1. Improvements in care homes following CQC inspection 1 October 2014 to 31 March 2016 Data used in slide deck relates to published re-inspections up to 31 March 2016.

2. Inadequate care homes: overview Number of inadequate locations that have been re-inspected after an original rating of ‘inadequate’ 1 Oct 2014 to 31 Mar 2016 Number of locations that have subsequently become inactive* 372 34 Number of these locations that improved their overall rating 273 Number of beds in these locations that improved their overall rating 12,435 2 * Please note that inactive is not indicative of closure, these locations may have subsequently come under new ownership.

3. Change in overall rating following inspection 3 73% of care homes originally rated as inadequate improved their overall rating following the most recent CQC inspection

4. Change in overall ratings by type of care home – residential and nursing 4 78% of nursing homes originally rated as inadequate improved their overall rating following a second inspection 68% of residential homes originally rated as inadequate improved their overall rating following a second inspection

5. Case studies 5 Case studies from CQC’s four regions North Region: Seaham View in County Durham, run by Swanton Care and Community, providing care and support for up to twelve people with a learning disability, autistic spectrum disorder, and associated complex needs. Central Region: Acorn Care Home in Birmingham, run by 1 st Care Limited, providing care for up to 22 people requiring nursing or dementia care. South Region: Glynn Court in Hampshire, run by Glynn Court Limited, providing care for up to 31 people requiring nursing or personal care, some of whom may have dementia. London Region: Precinct Road in Middlesex, run by Royal Mencap Society, providing personal care for up to five adults with a learning disability.

6. Case study 1: Seaham View in County Durham 6 CQC carried out unannounced inspections in October 2014, rating Seaham View as Inadequate due to serious concerns regarding the safety of people using the service. CQC inspectors saw first-hand the inability of staff to manage people’s complex needs: people were not engaged in meaningful activities, the environment did not meet people’s needs, and staff demonstrated a limited knowledge of caring for people with autism. CQC continued to monitor weekly updates on the home’s action plan, as well as work closely with local partner organisations before carrying out a re-inspection in February 2015 where the service was rated as Good overall. Here, inspectors found that staff training had been planned and most staff had been trained in autism awareness and positive behaviour support. People were being treated with dignity and respect and staff said that daily diaries and care plans had improved tremendously to ensure a programme of activities for people were meaningful and resourced appropriately. Dr Alison Rose-Quirie, Chief Executive at Swanton Care and Community, said: “Since the date of the first inspection at Seaham View, there has been a complete change of senior management and the establishment of a new service philosophy based on kindness, caring, safety, empowerment and respect. We are dedicated to continually improving the services we provide.” To read more about this case study, visit www.cqc.org.uk/care-home-improvementwww.cqc.org.uk/care-home-improvement

7. Case study 2: Acorn Care Home in Birmingham 7 CQC carried out unannounced inspections in February and March 2015, rating Acorn Care Home as Inadequate due to serious concerns in four areas. These related to the risk to people of unsafe care and abuse: people’s consent to care had not always been sought, people did not always receive their medicines as prescribed and the monitoring of the service was not effective. When CQC re-inspected in October 2015, the provider had made substantial improvements resulting in a new rating of Good across all areas. These included staff receiving training that enabled them to identify any possibility of abuse and take appropriate actions, sufficient staff to meet people’s identified needs, effective management of people’s healthcare, records now contained detail about how people preferred their care to be delivered and all staff said they now felt fully supported in their roles. One person said: “I feel safe living here and the staff are very good.” A staff member said: “We work well as a team now and things are more organised which benefits the people living here.” Nick Richards, Operations Director at 1st Care Limited, said: “The positivity and determination of the home’s manager and the positive working relationship with CQC ensured improvements were not only made, but were sustained.” To read more about this case study, visit www.cqc.org.uk/care-home-improvementwww.cqc.org.uk/care-home-improvement

8. Case study 3: Glynn Court Residential Home in Hampshire 8 Teamwork and new practices have helped ensure standards at Glynn Court Residential Home have improved after a CQC inspection rated the service as Inadequate in October 2014. This was due to concerns about how the provider and registered manager identified, assessed and managed risks in relation to the safety of people and the quality of care being provided. Following CQC’s action to remove the then registered manager from the home’s registration, as well as CQC’s monitoring of an action plan that set out how and when new changes would be implemented, CQC inspectors found significant improvements had taken place during a re-inspection in August 2015. A new registered manager had been appointed who helped turn around a number of the practices and culture of the home – and the service received a Good rating overall. CQC inspectors were impressed with the home’s work to drive through improvement and the commitment of the owner and staff to make sure this continued. As a result, the quality of life for people in the home has significantly improved with risks being properly assessed and managed, and staff fully involved in supporting people as a team. Karen Davison, Manager at Glynn Court Residential Home said: “When I started working at the home I explained to the team that evidence is key. If it wasn’t written down, it never happened. With every change we made, we explained the reasoning for doing it and what the processes were.” To read more about this case study, visit www.cqc.org.uk/care-home-improvementwww.cqc.org.uk/care-home-improvement

9. Case study 4: Precinct Road in Middlesex 9 At an inspection in June 2015, CQC rated Precinct Road as Inadequate overall due to no registered manager being in post and people using the service being at risk of receiving care or support that was inappropriate or unsafe. Possible safeguarding incidents had not been reported to the local authority or CQC, and there were not always enough staff to meet people’s needs. Where people were not able to make decisions about their care, requirements of the Deprivation of Liberty Safeguards (DoLS) – an important process that makes sure people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them – were not being adhered to. CQC re-inspected in October 2015 and found staff were dedicated to providing a safe, compassionate and high quality service that continually seeks to improve. A new registered manager was in post and there was a creative and person-centred approach. The home had carried out work to address possible risks to people and the provider did not deprive people of their liberty without authorisation. Tim Bell, whose son Kevin has been a resident at Precinct Road since 1999 said: “Kevin can’t speak or converse but he is well able to understand what I say to him. One of the things I like about Precinct Road is that they keep us fully informed about how Kevin is. The place has sometimes needed a lick of paint, but it’s not what it looks like that is important, but what it does in providing care.” To read more about this case study, visit www.cqc.org.uk/care-home-improvementwww.cqc.org.uk/care-home-improvement