CQC – listening and improving regulation 28 September 2011 Dame Jo Williams Chair, CQC

2 Where we are now Since launch in April 2009 we have introduced a new and radically different regulatory system for health and adult social care in England We have registered the NHS (April 2010), independent health and adult social care (October 2010), and in dental and independent ambulance services (April 2011) We have implemented a complex piece of legislation against a series of inflexible Parliamentary deadlines We have developed and rolled out new systems, processes, methodology, guidance, new ways of public reporting We are still processing high volumes of new providers and variations to existing registrations GP registration on hold until April 2013

3 From April 2009 Ongoing April 2014 onwards… CSA until Sept 2010 Apr CQC’s lifecycle – a five-year programme Phase 1 - legacy HCC, CSCI, MHAC Phase 2 Design and build Phase 3 Registration Phase 4 Implement and review Phase 5 Optimising the model

4 CQC – what CQC does and does not do What CQC does not do We do not make assessments of commissioning – although we can comment on shortcomings via themed reviews and investigations We don’t assess quality above essential standards We promote improvement by focusing on non-compliance CQC’s role Register – inspect – enforce – publish CQC registers care providers then checks whether they are meeting essential standards If not, we take action – they must put problems right or face enforcement action We publish what we find as quickly as possible We share what we know with our partners We put a premium on users/ whistleblowers

5 Regulations - minimum standards vs. improvement Role of regulation is context specific – resources affect quality of care Therefore if your role is to offer assurance around essential standards – a minimum bar for market entry – finite resources will be focused on poor quality That does not mean to say that minimum standards are the opposite to improvement, rather they are a lever to gradually improve the standard of care over time

6 InspectionAnalysisVoices Palette of Regulation Scheduled inspections Themed inspections Responsive inspections Themed reviews Quality Risk Profiles Other data sources Website feedback Telephone or written feedback Third party feedback Whistleblowing Safeguarding

7 Consultation on regulatory model Simplifying and strengthening model: Inspecting services more often – once a year More targeted inspections Continued risk-based regulation and focus on outcomes Continued scheduled, responsive and themed inspections Continued unannounced inspections

8 Consultation on regulatory model (ii) Significant changes we would like your views about: Judgements: compliant or non-compliant Consider impact on people after judgement of non-compliance Regulatory response based on significance of non-compliance and impact on people More transparent enforcement process Compliance report to refer to warning notice for non-compliance where appropriate Consultation closes on 9 December

9 Sharing information on the quality of residential care a summary of CQC’s judgement of compliance with essential standards and a provider’s compliance history an update on improvements against compliance conditions or CQC’s recommendations information from people who have used the service improved ways to support the public, and staff working within services, to tell us about their experiences From autumn, the CQC website will provide improved, accessible, useful, up-to-date information for the public, including:

10 How the new website will look Homepage Consumer focused Clear about what we do/can offer the public Focused on ability to look up location level reports/see major action we’re taking Information for providers and corporate information clearly signposted

11 Dilnot Commission recommendations Capping the lifetime contribution to adult social care costs that any individual needs to make Means-tested support should continue for those of lower means and the asset threshold for those in residential care increased from £23,250 to £100,000 Better information and advice A new national assessment system Portable assessments Advice and information for carers as well as improved carers’ assessments

12 Thank you Care Quality Commission Tel: