Back to the 80s Sheila Grant / Simon Spoerer ARC Annual Conferences 8 & 21 November 2017 1 Generic ASC deck (June Final) 1

ASC regulation The Poor Law (1587 – 1834 – 1948) Parishes, Poor Law Unions, Local Authorities The National Assistance Act 1948 Local Authorities The Residential Homes Act 1980 The Registered Homes Act 1984 The Care Act 2000 National Care Standards Commission Commission for Social Care Inspection Care Quality Commission The Health and Social Care Act 2008 (Regulated Activities, not services) Generic ASC deck (June Final)

Social care by bricks and mortar The National Assistance Act 1948 ‘Part III’ Private and voluntary provider registration Several exclusions Power to inspect Numbers condition Fit person, fit premises, fit conduct 1979 – Benefits for care home fees The Residential Homes Act 1980 Private and voluntary sector By discretion to age, sex, other needs Power to make regulations (not exercised) Generic ASC deck (June Final)

Social care market Registered Homes Act 1984 Fees benefits leads to explosion in private sector care home market Growing public concern about poor and exploitative services leads to: Registered Homes Act 1984 Care homes / Nursing Homes / Mental nursing homes ‘Personal care’ New conditions at any time Urgent cancellation Representations / Tribunal Specified regulations Staffing, records, facilities & services, annual inspection Notifications Warning Notices Registered Managers Generic ASC deck (June Final)

Commissioning NHS & Community Care Act 1990 Griffith Report 1983 Social and health care markets The beginnings of personalised care Supported Living (learning disability) Registered Homes (Amendment) Act 1991 As before, plus small care homes brought into registration (4 or fewer people) Led to the creation of arrangements for the regulation of ‘adult placement’ schemes – now known as ‘Shared Lives’. National Association of Adult Placement Schemes launched June 1992 Local authority care homes brought into scope of inspection 1994 Generic ASC deck (June Final)

Protection to personalisation Growing shift from bricks and mortar, inputs and service focus towards care at home, empowerment, and person centred outcomes Marketisation of social care Deregulation task force Regulation / accreditation Shared rooms & spatial standards ‘A Better Home Life’ ‘Homes are for Living In’ Supported Living Generic ASC deck (June Final)

Care Standards Act 2000 National Care Standards Commission All providers (including LAs) National Minimum Standards Commission for Social Care Inspection Inspecting for Better Lives Ratings Care Quality Commission Both health and social care 1: Compliance Francis Report – huge impact 2: Fresh Start 5 Key Questions KLOEs / CoRs Generic ASC deck (June Final)

Personalisation Walking the talk Winterbourne View Building the Right Support Registering the Right Support Specialist housing issues? Older people? Active support / positive behaviour support Next phase Registration transformation programme Focus on improvement Rapid intervention & enforcement when needed Generic ASC deck (June Final)

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Shelia Grant / Simon Spoerer Thank you www.cqc.org.uk enquiries@cqc.org.uk @CareQualityComm Shelia Grant / Simon Spoerer Generic ASC deck (June Final)