Presentation for
DLF Moving
and Handling
Practitioners
conference
Natalie Gourgaud
2 February 2016
1
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
Rebuilding trust
3
The scale of regulated care
General public
Care homes
Home-care
53 million (35 million adults)
• 565,000 residents
700,000 people receiving
home-care support per year
• 400,000 current residents
Private hospital
1.4 million people receive
treatment in a private hospital
per year
Dentists
• 22 million on a dentist list
• 165,000 going into care
per year
• 39,000 people with severe
learning disabilities in
residential care
NHS hospitals
• 18,000 in a care home or
care in their own home with
no kith or kin
• 11 million inpatients
per year
• 15 million NHS
• 7 million private
Health & social care staff
• 1.7m NHS staff
• 1.5m in adult social care
GP practices
• 52 million registered
with a GP
• 150m appointments
per year
NB There is overlap between our different audiences – none are wholly distinct from the others
• 90 million outpatient
appointments per year
• 18 million A&E
attendances
• 5 million emergency
admissions/year
• 600k maternity users
• 42,000 detained and
treated against their will
Adult Social Care Inspection
Directorate
ASC: What do we regulate?
17,350 residential social care homes with and without nursing; 8,110 domiciliary care
services; specialist college services; community based services for people with a
learning disability; extra care housing services; shared lives; supported living services;
hospice services.
We run the
Registration
service for all
sectors
regulated by
CQC
A typical inspection team for
residential or domiciliary social
care would have 1-2
inspectors, an expert by
experience and specialist (e.g.
dementia, pharmacy), with
team size depending on
provider size, location and risk.
Typical inspections:
- Residential care 2-5 days
- Domiciliary care 2-4 days
We manage the
relationship with
big corporate
providers and
provide market
oversight for the
social care sector
The Mum Test
Is it responsive to
people’s needs?
Is it
effective?
Is it
safe?
Is it
well-led?
Is it
caring?
Is it good enough for my Mum?
6
The new approach
7
Five key questions
Safe
Effective
Caring
By safe, we mean that people are protected from abuse and
avoidable harm.
By effective, we mean that people’s care, treatment and support
achieves good outcomes, promotes a good quality of life and is
evidence-based where possible.
By caring, we mean that staff involve and treat
people with compassion, kindness, dignity and
respect.
8
Five key questions
Responsive
Well - led
By responsive, we mean that services are organised so that
they meet people’s needs.
By well-led we mean that the 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.
9
Key Lines of Enquiry
Safe 2
How are risks to individuals and the service managed so that people
are protected and their freedom is supported and respected?
Prompts
• What arrangements are there for managing risk appropriately, and to make
sure that people are involved in decisions about any risks they may take?
• Are risk management policies and procedures followed to minimise
restrictions on people’s freedom, choice and control?
• How are the premises and equipment managed to keep people safe?
Key Lines of Enquiry
Effective 1
How do people receive effective care, which is based on best practice,
from staff who have the knowledge and skills they need to carry out
their roles and responsibilities?
Prompts
• Are people supported to have their assessed needs, preferences and
choices met by staff with the necessary skills and knowledge?
• Do staff have effective support, induction, supervision, appraisal and
training?
• Does the service have links with organisations that provide sector-specific
guidance and training linked to best practice in leadership and the delivery
of care?
• Do staff have the skills to communicate effectively so that they can carry out
their roles and responsibilities?
Key Lines of Enquiry
Effective 4
How are people supported to maintain good health, have access to
healthcare services and receive ongoing healthcare support?
Prompts
• How are people’s day-to-day health needs met?
• How does the service make sure that people have information and
explanations that they understand about their healthcare and treatment
options and their likely outcomes?
• How are people involved in regularly monitoring their health? Have any
changes that may require additional support or intervention been discussed
with them?
• Are referrals made quickly to relevant health services when people’s needs
change?
Key Lines of Enquiry
Responsive 1
How do people receive personalised care that is responsive to their
needs?
Prompts
• Are people’s care plans used to make sure that they receive care that is
centred on them as an individual, and is the planned care provided to them
when and where they need it?
• How does the service make sure that people have the time they need to
receive their care in a person-centred way?
Key Lines of Enquiry
• S3: How does the service make sure that there are sufficient numbers
of suitable staff to keep people safe and meet their needs?
• E5: How are people’s individual needs met by the adaptation, design
and decoration of the service?
• C1: How are positive caring relationships developed with people
using the service?
• C3: How is people’s privacy and dignity respected and promoted?
• W3:How does the service deliver high quality care?
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Four point scale
High level characteristics of each rating level
Innovative, creative, constantly striving to
improve, open and transparent
Consistent level of service people have a right to
expect, robust arrangements in place for when
things do go wrong
May have elements of good practice but
inconsistent, potential or actual risk, inconsistent
responses when things go wrong
Severe harm has or is likely to occur, shortfalls in
practice, ineffective or no action taken to put
things right or improve
15
First ASC inspections and ratings
Outstanding
Good
Requires
improvement
Inadequate
62
6885
3351
344
As at 26
January
2016
16
Safety and leadership
17
Adult social care
18
Why does this all matter?
People
are at
the
heart
of it
19