Andrea Sutcliffe, Chief Inspector of Adult Social Care for the Care Quality Commission (CQC) presented at the National Children and Adult Services Conference (NCAS) on 4 November 2016.
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Presentation: Adult social care: Quality Matters - Andrea Sutcliffe
1. 1
Andrea Sutcliffe, Chief Inspector of Adult Social Care
National Children and Adult Services Conference
4 November 2016
Adult
social care:
Quality
Matters
2. 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.
2
3. Our model of regulation
3
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
4. 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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6. 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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7. 7
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.
9. 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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10. 10
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.
13. 13
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
Source:HealthFoundation:APerfect
Storm,NHSImprovement
Source:ONSmid-yearpopulation
estimates
14. • 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
14Source: CQC – State of Care 2015/16
State of Care 2016: approaching a
tipping point?
15. State of Care 2016: system failing
the Mum Test
15
Home care
package
Nursing
home
Residential
home
Causes of
delayed
transfers of
care
April 2012 to
July 2016
16. 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
17. 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
18. 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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19. 19
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
20. 20
• 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