About CQC Sarah Seaholme Ram Sooriah 1 1

Our purpose Our role Our purpose and role We make sure health and social care services provide people with safe, effective, compassionate, high-quality care and we encourage care services to improve Our role We monitor, inspect and regulate services to make sure they meet fundamental standards of quality and safety and we publish what we find, including performance ratings to help people choose care Our purpose and role, as set out in our new strategy ‘Raising standards, putting people first’, published in April 2013, is clear. 2

Underpinning our approach Our judgements will be independent of the health and social care system; and politics We will always be on the side of people who use services Our relationship with providers will be constructive not adversarial Patients and other users will be at the heart of the regulatory process Providers and clinicians remain responsible for safety and quality No 100% guarantees The values underpinning our new approach are important. We are independent of the NHS and social care systems, and government and operate under our own legistlation. We are on the side of people who use services – patients, carers, families – and seek to be constructive with service providers, but we will have a zero tolerance approach where they break the rules. Providers, clinicians and those we regulate are ultimately responsible for quality and safety. And we cannot offer a 100% guarantee that poor care will not happen again. 3 3

Five things we will look at We will tackle the following five questions about services: Are they safe? Are they effective? Are they caring? Are they well led? Are they responsive to people’s needs? Our new approach sees a move to regulate around these five questions. People have a right to expect safe, effective, compassionate, high-quality care. We play a vital role in making sure that care services meet those expectations. 4

Things we will do differently Appoint chief inspectors of hospitals, adult social care and support, and primary and integrated care Develop fundamental standards Specialist inspectors leading expert teams, including clinical and other experts, including experts by experience NHS hospitals: national teams with expertise to carry out in depth reviews of hospitals with significant problems Our new strategy, published in April 2013, and our consultation document, ‘A New Start’, published in June 2013, outline key changes that we plan to make. The next 3 slides outline these. 5

Things we will do differently NHS hospitals: a clear programme for failing trusts that makes sure immediate action is taken to protect people and deal with failure Predict, identify and respond more quickly to services that are failing, or likely to fail, by using information and evidence in a more focused and open way – including people’s views and experiences Improve understanding of how well different care services work together Work more closely with our partners in the health and social care system to improve the quality and safety of care 6

Things we will do differently Publish better information for the public, including ratings of services A more thorough test for organisations applying to provide care services, making sure named directors, managers, and leaders commit to meeting standards which is tested Strengthen the protection of people whose rights are restricted under the Mental Health Act Build a high performing organisation that is well run and well led, has an open culture that supports its staff and is focused on delivering its purpose 7

What we will continue to do A programme of unannounced inspections and reporting across the sectors we regulate Inspections at any time in response to concerns Inspections and reviews on particular areas of care Regulatory and enforcement action However, some things remain. Most inspections continue to be unannounced, we continue to take longer looks at certain themes of care eg. Dementia, maternity. 8

Next steps Changes for 2013/14 set out in our Business Plan We will deliver: New fundamental standards New hospital inspection methods Hospital ratings Begin to develop changes for other sectors Continued involvement of staff, providers, stakeholders, public in the development of our work We are formulating our business plan and awaiting the results of our consultation which closes on 12 August 2013. While involving all of our stakeholders, staff and the public in our consultation and beyond, we will deliver new fundamental standards, new methods of inspecting hospitals (longer, with clinical and patient involvement, more in-depth), and hospital ratings will begin by the end of 2013. Changes will begin to develop for other sectors into 2014. 9

Consultation launch date – Monday 17 June Closing comments People have a right to know that care is safe, effective, compassionate and high quality We are changing the way we inspect and regulate to play a vital role in making sure that care meets those expectations Consultation launch date – Monday 17 June Consultation closes on 12 August 2013. Please give comments through our website – www.cqc.org.uk. 10 10 10

Regulated care in the London Primary medical services 1550 locations Independent healthcare 234 locations Independent ambulances 51 locations NHS Trusts 217 locations Adult social care 2,381 locations Primary dental care 1,004 locations 5491 locations

673 locations Regulated care in Team 1 184 locations 35 locations Primary medical services 184 locations Independent healthcare 35 locations Independent ambulances 3 locations NHS Trusts 9 locations Adult social care 271 locations Primary dental care 161 locations 103 care homes without nursing (older people LD and MH), 51 nursing homes, domiciliary agencies 105 and some supported living facilities, care homes for people who require treatment for substance misuse 673 locations

  The law says that health and social care services must meet essential standards. This is so that people know what to expect from health and social care services.   We, the Care Quality Commission, have made rules about what people can expect when services are meeting the essential standards.

How we checked Rainbow House   How we checked Rainbow House  We asked people for their views. We asked staff and managers for their views. We looked at policies, records and care plans.

We watched to see how staff treated people using the service.   We watched to see how staff treated people using the service.    We thought about what we learnt.   We decided what Rainbow House was doing right and what it was not doing well.

What they were doing right at Rainbow House   What they were doing right at Rainbow House   Before a person moves into Rainbow House their needs are checked.

The person and people important to them are asked what they think.   The person and people important to them are asked what they think.   Rainbow House gives people information about what it is like to live there in a way they understand.

Activities took place regularly inside the home and outside.   People were usually able to choose what activities they would like to do. Activities took place regularly inside the home and outside.   People got the right care and support in a safe way. Staff helped make people feel safe.

There were enough staff to care for people.   There were enough staff to care for people. More staff worked in the home when they were needed.   Staff got training to make sure they meet people’s needs in the best way.

The owner checked all staff and supported them to do their work.   The owner often checked Rainbow House to make sure care was good and people were safe.   The owner checked all staff and supported them to do their work.

What Rainbow House was not doing well   What Rainbow House was not doing well   The owner did not always make sure bedrooms were warm and safe, and the home well decorated.

  People’s records when they saw doctors and other professionals were not available.   What happens next? We have asked the owner to tell us how and when they will make things better. We will check they have done this.