Kathy Fodey Director of Regulation & Nursing Regulation and Quality Improvement Authority
THREE KEY QUESTIONS THE REGULATOR WILL ASK
WHAT WE DO
The Role of RQIA
Registered Establishments and Agencies
HOW DO WE GATHER INFORMATION
C7
inspectengagemonitorreport Against regulations and standards Speak to service users, cares, families, staff Professional judgement HSC Trusts, HSC Board, PHA, DHSSPS, PCC, COPNI, Joint Protocol Incidents, complaints, duty calls, whistleblowing Publish reports and reviews, develop guidance
Pre-Inspection: What do we know? Previous inspections/intelligence Self -assessment of standards Complaints Care management reviews Information that may trigger an unscheduled inspection Duty calls from family, staff, others Letters from family or staff HSC trust-led vulnerable adult investigations Media reports
RQIA Inspections Review of previous requirements/recommendations Interviews with patients, staff, relatives Assessment of care needs Assessment against standards /themes Review of care and management records Observations environment culture/ambience staffing/patient interactions routines
Whistleblowing A notable increase in whistleblowing to RQIA The winterbourne affect Guidance available on RQIA website May lead to safeguarding investigations Increased inspection monitoring activity Improvements to safety and quality of care
Cherry Tree House: Recommendations
HOW DO WE PROTECT AND DRIVE IMPROVEMENT
Number of recommendation and requirements by service category
Post-2012: Current Enforcement Activity urrent Enforcement Activity Why we use enforcement Service and Provider name Copy of notice Date of issue, compliance required Link to previous enforcement action Summary of issues Explanations of types of enforcement Link to inspection reports
REGULATION BREACHES
Domiciliary Care Agencies Reg. 15:Provision of services x 4 Reg. 13:Fitness of workers x 4 Reg. 21:Records x 3 Plus 6 other regulations x 1 each
Dental Practices Reg. 15: Quality of treatment – relating to decontamination x 5
Nursing Homes Reg. 14:Further requirements for health and welfare x 6 (choice, hazards, risk, training) Reg. 18:Facilities and services x 5 Reg. 13:Health and welfare x 5 (infection prevention, privacy & dignity, medicines management) Reg. 20:Staffing x 4 Plus 8 other regulations x 16 times in total
Residential Care Homes Reg. 13:Health and welfare x 3 Reg. 12:Quality of service x1 Reg. 15:Assessment of residents Reg. 21:fitness of workers x 1 Plus 2 other regulations x 1 each
WHAT MORE CAN WE DO
A need to move from being heard to being listened to… To hear = to be capable of perceiving sound To listen = to pay attention to what is being said
We won’t reinvent the wheel …
… but we may improve it!
Three key questions Is care safe Is care effective Is care compassionate
New inspection focus Analysis of intelligence and risk Safe Effective Compassionate