Proposed
changes to the
way we inspect
and regulate
care services
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Our purpose and role
Our purpose
We make sure health and social care services
provide people with safe, effective,
compassionate, high-quality care and we
encourage care services to improve
Our role
We monitor, inspect and regulate services to
make sure they meet fundamental standards
of quality and safety and we publish what we
find, including performance ratings to help
people choose care
2
Our direction
A strong, independent, expert inspectorate,
evidence-based judgements
Always on the side of people who use
services
3
Asking the right questions about
quality and safety
Safe?
Effective?
Caring?
Responsive to
people’s needs?
Well-led?
4
What will be different
FROM
TO
• Focus on Yes/No ‘compliance’
• Professional, intelligence-based judgements.
• A low and unclear bar
• Ratings: Clear reports that talk about safe,
effective, caring, well-led and responsive care
• 28 regulations, 16 outcomes
• Five key questions
• CQC as part of the system
with responsibility for
improvement
• On the side of people who use services.
• Generalist inspectors
• Specialist with teams of experts.
• Generic inspections
• Longer, thorough and people-focussed
inspections.
• Corporate body and registered
manager held to account for
the quality of care
• Individuals at Board level also held to account
for the quality of care.
• Providers and commissioners clearly
responsible for improvement.
5
A New Start
Consultation
launched June
2013
6
New Operating Model
Surveillance
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Registration
A more rigorous test to
deliver safe, effective,
compassionate, highquality care
Legally binding
Named leaders held
accountable
Surveillance
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Surveillance
Continuous monitoring to
identify failures and risk of
failure
“Smoke alarms” and “tin
openers”
Use local and national
information sources
Use qualitative information
from people
Surveillance
Surveillance
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Inspection
Chief Inspectors of Hospitals,
Social Care, and General
Practice
Expert inspection teams
Longer inspections, more time
talking to people
Intelligence used to decide
when, where and
what to inspect
Inspectors using professional
judgement
Surveillance
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Clear standards
Services must meet
fundamentals of care and
the expected standards
Three levels
o
o
o
Fundamentals of care
Expected standards of care
High quality care.
Surveillance
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The fundamentals of care –
suggestions to promote debate
I will be cared for in a clean environment
I will be protected from abuse and discrimination
I will be protected from harm during my care and treatment
I will be given pain relief or other prescribed medication when I need it
When I am discharged my ongoing care will have been organised
properly first
I will be helped to use the toilet and to wash when I need it
I will be given enough food and drink and helped to eat and drink if I need
it
If I complain about my care, I will be listened to and not victimised as a
result
I will not be held against my will, coerced or denied care and treatment
without my consent or the proper legal authority
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Ratings
Ratings for services as well as
provider eg Maternity services
Ratings to help people choose
between services and to encourage
improvement.
Ratings for each?
o Safe
o Effective
o Caring
o Responsive to people’s needs
Surveillance
o Well-led
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Taking action
Providers of care to be open and honest about
issues affecting care – a duty of candour
New powers to:
• Hold individuals accountable for poor care
• Prosecute before issue of a formal warning first
Action in the NHS – phases:
1. Chief Inspector of Hospitals identifies failures
and requires improvement
2. Special measures – programme for action by Monitor or NHS TDA to
protect people and deal with the failure
3. Monitor or NHS TDA can dismiss the Board, and, if necessary, a special
administrator appointed. In rare cases, the service may be closed
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Questions for table top discussion
• What do you think of the overall changes we are making?
• Do you agree with the five questions we will ask?
• What will be the impact on how you train and support staff?
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