1. Care Quality Commission: Insights
David Finney
David Finney Associates

2. Why is CQC relevant? It is the law enforcement body
Is it the representation of Christian principles?
How does it work in practice?

3. A brief history 1984 – Registered Homes Act
Local Authority & PCT responsibility
Care homes & Nursing Homes – some residential rehab services included
2000 – Care Standards Act
National Care Standards Commission – 2002
National Minimum Standards
Included domiciliary care, not community drug services
2004 – Commission for Social Care Inspection –CSCI
Social Services Inspectorate & Adult Social Care (NCSC)
Healthcare Commission was separate.

4. More up to date 2008 – Health & Social Care Act
2009 – Care Quality Commission – CQC
CSCI
Healthcare Commission
Mental Health Act Commission
What next?
Mid Staffordshire Hospital – Duty of Candour
Winterbourne View – focus on Directors, “Fit & Proper Person Test”
Care Act 2014 – focus on assessment & funding, & ratings
Overall Increasing responsibilities for CQC.

5. What does CQC look like? Chief Executive – David Behan
Three directorates
Adult Social Care
Primary Care – GP’s & Dentists
Hospitals
Registration
Inspection
Enforcement

6. Where do substance misuse services fit?
Residential Rehab services – including detox
“Accommodation for persons requiring treatment for substance misuse”
Community Drug & Alcohol Services
“Treatment for disease, disorder or injury”
What about – supported accommodation, after care, counselling services?

7. What standards do CQC apply?
Fundamental Standards
Key Lines of Enquiry
Safe, Effective, Caring, Responsive, Well-Led

8. Safe
Physical environments that maintain safety and dignity – awareness of environmental risks
A sufficient number of staff to provide safe care
Good basic medicines management and safe prescribing and administration of medicines
High quality initial and ongoing risk assessment
Good safeguarding practice
Reporting and learning from incidents and adverse events

9. Safe – a Christian perspective
Like the “Cities of Refuge” Numbers 35v6
If take refuge in God we will be kept safe Ps 12v7 Ps 27v5
In the “day of trouble” we will be kept safe Ps140v4
The needy will lie down in safety Isaiah 14v4

10. Effective Person-centred assessment and care
Assessment of physical health and ongoing monitoring
Adherence to national guidelines
Staff with the required range of specialist skills and qualifications, good teamwork and inter- agency working
Specialist training of staff, regular supervision and appraisal
Application of the Mental Capacity Act

11. Effective – a Christian perspective
Person centred – the individual matters to God
Held in the palm of his hand – Isaiah 49v16
Even the hairs of you head are numbered Matt 10v30
Delivered to the highest standard
Build with care 1 Corinthians 3:10
Work with all your heart, as unto the Lord – Col 3 v 23-24

12. Caring
Quality of interactions between staff and clients – compassion, respect, dignity
All decisions about care and treatment involve the person and, whenever appropriate, their family and friends
Staff provide information about the service, treatment and care in a form that is accessible to people who use the service and to their family and friends

13. Caring – a Christian perspective
Love your neighbour as yourself – Mark 12v21
Our God is full of compassion Ps 116v5
Redeems your life from the pit and crowns you with love and compassion Ps 103v4
Jesus came to bring life in all its fullness – John 10v10

14. Responsive Good pathways for access
Discharge planning and quality of joint working with other agencies
Comfort of the environment and quality of food
Facilities capable of meeting the needs of people with disabilities
Listening to and learning from concerns and complaints

15. Responsive – a Christian perspective
Meeting people at their point of need – Blind man - Luke 18v41
Jesus response to marginalised – Samaritan woman at the well – John 4v9

16. Well-Led Vision, values and sense of purpose
Quality of governance as indicated by findings from other key questions
Leadership, morale and staff engagement
Commitment to quality improvement

17. Well-Led – a Christian perspective
Vision – without it the people perish – Micah 3v6
To act justly, love mercy and walk humbly with your God Micah 6v8
In partnership with God – extending the kingdom – Ps 127v1
Led by the Spirit – Rom 8v14

18. Current Issues Medical/clinical perspective of Inspectors
Governance – how to monitor quality in the service?
High number of “regulatory breaches” – first tranche – 62%
Brief guides developed
Detox services
Ligature Points
Blanket restrictions

19. Issues of concern to CQC
Poor supervision of staff and absence of appraisals.
Absence of DBS checks.
Poor practice with respect to safeguarding.
Poor medicines management including procedures for ordering, receipt, storage, administration and disposal of controlled drugs.
Doctors prescribing medication by telephone or by without adequate knowledge of the patient’s health.
Failure to assess safety of the physical environment.

20. Next steps New methodology Solely based upon Hospital services
What about residential and community services?
Ratings
Outstanding, Good, Requires Improvement, Inadequate
Consultation in January 2018

21. And Finally
Do Not be discouraged – I am with you – says the Lord – Joshua 1v9