Care Quality Commission `A New Start` Consultation (England)

Care Quality Commission: ‘A
New Start’ Consultation
June 2013
Full details on the CQC Consultation are available here:
 This slide deck presents key points and
emerging issues on the consultation ‘A
New Start’ from the Care Quality
 Please use it to share with your
colleagues and feedback to by mid July
as the RCN develops our response
Background to the
 Prompted by:
 Francis, Winterbourne View, Morecambe
 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
Monitor/TDA to
take action
Simplification to focus on 5
 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
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
 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’ 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
 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’
CQC Examples
‘Reasonable’ fundamental standards
“I will be helped to use the toilet and to
 Organisational not individual?
wash when I need it”
 Complementary to code or duplicatory?
“There will always be enough members
 Realistic or setting up organisations to fail? 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
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?
 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
020 7647 3901
By mid July

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