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Andrea Sutcliffe, Chief Inspector of Adult Social Care

National Children and Adult Services Conference

4 November 2016

Adult

social care:

Quality

Matters

Our purpose

The Care Quality

Commission is the

independent regulator of

health and adult social care

in England.

We make sure health and social

care services provide people

with safe, effective,

compassionate, high-quality

care and we encourage care

services to improve.

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Our model of regulation

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Register

Monitor,

inspect

and rate

Enforce Independent

voice

We register

those who

apply to CQC

to provide

health and

adult social

care services

We monitor

services, carry

out expert

inspections,

and judge each

service, usually

to give an

overall rating,

and conduct

thematic

reviews

Where we find

poor care, we

ask providers

to improve and

can enforce

this if

necessary

We provide an

independent

voice on

the state of

health and adult

social care

in England on

issues that

matter to the

public,

providers and

stakeholders

The Mum (or anyone you love) Test

Is it good enough for my Mum?

Is it

safe?

Is it

caring?

Is it

effective?

Is it responsive to

people’s needs?

Is it

well-led?

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State of Care 2016

• Published 13 October 2016

State of Care 2016: Adult social care

• Many services are providing good quality care – over 70%

• More than three-quarters of re-inspected inadequate locations improved

• 84% of community social care locations, including 92% Shared Lives services, Good or Outstanding

• Caring achieves highest scores – 90% Good, 2% Outstanding

The good news

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Great care

The provider and staff supported people in a number of creative ways to

lead a fulfilling life with a commitment and determination to promote

people's quality of life.

A person who liked

heavy metal had a CD

player and headphones.

Another person liked

birds – they had their

own budgies and love

birds to look after.

Relatives told us they were amazed and moved by the changes they

saw in their family member when they used their iPads.

Innovative ways of involving people were used so people were at the

heart of everything. People were listened to and their comments acted on.

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Unsung heroes

State of Care 2016: Adult social care

• 26% services Require Improvement and 2% are Inadequate

• Poorer performance for safety and leadership

• Nearly a quarter of re-inspected inadequate services did not improve

• Half of services rated requires improvement did not improve on re-inspection – 8% became inadequate

• Services for older people fare worse than those for people with a learning disability

The worrying news

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Poor care

One member of

staff when asked

about MCA “I

probably have

had training, I

can’t think what it

is off hand, is it

when people are

too ga ga?”

The home was not clean. Bins outside the

home were over-flowing and household

rubbish was kept in the garden which could

encourage pest infestation.

Staff employed at the home did not have the skills

and knowledge required to support people safely.

People were not

receiving medicines

safely and the

temperature for

storing medicines

was too high to

ensure medicines

were effective.

There has been

inconsistent

leadership at the

home, with

management

changes and

periods of

management

absence.

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State of Care 2016: older people’s care

Source: CQC data

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State of Care 2016: headline news

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State of Care 2016: a challenging environment

• Ageing population with complex needs, 85+ up 33%

• Greater demand for adult social care, but less access

• Two thirds of NHS providers recorded a deficit last year

• Shortage of GPs and increasing vacancy levels

• Improvement increasingly difficult

Sourc

e: H

ealth

Foundatio

n: A

Perfe

ct

Sto

rm, N

HS

Impro

vem

ent

Sourc

e: O

NS

mid

-year p

opula

tion

estim

ate

s

• Age UK estimated in 2015 over a million older people have unmet social care needs, up 800,000 from 2010

• 26% fewer older people receive LA funded care – 81% of councils reduced spending on social care

• Five-year increase in nursing home beds now stalled

• Some providers resigning contracts, councils warn of more

• Recruitment and retention of staff a challenge

14 Source: CQC – State of Care 2015/16

State of Care 2016: approaching a tipping point?

State of Care 2016: system failing the Mum Test

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Home care

package

Nursing

home

Residential

home

Causes of

delayed

transfers of

care

April 2012 to

July 2016

CQC: encouraging improvement with hard and soft levers

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• Force – where people are at risk of harm and urgent action is needed.

• Inform – share findings, analysis and insights (passive) and encourage

national and local partners/improvement bodies to act on our findings (active).

• Model – ‘well-led’ mirrors conditions for improvement, methods encourage

organisations to embed good practices within their own ways of working.

• Recognise – celebrate good and outstanding, ratings reward high-quality,

potential earned autonomy for good and outstanding.

Recognise

Quality matters: a collective effort

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The public – people who use services, families and carers

Staff – capable, confident and supported

Providers – culture, organisation, expectations

Commissioners and funders – expectations of quality

Regulators – monitor, inspect, rate, take action, celebrate

Person-

centred, high-

quality care

for all

Caring & responsive

Sustainable use of

resources

Well led

Adult

social

care

Health

care

A single shared view of quality that works for health and social care

Quality matters: a shared view

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Quality matters: CQC commitment

• CQC will:

• Work across the national system of health and social care

• Use our independent voice to give leadership and support

• Encourage improvement,

innovation and

sustainability in care

• Improve our effectiveness

• Promote a single shared

view

• Collaborate on practical

initiatives to improve

people’s experiences

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• Commissioners and funders

Quality matters: what will you do?

We have all got to make social care the priority it deserves to be

• National bodies

• Providers and staff

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Quality matters: why

Copyright: Community Care

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Quality matters: why

Copyright: Oomph!

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Thank you

www.cqc.org.uk

enquiries@cqc.org.uk

@CareQualityComm

Andrea Sutcliffe

Chief Inspector of Adult Social Care

@CrouchEndTiger7

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