1. Welcome

2. Join us!

3. Support
Business support, resources and advice
On-line member forum
Preferential DBS
Website listing
Influence
Collaborate with and lobby lead stakeholders in the sector
A voice for provider organisations, represented in joint planning, consultations and service development initiatives
Research and evidence-based models of good practice.

4. Quality
Preferential access to seminars, training and conferences supporting good practice, research and evidence based services
Regular bulletin on current issues
Sharing of experiences, good practice and identification of key issues relating to service development and delivery.
Individually tailored support with organisational development, quality improvements and other service delivery issues.

5. 2. ONE sentence describing what you do
1. Name of your service
2. ONE sentence describing what you do
3. Website link
Holly Stockdale

6. Sue Burn Inspection Manager, Somerset ASC October 2017
The state of health care and adult social care 2016/17 and Quality Matters
Sue Burn
Inspection Manager, Somerset ASC
October 2017

7. Unique oversight of health and care
Full picture of the quality of health and social care in England, with ratings for all sectors
Now have a baseline from which to draw conclusions about quality and safety of care and what influences this
21,256 adult social care services
152 NHS acute hospital trusts
197 independent acute hospitals
18 NHS community health trusts
54 NHS mental health trusts
226 independent mental health locations
10 NHS ambulance trusts
7,028 primary medical care services
Increasingly, CQC will report on quality of areas and coordination across services – for care fit for the 21st century
Is it safe?
Is it effective?
Is it caring?
Is it responsive?
Is it well-led?

8. Congratulations to staff
Results are a credit to frontline staff, managers and leaders

9. Health and care services are at full stretch – which impacts upon people
Increased complexity of demand = new challenges
Providers must change to meet complexity and challenges
Future quality of care is precarious
Providers struggling to cope with more complex demand
People waiting over four hours at A&E
More planned operations cancelled and people waiting longer
Increasing demand for mental health services, affecting waiting time
Fewer nursing home beds
Adult social care providers handing back contracts
One in eight older people are not receiving help they need

10. Care providers are under pressure
Need for adult social care continues to rise
4,000 fewer beds in nursing homes - 2% reduction over two years
Source: CQC registration data

11. Are adult social care services closer to the tipping point?

12. Variation and the tipping point
Some areas closer to the tipping point, others further away
Factors affecting the tipping point vary geographically – ratings variation is one aspect
Source: CQC ratings data, 31 July 2017
ADULT SOCIAL CARE RATINGS BY LOCAL AUTHORITY
Percentage of
good and outstanding
Top 20%
Upper 20-40%
Middle 20%
Lower 20-40%
Bottom 20%

13. The quality of care across England is mostly good
Much is encouraging – despite challenging circumstances, most people are still getting high quality care
NHS mental
health core services
68%
good
NHS acute hospital core services
55%
good
Adult
social
care %
good GP
practices
89%
good

14. 100% 80% 80% Improvement Adult social care 82% Mental GP Health
Common factors leading to improvement:
Patient-centred care
Strong leadership
Positive culture
Shared vision
Outward looking approach
Involving people, communities, partners and collaborating
Of those services originally rated inadequate, most have improved
Adult social care 82%
Mental
Health
100% GP
practices
80%
Hospitals
80%

15. 26% 18% 2% Deterioration Adult Mental social NHS acute hospitals GP
While recognising improvement, there is deterioration to be addressed
Where services rated good were re-inspected, some have fallen
Mental
health
26%
fallen
Adult
social
care %
fallen
NHS acute hospitals
18%
fallen GP
practices 2%
fallen

16. Adult social care
78% rated good, but 19% rated requires improvement and 1% (303 locations) inadequate
Caring rated best – 92% good and 3% outstanding. Safe and well-led poorest – 22% requires improvement and 2% inadequate
High-performing services have strong leaders – innovative registered managers known to staff, people using the service, carers and families had a positive impact
High-quality services are person-centred – staff get to know people as people, understanding their interests, likes and dislikes
Most enforcement for poor care relates to governance, safety, staffing and person-centred care
Quality matters joint commitment developed

17. Somerset ratings – top 20% nationally (July/Aug 2017)

18. Outstanding services = 14
Cambian Lufton Manor
Cream Residential Care
The Dairy House
Dunkirk Memorial House
Castle House Nursing Home
Highfield House
Beaufort House
Halcon House
Frith House
Ashcroft
Bluebird Care – South Somerset
Bluebird Care
Blue Moon Care
Dunster Lodge Domicilliary Care

19. Challenges
Improve planning, delivery and experience for mental health – Mental Health Act and the Green Paper
Long-term sustainable solution for adult social care needed
Services in all sectors must collaborate locally

20. Local collaboration and joined-up care
Complexity + challenges = collaboration
Golden thread connecting vision to delivery
Putting people first
Shared vision and strong leadership
All staff to share that vision and deliver to action
Work together as part of a system

21. Quality Matters: ambition
Champion the importance of high-quality care and support
Have a shared understanding of what good quality care is and what needs to be done to improve it
Agree shared priorities for quality improvement and a shared commitment to taking collective action to address them
Foster stronger and more effective partnerships
Collective action that creates the conditions for improvement
See an improvement in quality that makes a real difference to the lives of people using adult social care

22. Quality Matters: a shared view of quality for health and social care

23. Quality Matters: principles
Promote quality through everything we do
Support and encourage improvement
Co-ordinate action

24. Quality Matters: action plan
Acting on feedback, concerns and compliments
Measuring, collecting and using data more effectively
Commissioning for outcomes
Better support for improvement
Shared focus on areas for improvement
Improving the profile of adult social care

25. Thank you #Qualitymatters #Stateofsocialcare www.cqc.org.uk
@CareQualityComm
Sue Burn
Inspection Manager 24

26. Developments in CQC Regulation
Mei-Ling Huang
Partner
Health & social care team

27. Overview Lessons from the State of Care report Changes in inspections
Problem areas in inspections
Enforcement
Prosecutions
Unregistered carers

28. Lessons from the State of Care
Don’t become complacent.
If you rated as requiring improvement, examine the evidence.
If you are found to require improvement, prepare yourself for closer scrutiny.

29. Changes in inspections
New guidance/handbook
Provider Information Collection (PIC)
New KLOE’s and prompts

30. What to look out for in inspections
Administration of medication
Risk assessments
Staffing
Audits
Activities
Safeguarding
Dignity and respect
Hydration and nutrition

31. Enforcement Urgent requests for information
Use of the urgent procedure to impose conditions on registration (embargos)
Failure to take account of the bigger picture
Revised use of Fit and Proper Person test for directors

32. Prosecutions Five prosecutions since 2015. Eight more in the pipeline.
LA’s also prompting criminal prosecutions via safeguarding.

33. Unregistered carers
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You do not need any care experience to become a host. CareRooms will provide all the necessary training you need in order to become a host, the role starts as simple as providing a cup of tea and some company.”
- CareRooms.com

34. Questions?

37. Maggie Norris / APRIL UK
APRIL UK - established in 1997
Award-winning health insurance specialist
Part of the APRIL Group – global insurance provider
Bristol-based head office and a national distribution network
Offer protection and health insurance to individuals and SMEs
Specialisms: medical insurance, accident & sickness and life cover
Authorised and regulated by the Financial Conduct Authority

38. Introduction Brief history How can we help? Example cases
2017 Cooper Associates Group Financial Advice for the Long-term Care Market
Introduction
Brief history
How can we help?
Example cases
Where do we go from here?
Summary

39. As the Care Sector Procurement Specialist we have the privilege of working with 22 care groups to deliver savings...... TM
Marr Procurement is a proud sponsor of the

40. Royds Withy King
Lawyers ahead of the curve

41. Our services for care providers
HR and employment
immigration law
safeguarding and inquests
mental capacity and DOLS
service user contracts
business sales and acquisitions
property development, construction and finance

42. Care Advisor Service Employment law advice
employment contracts & handbooks
Insurance against claims/awards
Health & safety
consultancy
defence costs insurance
Safeguarding and CQC compliance advice
Mental capacity and DOLS
Immigration advice

43. Our services for care providers
CQC registration
Challenging CQC inspections and enforcement
Factual accuracy logs
Ratings reviews
Action plans
Embargos
Warning notices
Special measures
Cancellation of registration
Local Authority fee negotiations
Judicial review
Contract and fees disputes
Litigation

44. Offers for RCPA members
Free review of:
Employment contracts
Staff policies and handbooks
Service user contracts
Free social care and employment e-updates
Free initial telephone consultation

45. Thanks for coming