Implications of Service Transformation Please welcome our third speaker Mei-Ling Huang, Partner QualitySolicitors Burroughs Day Implications of Service Transformation

RCPA Conference 15th November 2016 @QS_BurroughsDay

Social care specialists Challenging CQC inspections and enforcement Negotiations and disputes with local authorities Recovery of care fees Safeguarding Mental capacity and Court of Protection Employment law Business sales and acquisitions Commercial property, leases and tenancies

How we can help Services for Businesses: Services for Individuals: Commercial Law Residential Property Commercial Property Employment, HR & Discrimination Advice Advice for Business Start-ups Family & Relationships Charity Law Lasting Powers of Attorney Debt Recovery Litigation Medical Negligence Employment Law Mental Capacity Health & Social Care Law Personal Injury Legal Costs Probate Pharmacy Law Wills and Tax Planning

CQC Inspections and enforcement Mei-Ling Huang Partner

Overview Inspections Ratings Ratings reviews Enforcement

SSP Health Limited If you can prove that CQC have got it wrong in your draft report but they ignore you, what can you do about it? “We didn’t see it, so it doesn’t exist.” An independent review of the factual accuracy process is required if the provider requests it

New Factual Accuracy Logs Section A – Typographical errors Section B – Accuracy of the evidence in the report Section C – Completeness of the evidence You may make a separate complaint regarding the conduct of the inspection Important: Include everything at this stage!

Factual Accuracy Log Steps Draft report to provider; Submit factual accuracy log with all your arguments; Inspector responds to log; Log internally reviewed by someone else in CQC; CQC sends responses to the factual accuracy log and final report; Report is published.

2015/16 State of Care 596 services rated inadequate as of July 2016 Some were re-inspected 139 achieved a “good rating” (23%) 316 achieved “requires improvement” (53%) This leaves 141 unaccounted for – perhaps closed.

State of Care 2015/16 Many services were caring. Performance flows from management. Most of the regulatory compliance action taken related to management, safety and staffing.

New Ratings (1) Residential homes that have been rated under the new system as of September 2016: 0.8% outstanding 69% good 26% require improvement 3% inadequate 1% not rated

New Ratings (2) Nursing homes (as of September 2016): 0.6% outstanding 58% good 35% require improvement 5% inadequate 2% not rated

New Ratings (3) Home care agencies (as of September 2016): 1% outstanding 73% good 21% require improvement 2% inadequate 2% not rated

Is there too much variation in ratings? “We will be clearer when services are good with outstanding features and where the rating of requires improvement does and does not entail a breach of regulations”.

Changing your rating Factual accuracy logs are still the most effective way to obtain a change Add in positive points omitted from draft report

Changing your rating (2) Request for ratings review Procedural argument 500 words! Low chance of getting the rating changed

Ratings reviews July 2016 Reviews requested - 290 No grounds - 178 Paused due to external factors - 17 Under investigation by CQC team - 31 Under consideration by reviewer - 4

Ratings reviews July 2016 Outcomes of 236 completed cases: Not reviewed due to “no grounds” - 193 Ratings increased - 14 Ratings decreased - 2 Ratings increased and decreased - 2 No change to ratings - 25

Enforcement Fewer warning notices Embargoes Cancellation of managers’ registration

Help is at hand!!! Call us if… Your draft report is not accurate You are on the cusp of a rating (e.g. 2 ‘requires improvement’ and 3 ‘goods’) You have any ‘inadequate’ ratings You receive a warning notice, notice of proposal or notice about special measures

QUESTIONS

Thank you for listening For a free initial consultation please contact Our Social Care Team 0117 929 0333 care@qsbdlaw.com