planning; LAs to
consider how to respond to failure of a
significant provider, linking with neighbouring
authorities where necessary
20
Promoting responsible behaviours
• Focus on wellbeing of those needing care
• Information
• Sharing – Building Trust
• Availability of key personal data
• Media Protocols
• Local, Regional, National
• Clear plan and accountabilities
• Communication vital – LAs should have
capacity to react quickly and effectively to
minimise uncertainty and anxiety
• Service Users, Carers, & Staff
21
Thank you
www.cqc.org.uk
enquiries@cqc.org.uk
@CareQualityComm
22