The current state of adult social care – how resilient is it? Andrea Sutcliffe, Chief Inspector Adult Social Care Principal Social Worker’s Network 21 July 2017 1 1

Our purpose The Care Quality Commission is the independent regulator of health and adult social care in England We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve Strategy Slides - 24 May 2016 - MASTER

The Mum (or anyone you love) 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?

The State of Adult Social Care Not good enough Yes! Source: State of adult social care services 2014/17. CQC ratings data 5 May 2017. Numbers show total active locations rated

The State of Adult Social Care: by key question Source: State of adult social care services 2014/17. CQC ratings data 5 May 2017. Figures in bars are percentages. Source: State of adult social care services 2014/17

The State of Adult Social Care : by key service type Source: State of adult social care services 2014/17. CQC ratings data 5 May 2017. Source: State of adult social care services 2014/17

Current overall ratings by size and type of care home Source: State of adult social care services 2014/17. CQC ratings data 5 May 2017. 7

Current overall ratings by size of domiciliary care service Source: State of adult social care services 2014/17. CQC ratings data 5 May 2017. 8

Re-inspection of inadequate services – all providers 686 originally rated inadequate 9

Re-inspection of requires improvement services 3,951 originally rated requires improvement 10

Re-inspection of good and outstanding services 1,830 originally rated good 8 originally rated outstanding 11

What can we do about it? 12

How resilient? Challenging context: Resources Staffing Growing demand & unmet need Majority of services are good but quality is precarious: Few Outstanding services Safety and leadership at risk Struggle to improve, especially Requires Improvement Deterioration of some good services 13

Quality matters: a shared commitment to high quality, person-centred adult social care 14

What people told us they wanted www.penmendonca.com 15

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 16

Promote quality through everything we do Our principles Promote quality through everything we do Support and encourage improvement Coordinate action 17

Our action plan priorities Acting on feedback, concerns and compliments Measuring, collecting and using data more effectively Commissioning for better outcomes Better support for improvement Shared focus areas for improvement Improving the profile of adult social care In order to ensure we are clear about how we will achieve concrete action to improve quality, our shared priorities are set out in an action plan. This lists the six things that we want to do first in order to make our commitment a reality, and each of these six things is supported by different organisations working in collaboration. The action plan is a ‘live’ document and will be updated as actions are achieved and as new priorities emerge – remaining in the spirit of the principles set out in the central Quality matters document. As we embark on our journey to improve the quality of adult social care, we will focus on these six priorities for action. These initial priorities have been identified by people who use services, their families and carers, providers, commissioners, and organisations that support and oversee adult social care services. Priority 1 – Acting on feedback, concerns and complaints Ensure that people who use services, their families and carers receive information that is clear and standardised, and that complaints are handled quickly and effectively. Ensure that there is a strong approach to the duty of candour so there is a culture of being open and honest when something goes wrong. Measuring, collecting and using data more effectively Review quantitative and qualitative data across the system and develop a common approach to measuring key quality metrics to ensure consistency. Collect and share the common metrics among commissioners, regulators and providers as suitable and proportionate. Agree and make available suitable and relevant information for the needs of the public. Commissioning for better outcomes Identify opportunities and risks from this approach and embed in commissioning practice. Don’t commission new services that are failing. Review guidelines for quality in commissioning and ensure these are co-produced. Explore how information about people’s experience of care can be used to improve the commissioning process. Better support for improvement Review sector-level improvement initiatives to support all organisations to improve. Describe clearly the role of national organisations within social care and how they work together to encourage improvement. Shared focus areas for improvement Ensure that adult social care is considered across health and social care initiatives (such as Sustainability and Transformation Plans) and that people work collaboratively across sectors. Improving the profile of adult social care Champion everything that is great about adult social care so more people understand, support and celebrate the fantastic difference care and support makes to people’s lives. Attract even more talented people to a career in adult social care. 18

Our single shared view of quality 19

Chief Inspector of Adult Social Care Thank you #Qualitymatters #Stateofsocialcare www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm Andrea Sutcliffe Chief Inspector of Adult Social Care @CrouchEndTiger7 20 20