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 0 0 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 1 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. 2 2 Asking the right questions about quality and safety Safe? Effective? Caring? Well-led? Responsive to people’s needs? 3 3 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. 4 4 Intelligent monitoring Ongoing monitoring to identify failures and risk of failure Use local and national information sources Use qualitative information from people Intelligence Surveillance 5 5 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 6 6 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 7 7 Our regulatory approach to specialist mental health and learning disability services 8 8 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 9 9 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 10 10 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 11 11 Gathering people’s views about services     Focus groups Telephone interviews Face-to-face interviews Developing inclusive communications tools and methods 12 12 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 13 13 Useful contacts and links Afra Kelsall, Transformation manager, CQC, [email protected] 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 14 14