Quality, Standards, Regulation and Ratings an essential policy update for frontline managers Venue: London Date: 2 March 2016

In summary The promise of the Care Act A deepening crisis in social care? Making sense of the Spending Review Continuing concerns about quality, regulation and inspection And finally … implications for providers

Quality, standards, regulation & ratings: a brief policy update

1. The promise of the Care Act Rebalances the focus of care and support on promoting wellbeing and preventing (or delaying) needs Shift from duty to provide services to meeting needs i.e. person-centred Assessments should be “appropriate, proportionate, person-centred and ensure focus on duty to promote wellbeing”

The promise of the Care Act (2) Provides for the development of national eligibility criteria Treats carers as equal to the person they care for and on the same legal footing Duty on LAs to produce care and support plans and to offer a personal budget

The promise of the Care Act (3) LAs must facilitate a diverse, vibrant and sustainable ‘market’ for care services. Good commissioning should follow key principles outlined in the Act LAs will be required to promote integration with NHS and other key partners Reforms how care and support is funded, to create a cap on care costs (but not yet!)

2. A deepening crisis in social care?

2. A deepening crisis? Public sector funding - continued austerity Chronic under-funding On-going workforce challenges and the National Living Wage Crisis in social care will be a crisis for the NHS

3. Making sense of the SR settlement

3. Making sense of the Spending Review settlement An increasingly fragile care market Public sector finance and the 2% percept Commissioning and market shaping The contribution of the Better Care Fund Market developments – specialisation, diversification and segmentation

3. Making sense of the Spending Review settlement Responding to the Spending Review alongside commissioners, other provider bodies and the Care & Support Alliance ‘NHS cannot function without good social care’ ‘What is happening to £6b saved?’ ‘How ensure 2% levy is used equitably?’ Social care settlement ‘backloaded’

4. Concerns about quality, regulation and inspection

Concerns about quality and inspection Continuing concerns about quality The reality of quality ratings Provider concerns about how the system is working Further transparency and openness

CQC market oversight ‘Difficult to replace’ providers LA responsibilities and new duties for national oversight by CQC Assessing provider’s financial sustainability Informing LAs Special Measures

5. Implications for providers

Some implications for providers Personal budgets and Direct Payments – new forms of commissioning? Influencing local markets Sustainability and the pace of change Be prepared

Some implications for providers Common themes on sustainability: Dynamic leadership Understanding national policy in local context Working with commissioners on market shaping Care Act duties Collaborative working

Some implications for providers Integration, integration, integration … but remember housing Innovation, flexibility and new ways of working … but ‘rebalancing’ of the sector inevitable Key to implementation is leadership (and particularly the frontline manager)

And finally… Resources are available to support providers: CQC SCIE Skills for Care NCF and VODG Care Provider Alliance/LGA