1. CQC Update Paula Eaton 2nd November 2015 Generic ASC deck (June Final)

2. Adult Social Care Vision The Mum Test
Is it safe?
Is it caring?
Is it
effective?
Is it responsive to people’s needs?
well-led?
Is it good enough for my Mum?

3. Responsive to people’s needs? Well-led?
Asking the right questions about quality and safety
Safe?
Effective?
Caring?
Responsive to people’s needs?
Well-led? 3

4. Five key questions Safe
By safe, we mean that people are protected from abuse and avoidable harm.
Effective
By effective, we mean that people’s care, treatment and support achieves good outcomes, promotes a good quality of life and is evidence-based where possible.
Caring
By caring, we mean that staff involve and treat people with compassion, kindness, dignity and respect.

5. Five key questions Responsive
By responsive, we mean that services are organised so that they meet people’s needs.
Well - led
By well-led we mean that the leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.

6. Inspection Process Prior to Inspection
Information held by CQC including PIR
Contact with key stakeholders
Inspection
Single inspector or team
Seeking the views of people and their families/friends
Observations
Talking to staff
Looking at records
Reporting
Enforcement Action

7. Duty of candour Purpose Actions for providers CQC
Promotes adoption of openness and transparency in services
Supports development of safety culture
Actions for providers
Inform people when things go wrong
Provide support, truthful information & apology
CQC
Registration
Inspection – existing key lines of enquiry
Providers must be open and honest with people when things go wrong with care and treatment. Providers must give them reasonable support, truthful information and a written apology.
Providers must have an open and honest culture at all levels and have systems in place for knowing about notifiable safety incidents. The provider must keep written records and offer reasonable support to the patient or service user in relation to the incident.
A requirement to be candid is already in the NHS contract so, in theory, NHS trusts should already be fostering a culture of openness and honesty. The duty of candour means CQC can take enforcement action against services that don’t satisfy these requirements.

8. Special measures Purpose Actions for providers CQC
Ensure failing services improve or close
Actions for providers
Use time available to improve service
CQC
Services rated as inadequate will go into special measures
Time limited period to improve
Improvements made – out of special measures
No improvement – move to cancel registration
Does not replace enforcement action
Generic ASC deck (June Final)

9. Scores on the doors Purpose Actions for providers CQC
Public able to see rating of service quickly and easily
Actions for providers
Display ratings in service and website
Suggest accompany with additional information
CQC
Will provide template
Inspection – check that rating is displayed
Generic ASC deck (June Final)

10. Four point scale High level characteristics of each rating level
Innovative, creative, constantly striving to improve, open and transparent
Consistent level of service people have a right to expect, robust arrangements in place for when things do go wrong
May have elements of good practice but inconsistent, potential or actual risk, inconsistent responses when things go wrong
Severe harm has or is likely to occur, shortfalls in practice, ineffective or no action taken to put things right or improve 10

11. Adult Social Care services
Latest ratings at 26 October 2015
Adult Social Care services
44 (<1%) Outstanding
5130 (59%) Good
2963 (34%) Requires Improvement
584 ( 6%) Inadequate
Total 11

12. Examples of Good Person Centred Care
‘There were a range of risk assessments including support
for a person with behaviour that challenged the service,
and strategies to assist a person to understand why they
should adhere to medically advised healthy eating
guidelines while recognising the person’s individual rights
and preferences. This showed that the service strived to
promote people’s independence, taking into account the
need to minimise risks to their safety’.
‘The rotas showed that although the service was not sure how long the person would remain an in-patient; the deputy manager had made provisional short-term arrangements for the person
to have a staff member at their bedside every day, in
accordance with their needs’. 12

13. Examples of Good Person Centred Care
‘Staff knew people very well and were in tune with peoples‘ needs by adjusting the care they provided. For example, we observed a member of staff supporting a lady with dementia to eat very well. The member of staff spoke to her and adjusted her speed well to accommodate the person. The staff member understood when the person wanted a drink noting that the lady’s eyes changed’.
‘One person with particular mobility difficulties had wanted to go out to a concert. We saw staff had obtained and altered a piece of equipment so that this person could go on the outings of their choice’. 13

14. Examples of Good Person Centred Care
‘There were colour changes to floors and walls,
pictorial signage and personalised front doors to assist
people to recognise where they were’.
‘The staff also held a weekly ‘farmers market’ in the dining
room…..We saw that a variety of fresh food was displayed and the
services housekeeper spoke with people about what food
they would like and would cook an individual meal if
needed. For example, one person attended the farmers
market and saw a pork chop. They remembered how they
used to always cook a pork chop for their partner. The staff
then cooked an individual pork chop meal for that person’. 14

15. Examples of Good person Centred Care
‘Understanding peoples' interests and hobbies was key to
providing person centred care in the home. One person has
been involved in teaching other people how to paint as
teaching was their background’.
‘The plans included people’s likes and dislikes and what was important to that person. For example the plan for one person stated it was important that their day clothes were coordinated and they wore make-up’. 15

16. Examples of Good person Centred Care
‘One person told us that their girlfriend lived at another service managed by the provider and they saw each other regularly. Staff confirmed that they were consulting with the person and their girlfriend in order to help plan a European holiday, in accordance with their wishes’. 16

17. Examples of Good Person Centred Care
‘Staff were given the opportunity to build meaningful relationships with people and ample time to meet people’s needs and provide companionship’
‘The activities encouraged people to test their
physical and mental dexterity as individuals and groups
and enabled people to share their life
skills and experiences. Peoples
comments included, “It’s amazing,
just lovely”. 17

18. Examples of Good Person Centred Care
‘We saw evidence that a person whose family had brought them from abroad for one last visit had been taken ill on their visit and received care in Cheviot Nursing Home. The support provided to the person, their family and their extended family had been described by the family as, ‘….nothing but outstanding.’
‘This was demonstrated by people having the opportunity to invite friends and relatives into their home for a private dinner party. A notice on the wall advertised this experience with the following wording, ‘Would you and your loved ones like to like to enjoy fine dining at Cheviot under the stars or in your own room. Your choice of menu for a two course meal special occasions catered for.’ 18

19. Examples of Good Person Centred Care
‘Every aspect of peoples' experiences in the home were
delivered to the advertised care philosophy of being
Supportive, Personal, Attentive, Relationship Centred, Kind, Listening and Enabling or SPARKLE’.
‘People using the service and
their representatives had been invited to attend a three day event organised by the provider. Its’ purpose was to consider the future development of the organisation. The results of the most recent questionnaires showed that people were happy with the quality of care and support’. 19

20. People are at the Heart of It20