FDAP Workshop David Finney Social Care Consultant 11 November
2010
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Aims of workshop Think about quality Fit for purpose Measurable
change Continual Improvement Think about excellence Exceeding the
mark Going the extra distance
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Focus of this workshop Care Quality Commission definitions
Overlap with NDTMS, Supporting People, TOPS & others Examples
from the CQC Provider Compliance Assessment document Think about
what we mean by outcomes and how this links with commissioners
expectations
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From Standards to Outcomes From...You will have..... three
meals a day, including at least one cooked meal,....etc To...You
demonstrate that... people who use services are supported to have
adequate nutrition and hydration
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From Standards to Outcomes (2) The home carries out a needs
assessment covering :- Suitable accommodation & personal
support Meaningful education, training and/or occupation
Family/social contact Provision of disability equipment Method of
communication Etc People who use services experience effective,
safe and appropriate care, treatment & support that meets their
needs and protects their rights
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From Standards to Outcomes (3) From inputs to outcomes From
processes to experience of people in services Generalised
statements allows for flexibility Example: Care is centred on them
as an individual and considers all aspects of individual
circumstances Means you need to demonstrate that........
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How to measure quality? Demonstrate that you have the evidence
that outcomes are met Say how the experience of people using
services is improved through service delivery
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Outcome Evidence (1) Principles Show how individual needs are
met The views of people using services Describe the experience
people have Say how equality, diversity & human rights are
protected Show how people are directly involved in decision making
about: Planning their own care Running of the establishment
Describe how people are kept safe
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Outcome evidence (2) Policies & procedures? List is not
enough not sufficient on their own Say how put into practice to
ensure needs are met Impact they have on outcomes How help meet
needs How people are involved in their development How they are
reviewed
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Outcome evidence (3) Summary Best evidence comes directly from
clients Focus on the experience of individuals Demonstrates:
Appropriate assessments and care planning How risks are addressed
and minimised How feedback has been listened to Results of any
improvements
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Great sources of evidence Written comments from service users
or carers Notes of community meetings
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Where do we find the CQC outcomes?
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CQC what they expect (1) Regulation 10 Registered person must:-
Regularly assess and monitor the quality of the services provided
in the carrying on of the regulated activity....
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CQC what they expect (2) Regulation 10 The Registered person
must send to the Commission, -when requested to do so:- -a written
report - (quality monitoring) -Together with any plans for
improving the service So Self Assessment is the key
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Written Report? The Provider Compliance Assessment Report
(PCA)
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Provider Compliance Assessment Covers 16 Outcomes in 16
sections Is a living document continually updated Any outcome can
be singly requested by CQC Asks for evidence for each prompt One
for each location
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How do providers fill in the summary of evidence? Look at key
principles in each outcome Assess for compliance Identify if an
action plan is needed.
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Lets look at an example! Outcome 1 Involvement &
information Note that there are some which apply specifically to
Residential Substance Misuse Services 1L Work through some of the
prompts
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Involvement & Information Outcomes 1 General principles How
do you help people understand the options open to them to enable
them to make an informed choice Brochure Rules and restrictions -
explained Treatment philosophy Pre-assessment phase Make sure
people can have a say about how their individual needs are met
Assessment conducted in cooperation with a client Individual needs
& preferences are highlighted How treatment programme meets
their needs Includes equality & diversity information Involve
people in the running of the service Community meetings Policy
review Privacy & dignity how maintained?
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Personalised care & support Outcomes 4, 5 & 6 Make sure
people have Personalised care plan Involvement in drawing up care
plan Involved in reviewing care plan Health issues are well
documented Healthy living choices including nutrition - outlined
Cooperation with other providers/professionals Protocols or
agreements in place Discharge arrangements are thorough (see 4N
& 4O)
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Safeguarding & Safety Outcomes 8,9,10 & 11 Safeguarding
Cleanliness & Infection control Management of medicines
Premises & equipment.
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Safeguarding Principles Take action to identify and prevent
abuse Staff and s/u understand aspects of abuse 7Q Guidelines for
staff Respond appropriately when abuse suspected Have local
safeguarding procedures available Have internal procedures
regarding safeguarding Understand how diversity influences
safeguarding Protect others from negative behaviour Specific
procedures regarding money 7M
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Premises Outcomes 10 & 11 Regulations specify:- Suitable
design & layout sharing & room sizes n/a !! Security
Maintenance Specific issues Suitability you explain Legislation
H&SAW, Fire, COSHH, DDA, Food, Elec Disposal of clinical waste
Risk assessment include self harm 10P - RSM Space toilets,
therapeutic activity, outdoor 10M
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Staff Outcome 12 Requirements Recruitment checks, qualified,
legally in UK, registered with professional body. Employment
practice job description, roles & responsibilities Agency need
written confirmation of checks Expectations (which accord with
excellence) Communication Promote independence Identify &
respond to changing needs Aware of company policies &
procedures
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Staffing Outcome 13 Sufficient staff Competencies
Qualifications Skills Based on a needs analysis Management
structures that enable effective maintenance of staffing levels
Respond to changing circumstances leave, sickness, vacancies,
emergencies
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Supporting Staff Outcome 14 Induction Skills for Care 14E
Learning & development (contributes to excellence) Based on
needs of people using service Plan which covers mandatory &
sector requirements Record of staff attendance Resources made
available Supervision One to one or group so can be peer support At
a time & frequency agreed with line manager
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Quality & Management Outcome 16 Relevant sources:- Feedback
from people who use services Observations Audits Adverse events,
incidents, errors & near misses Comments & complaints
Investigations into misconduct Expert bodies What about your
clinical governance arrangements?
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The CQC system (1) The Quality Risk Profile
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The CQC system (2) Wide range of sources of information
Stakeholders Own surveys Direct contact with service telephone or
visit Intelligence safeguarding, complaints, notifications Provider
Compliance Assessment
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Excellence (1) SCIE have identified four key areas: Control
over significant life decisions Day to day choices for the
individual decision to participate How a place is run community
meetings Management listen to staff & service users Evidence of
changes as a result of listening Positive relationships
Partners/family/friends /community a process Staff treat with
dignity match this with challenge! Focus on people as individuals
personalise the programme Sensitivity to changes in peoples
lives
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Excellence (2) Meaningful activities Finds out what people want
to do emphasize agreement in participating in treatment Seeks to
develop independence emphasize goals of treatment Community
activities challenge to consider external Organisation factors
Quality assurance through review -learning organisation Commitment
to excellent outcomes for service users Commitment to staff
development Introduction in Spring 2011.
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The ongoing journey Have you got an approach to the CQC
Assessment? What elements of excellence are you aiming for? Is
there crossover with NDTMS, TOPS & SP Quality framework? Is
there a better way?
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And finally Training Consultancy External review Simplex
solutions Best of luck for the future [email protected]
www.davidfinney.org.uk