helping to make care better cynthia bower, ceo national care association conference 11 november 2009

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  • Helping to make care betterCynthia Bower, CEO National Care Association Conference 11 November 2009

  • *Our RoleWe make sure people get better care Who are we improving care for ?People who use services, carers and familiesPeople in more vulnerable circumstancesOperating principles Involve users to focus on what is important to themExpertise and independence

    Promote equality, diversity and human rights Engage with those providing and commissioning care Ensure regulation is proportionate, targeted, consistent, evidence-based, transparent and accountableWhat we will do to achieve our prioritiesPublic and taxpayersOur priorities Ensuring care is centred on peoples needsActing swiftly to help eliminate poor quality care Championing joined up care Promoting high quality careRegulating effectively in partnershipRegistration and ongoing monitoringRegular reviews of performance Enforcement Special reviews and studies Mental Health Act visitsPublishing information

  • Influencing the future of social care

    We are actively contributing to the current debates on social care:

    We gave written evidence to the Health Select Committee Inquiry on the future of social care, including personalisation and more effective, consistent and user-friendly services

    We responded to the Department of Health consultation on eligibility criteria, to achieve more fairness and consistency for people seeking support

    We contributed views to the Green Paper Shaping the Future of Care Together consultation about the future provision, arrangement and funding of social care, including the proposed establishment of a National Care Service

  • What did we say?

    Personalisation still has a long way to go people still need to be put firstNote the impact of the recession on qualityFunding should be fair, simple and sustainableSupport universality: information, advocacy, national assessmentNeed clarity about care and support for all people, not just people aged 65 and overOur new registration system: standards, dignity, rights

  • Registration -whats changing? A single way of judging qualityPrivate and voluntary healthcare (PVH) providers registeredProviders of adult social care (ASC) registeredNHS providers are not registeredAll providers of health and adult social care registered with CQCNational Minimum Standards (ASC and PVH) - different regulation and NMS for each settingStandards for Better Health considered as part of annual health checkSingle set of essential standards of quality and safety for all settingsCare Standards Act 2000 enforcement action limited to statutory notices and closuresLimited enforcement powers for NHS providersStrengthened and extended range of enforcement powers for providers from all sectors Old systemNew systemOrganisationsStandards/ requirementsEnforcement

  • The difference registration will makeAll health and adult social care providers are meeting a wide range of essential standards of quality and safetyStandards are focused on outcomes - what is needed to make sure people who use services have a quality experience - a direct result of what people said they wantedA single regulatory framework across health and adult social care, making it easier to compare one provider with another

  • Timeline for Adult Social Care and Independent Healthcare

  • Registration timelineSubject to legislation

    January 2010NHS trusts (incl PCT provider trusts) apply to be registeredApril 2010NHS trusts are registeredApril 2010Adult social care (CSA-registered); Private & Voluntary healthcare (CSA-registered) apply to be registeredOctober 2010Adult social care (CSA-reg); Private & Voluntary healthcare CSA-reg) are registeredApril 2011Private ambulance services, prison health services, independent midwifery, dental practices are registeredApril 2012Primary medical services are registered

  • Preparing for Registration From December, subject to legislation

  • Preparing for registration what you can do now

    Check your own internal reporting and audit systems

    Consider what evidence you already hold and what you need to create

    Consider evidence on outcomes

    Be aware of activities in other sectors as they come into new registration system

  • *We monitor compliance continuouslyThe published Register of Providers will be accompanied by a process of Ongoing Monitoring of Compliance. This is now in the planning stages.CQC plans to maintain an up-to-date profile on each registered providerNew information can be uploaded to their profile at any timeInformation can reach us from a number of external sources e.g.- people who use services, their families and carers- partner organisations such as the Ombudsman, commissioners- statutory notifications- staff & other professionals

  • Fees

    Adequacy, Fairness, Simplicity and Evolution

    We are now consulting on our proposed fee structure for NHS trusts for the first year of registrationIn early 2010 we will consult on fees for Adult Social Care and Independent Healthcare for the period Oct 2010-March 2011In late 2010 we will consult on a long term system of fees to come into effect for all providers including all dental practices and primary medical care

  • Acting swiftlyAnalysing risk

    Our assessors will regularly review provider profiles

    They will use the guidance about compliance to assess any risks

    We will take action swiftly when we need toMaking judgements

    We will take proportionate action

    We will take account of the providers capacity to improve and work with the provider to achieve this end

    If non-compliance is more serious, then we may take enforcement action

  • ConclusionWe all share the benefits of registration that

    Is more dynamic and responsiveIdentifies sooner causes of concernProtects and promotes equality, diversity and human rightsMakes use of relevant information from other organisations and people who use servicesReduces unnecessary regulatory burdens and costsIncreases complianceIncreases credibility

    **Condensed overview of how the Care Quality Commission operates. The people we serve; our strategic priorities; what we will do to achieve them Registration and ongoing monitoring of compliance; openness and transparency of information we will publish.CQC is actively contributing to current political debates about the future of social care and in particular the Green Paper Shaping the Future of Care Together

    The principles of our new registration programme and their focus on essential standards of quality and safety, their outcomes of dignity and rights are highly relevant to the debate about the future of social care.

    The whole landscape of regulation of health and adult social care is changing: the Registration Programme forms an important and integrated part of that.

    Current standards are being replaced by new essential standards of quality and safety set by governmentFrom April 2010, all regulated health and adult social care providers are required by law to register with CQC and show they meet these essential standards of quality and safety.CQC has new powers of enforcement to make sure that swift action is taken where providers are not compliantApplies to NHS trusts, independent health and adult social care providers registered with former commissions and new providersRegistration will relate to the regulated activities carried out, and not the individual services or service locations. Under the new system, instead of being separately registered for each of your services, you will be registered for each of the regulated activities you provide.Because of these changes, existing registrations made under the Care Standards Act 2000 are not transferable to the new system. You will need to make a new application for registration and there can be no automatic passport through to the new system.

    The new system means that people who use services can expect all registered providers to meet the same set of essential standards of quality and safety and to respect their dignity and rights.It also marks a change from regulation that is mainly based on systems, processes and policies to one that is based on outcomes, what constitutes a quality experience for people who use services.Continual monitoring and checking will make sure that potential problems are identified early and that swift action is taken where services are failing people.The system will also make it easier for people to compare one provider with another, and for providers to work together or properly join up in delivering care.We are now in Phase 2 of our programme, Refining the process. We are working out just which providers of adult social care and independent health care will be brought into the programme first and we will announce to you the exact dates when we know them.

    The new regulatory framework is introduced from April next year when NHS trusts will be the first to register with usAdult social care and independent healthcare providers will be registered with us from October 2010 because the Care Standards Act 2000 which currently applies to them remains in force until that date.You will be able to apply for registration between April and September next year. As I mentioned, the exact dates will be advised soon.Between April and September we may talk to adult social care and independent healthcare providers about their applications and may ask you to supply more evidence to support your applicationsFrom October 2010 adult social care and independent healthcare providers must be registered.Registration then continues incrementally through 2011 and 2012 as we add private healthcare and primary medical services.In December this year the legislation that underpins the new registration syst