Quality Framework

Historical Context of the QPA award in Shropshire First introduced in 2004 for Residential and Nursing care, 2008 for Domiciliary care Aims to improve and reward quality Based on CQC ratings Linked to annual fee negotiations Built on the pre-placement contract implemented by the Council Based on Independent accreditation

How much do Care Homes receive? Initially an additional £14 per week per bed was awarded based on a weighted score. Then moved to a differential scheme of 3 tiers paying £15, £20 and £25 per bed per week. Paying a higher premium for higher quality services.

Payments Built into fee negotiations Does not recognise homes with a poor rating Continues to reward higher quality services Focus on Nursing and EMI

Care Home Payments 2012 to 2014 Year 1 Uplift table StarNursing EMIResidential EMINursing Non EMI Residential Non EMI 0tbc 12.75%1.50%2.75% 24.50%2.50%3.50%3.00% 36.00%3.00%4.50%3.50% Year 2 Uplift table StarNursing EMIResidential EMINursing Non EMI Residential Non EMI 0tbc 11.00% 21.75%1.50%1.75%1.50% 32.50%2.00%2.50%2.00% Residential & Nursing

% rated Poor 6.9%4.6%2.3%1.5% % rated Acceptable 9.9%8.3%7.6%6.1% % rated Good 46.7%54.8%47.3%46.6% % rated Excellent 28.0%31.2%40.5%42.0% The Impact on Care Home Ratings in Shropshire Source: CRILL overall analysis 2007 and 2008 Shropshire snapshot 2009 and 2010

The system now: Providers who believe they have improved their services since CQC rating ended can apply for the QPA. The process is provider driven and includes Application/ Self Assessment Safeguarding checks Contract monitoring

Accreditation The application will be accredited by a Panel process being developed by the local authority, membership to include: -Elected Members -Head of Service -Contracts Officer The panel process will also be used by the Council to withdraw QPA from an individual Provider

1) Was it a continuously 2 or 3 star rated service under CQC for the period 2008 – 2010? 1) Was it a continuously 2 or 3 star rated service under CQC for the period 2008 – 2010? 2 ) Has it been assessed as being fully compliant by CQC under the new inspection regime? Has the organisation self-assessed as being fully compliant in all outcomes?  If you have not been inspected by CQC complete the quality form to summarise your evidence.  If you have been inspected by CQC please list the outcomes reviewed and complete the quality form to summarise your evidence. 2 ) Has it been assessed as being fully compliant by CQC under the new inspection regime? Has the organisation self-assessed as being fully compliant in all outcomes?  If you have not been inspected by CQC complete the quality form to summarise your evidence.  If you have been inspected by CQC please list the outcomes reviewed and complete the quality form to summarise your evidence. No Yes Is this a new service? Is this a new service? Yes No Cannot receive a premium before 4/2013 Cannot receive a premium before 4/2013 Yes No Cannot receive a premium before 4/2013 Cannot receive a premium before 4/2013

Quality Rating Self Assessment Audit. Organisations that were deemed as excellent by CQC prior to 1 st October 2010 will retain this rating providing there has been no significant change to owners/management or information leads the Local Authority to have a reason to re- evaluate the rating. Organisations in the Adult Protection Process for Institutional Abuse cannot be recognised by the quality framework. Organisations that are currently not recognised as being excellent but wish to be recognised as “excellent” must complete a submission evidencing why they consider they now offer an “excellent “service. The important factor is what has changed and how have you evaluated the change? The key themes: Choice and control over decisions Good relationships Meaningful activity Organisational factors Organisations that have been inspected and rated by CQC but wish to have improvements recognised with a new rating.

Organisation: Site: Proprietor (s): Registered Manager: Date of Registration: If manager is not yet registered please state the date appointed as manager: Quality Risk Profile – CQC rating

Choice and control over decisions This may include: choice over who they live with, who supports them, how and when they are supported and daily routines. Supporting people to make informed decisions, take risks (mental capacity act), provide information in an appropriate format, access advocacy services when appropriate and support any disagreements to an acceptable and speedy resolution. Managers that lead by example are approachable and available. Staff training and recruitment Involves everyone in consultations when designing and managing services. What has changed? List of supplementary evidence

Good Relationships: Respect and promote human rights Treat everyone with dignity and respect Enable contact with people who are important to the people you support Sensitive and pro active to meet religious/cultural and personal needs Managers that lead by example are approachable and available. Staff training and recruitment to provide a positive and competent workforce Strong Community presence What has changed? List of supplementary evidence:

Meaningful Activity to consider: This can mean providing task orientated activities in a person centred approach, thereby making daily activities meaningful. ( Domiciliary Care) Support people to be independent Supporting people to make informed decisions, take risks (mental capacity act), find out what is important to them and enable activities. Be creative and flexible to meet the aspirations of the service users. Managers that lead by example are approachable and available. Staff training and recruitment to provide a positive and competent workforce What has changed? List of supplementary evidence:

Organisational Factors to consider Deliver positive outcomes for people and evidence this over a long period of time. Develop skills and knowledge of the workforce Embed a culture that supports and enables people to achieve individual aims and objectives. Review and develop values, promoting respect, dignity and independence. Continuous learning and consultation Record keeping and recording processes that evidence actual delivery of the service. What has changed? List of supplementary evidence:

Any other information Signed:Position: Date:

The Way Forward 2013/14 Include an Independent Assessment e.g. Healthwatch Review and evaluation locally of the process so far Will become more focused on gathering service user feedback Will be more outcome-focused

Debbie Price Shropshire Partners in Care 6 Farriers Business Centre Annscroft Shrewsbury SY5 8AN Ruth Houghton Shropshire Council Assessment & Eligibility Shirehall Abbey Foregate Shrewsbury SY2 6ND