Care Quality Commission: ‘A New Start’ Consultation(England)

June 2013

Full details on the CQC Consultation are available here: http://www.cqc.org.uk/sites/default/files/media/documents/cqc_consultation_2013_tagged.pdf

Introduction

This slide deck presents key points and emerging issues on the consultation ‘A New Start’ from the Care Quality Commission

Please use it to share with your colleagues and feedback to leela.barham@rcn.org.uk by mid July as the RCN develops our response

Background to the consultation Prompted by:

Francis, Winterbourne View, Morecambe Bay

Implementing new strategy under new leadership of David Behan and David Prior

Widespread criticism of ‘old’ CQC (and new reports emerging all the time of problems at CQC in the past)

New operating model

Informed by 6 C’s Chief Inspector of Hospitals can

request Monitor/TDA to

take action

Simplification to focus on 5 questions When CQC inspect they will ask the

following questions about care services: Are they safe? Are they effective? Are they caring? Are they responsive to people’s needs? Are they well-led?

Proposed changes and initial RCN view

✔

✔

✔

✔

✔

✔

RCN View*

?

?

*RCN based on previous consultation responses and member engagement. Subject to discussion and due process to reach final position(s)

Other encouraging signs

Staffing highlighted in registration:“They must show us that they focus on the right things when they employ staff, such as their

qualifications, clinical supervision and continuing professional development” (p11)

Approach inspections from the perspective of peer review Co-ordination with existing inspections and visits e.g. Royal

College visits Inspect at night and at weekends and talk more to frontline staff Can ask NMC to act or HSE Will include concerns raised by staff as part of indicators looked

at Will consider avoidable morbidity

Tier 1 Indicators for an Acute Trust

RCN view that staffing is both an indicator for safety and a well-led organisation

‘Well led’ indicators

RCN looking at indicators and exploring whether there are preferred indicators for staffing that can act as a trigger for further investigation

Areas where there may be tension with RCN view Ratings

Intention for overall rating But devil in the detail Setting is relevant; makes more sense for care homes than for hospitals Further consultation later this year on the details of this But just what will this mean for public, patients, carers, staff?

Frequency of inspection In 2011 our members told us that they wanted annual inspections Not sure of view about ‘earned autonomy’ which will mean an unannounced

inspection once every 3 to 5 years for those rated as ‘outstanding’ ‘Reasonable’ fundamental standards

Organisational not individual? Complementary to code or duplicatory? Realistic or setting up organisations to fail?

CQC Examples“I will be helped to use the toilet and to wash when I need it”“There will always be enough members of staff available to keep me safe and meet my health and welfare needs”

Areas we’re unsure about

How will CQC work with Monitor and others? Will it work?

Will CQC be able to staff this new model? But intention to make work at CQC an attractive

career option but concerns of workload, lack of support voiced by our members working at CQC

Sufficient focus on staffing (numbers and skill mix)?

What could it mean to practicing nurses? See CQC less often but when they do it will be for

longer (6-7 days on site) and it should be more clinically credible

May be asked by public and patients and carers about their organisations’ rating

May be less work in preparing for CQC inspection Opportunities for members to get involved:

Directly - as part of expert team Indirectly - their comments will be looked at by CQC and as

part of peer review?

Timeline

Consultation response due 12th August but your thoughts by mid July please to allow for sign off

Implementing changes will take 2 years

Tell us your thoughts

Contact: Leela Barham

leela.barham@rcn.org.uk

020 7647 3901

By mid July