The Care Quality Commission:A New ApproachElaine WrightHead of Quality ComplianceThe Princess Alexandra NHS Trust
Who are the CQC?
Why a new approach?
Reports: Cavendish July 2013, Berwick August 2013, Clywd-Hart October 2013
Fundamental Care Standards Person centred care Dignity and respect Need for consent Safe care and treatment Safeguarding Nutrition and hydration needs Premises and equipment Receiving and acting on complaints Good governance Staffing Fit and proper persons employed Duty of Candour
CQC 5 Domains Safe: protecting people from abuse and avoidable
harm. Effective: care, treatment and support achieves
good outcomes, promotes a good quality of life and is based on the best available evidence.
Caring: Staff involve and treat people with compassion, kindness, dignity and respect.
Responsive: Services are organised so that they meet people’s needs.
Well-led: Leadership, management and governance of the organisation assures the delivery of high-quality person-centred care, supports learning and innovation, and promotes an open and fair culture.
What is the service track record on safety? Have we learned when things went wrong? Have we improved safety from reviewing
incidents and complaints? Are our risks assessed and appropriately
managed? Are people who use the service treated with
kindness, dignity, respect and compassion?
Key Lines of Enquiry
What does good look like? Care, treatment and support achieve good outcomes Care is patient-centered and holistically assessed. National and international evidence-based best practice Staff are appropriately qualified, competent with good
inductions, appraisal and performance management Multi-disciplinary approach to care and treatment Discharge, transfers etc. are planned in advance and
involve the holistic assessment of peoples needs Staff practices comply with health legislation for the area
Core services inspected Urgent and emergency services Medical care (including older people’s care) Surgery Critical care Maternity and gynaecology Services for children and young people
◦ Transition services child to adult End of life care Outpatients and diagnostic imaging
Gathering evidence Checking essential equipment (resus) Pathway tracking people through their care
◦ Referral to treatment times Interviewing staff Reviewing records Reviewing policies, procedures and PGD’s Interviewing service users and their carers Checking prescriptions and talking to the pharmacists Attending and observing a MDT Maintenance of equipment Local rules IR(ME)R 2000 Waiting times Acute kidney injury, Contrast Induced Nephropathy WHO checklist NatSSIPs Local Safety Standards for invasive
procedures
Managing the inspection process Communication, information,
support and engagement CEO sets the scene Be prepared for visits in and out of
hours (do staff know what to do? Gathering evidence Focus groups Initial feedback Draft report Final report Ratings advertised Future inspection process yearly
D Day
National and Local Safety Standards for invasive procedures (7th Sept 2015)◦ Making a cut or a hole to gain access to the inside
of the patients body. Standardise procedural care and patient
pathway Ownership of local standards Patient user involvement Documentation Audit & review
OPD and Diagnostics Future inspection process
The role of NatSSIPs
What’s happening locally? MDT, patient user involvement Steering group What’s in place, SOP’s Human factors training by the team Policies, procedures in place Staffing/finance implications
What do we need to consider?
Human Factors
Any questions?
http://www.england.nhs.uk/2015/09/07/natssips/
http://www.england.nhs.uk/ourwork/patientsafety/never-events/
http://www.legislation.gov.uk/ukdsi/2014/9780111117613
http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf
http://www.nice.org.uk/about/what-we-do/our-programmes/nice-guidance/nice-interventional-procedures-guidance
References
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