What good looks like - The new regulatory model for inspecting LD

What good looks
like - The new
regulatory model
for inspecting LD
services
Afra Kelsall, Transformation
manager, CQC
Gavin Harding, MBE, Co-chair of
National Forum of People with
Learning Disabilities
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CQC has committed to key changes to regulation
Our 2013 to 2016 strategy published on
the 18th April
SOURCE: 2013 to 2016 Strategy Infographic
Areas for the consultation
published on 17th June
• Outlining new regulatory
models that make better use
of inspection and evidence,
and what this means for
NHS acute hospitals
•
Developing new
Fundamental Standards
•
•
Appointing Chief Inspectors
•
Working better with other
regulators and organisations
to improve care
Publishing ratings of care
services, starting with NHS
acute hospitals
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What will be different
FROM
• Focus on Yes/No ‘compliance’
• A low and unclear bar
TO
• Professional, intelligence-based judgements.
• Ratings: Clear reports that talk about safe,
effective, caring, well-led and responsive care
• 28 regulations, 16 outcomes
• Five key questions
• CQC as part of the system
with responsibility for
improvement
• On the side of people who use services.
• Generalist inspectors
• Specialist with teams of experts.
• Generic inspections
• Longer, thorough and people-focussed
inspections.
• Corporate body and registered
manager held to account for
the quality of care
• Individuals at Board level also held to account
for the quality of care.
• Providers and commissioners clearly
responsible for improvement.
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Asking the right questions about
quality and safety
Safe?
Effective?
Caring?
Well-led?
Responsive to
people’s needs?
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The New Regulations
New government regulations – to be introduced April 2015
• Fewer in number and more concise than current 16 Quality
and Safety regulations; plus additional regulation (Fit and
Proper Person Test & Duty of Candour)
• Set out the high level ‘outcome’ that providers must deliver
in order to meet the regulation
• In effect setting the fundamental standards in legislation
o
Where the quality of care at an NHS trust requires significant
improvement, new options exist to place a trust in special
measures or to use the new single failure regime – we works
closely with NHS TDA/Monitor in these circumstances.
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Intelligent monitoring
Ongoing monitoring to
identify failures and risk of
failure
Use local and national
information sources
Use qualitative information
from people
Intelligence
Surveillance
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Inspections
Chief Inspectors of Hospitals, Social
Care, and General Practice
Expert inspection teams
Longer inspections, more time
talking to people
Intelligence used to decide when,
where and what to inspect
Inspectors using professional
judgement
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Ratings
Ratings to help people choose between
services and to encourage improvement
Ratings for providers, and more
granular
Ratings for each question
o
o
o
o
o
Safe
Effective
Caring
Responsive to people’s needs
Well-led
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Our regulatory
approach to specialist
mental health and
learning disability services
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Core services to be inspected from
October 2014
Acute wards for adults of working age and psychiatric intensive care units
Long stay/rehabilitation mental health wards for working age adults
Forensic inpatient/secure wards
Child and adolescent mental health wards (Tier 4)
Wards for older people with mental health problems
Wards for people with learning disabilities or autism
Community-based mental health services for adults of working age
Mental health crisis services and health-based places of safety
Specialist community mental health services for children and young
people
Community-based mental health services for older people
Community mental health services for people with learning disabilities or
autism
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Use of Key Lines Of Enquiry in
mental health inspections
Mental health KLOE mandatory for all mental health
inspections, including specialist learning disability
services
Module for specialist services for people with learning
disabilities and people with autism is optional
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Specific changes for regulation of
specialist MH and LD services
Alignment of regulation and Mental Health Act
(MHA) monitoring for providers that operate
the MHA
Greater focus on community services
Making greater use of information from
people who use services/introducing new
methods
Consistent focus on core services including
where there are known inequalities or people
are in especially vulnerable circumstances
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Gathering people’s views about
services


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Focus groups
Telephone interviews
Face-to-face interviews
Developing inclusive communications tools and
methods
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Update on CQC’s New Approach to
inspection of mental health services
• Completed two waves of mental health
inspections
• Included:
 Calderstones
 St Andrews
 As well as learning disability services provided
by mental health and combined NHS trusts
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Useful contacts and links
Afra Kelsall, Transformation manager, CQC, afra.kelsall@cqc.org.uk
07920 150510
Provider handbook:
http://www.cqc.org.uk/content/hospitals-0
Appendices to provide handbook (including KLOEs and LD module):
http://www.cqc.org.uk/sites/default/files/20140925_mental_health_pro
vider_handbook_appendices_final.pdf
Response to consultation on handbook:
http://www.cqc.org.uk/sites/default/files/20140924_hospitals_handboo
k_consultation_response_final.pdf
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