Lisa Lenton, ARC England Director, attended the CQC Trade Association meeting on 13th April. The key points are summarised below for your reference:

  • Ratings – there has been a marginal change overall in Adult Social Care ratings. Details listed below:

The current overall ratings by service type were presented. Community social care (744 inspected) having the best ratings (2% Inadequate, 19% Requires Improvement, 77% Good, 1% Outstanding). The least well performing was within Nursing homes, 3278 inspected although the marginal shift is a positive one (5% Inadequate, 42% Requires Improvement, 52% Good, <0.5% Outstanding). At the moment there is no data available in respect of the breakdown between provision e.g. learning disability, older persons etc. We have requested this previously but data is still not available. This was requested and noted again.

The data continues to show that ‘small’ nursing and residential homes performed best from an inspection point of view.

Domiciliary Care Agency ratings – the ratings pattern follow that of nursing and residential homes, as in the larger the provision the less favourable the ratings. This was discussed as in a care home setting for example, it is fair to suggest that the larger the service, the less personal it is may become, but that can’t be said of domiciliary care. By the very nature of domiciliary care, the service delivered is within an individual’s home setting therefore the question is why should it become less personal regardless the size of the provider. This was discussed for a while; some theories included the lack of consistency of staff for example. If you as providers, have any comments or ideas please let us know.

Overall ratings for Adult Social Care up to 6th April 2016 – 

– Inadequate – 3% (from 4%)

– Requires improvement – 29% (slightly down from 32%)

– Good 67% (up from 63%)

– Outstanding – 1% (up from 0.5%)

 CQC’s aim was to complete a baseline inspection, under the ‘new’ regime within Adult Social Care by 30th September 2016. It was acknowledged that realistically this will NOT be achieved, and will be extended past this date. This will be confirmed soon, and an update will follow in due course.

  • DBS – delays and concerns regarding significant delays with the processing timeframes with the Metropolitan Police

This issue has been raised with CQC, as it affects providers across all sectors with varying degrees of impact. At the meeting today, it was stated that although this does not change what is expected of providers, inspectors have been advised to consider each situation on a case-by-case basis and take a “pragmatic and proportionate approach”. A communication has been developed for inspectors; we have asked for a copy of this to inform providers and offer more clarity and we will forward this on to you once it is received.

  • Fees – Providers will be aware that the revised fees have been published. Discussion ensued regarding the consultation process itself, as the decision CQC took was against the swathe of opinion collected during the process. The point was raised that members (providers) had taken time and resource to input into the consultation process, which in the end carried no weight.
  • Adult Social Care – Improvement story

 It was advised that CQC are reviewing the ratings information for Care Homes rated as ‘inadequate’ and subsequently re-inspected between 1st October 2015 and 3rd March 2016. Information will be shared on this once published, after purdah.

  • ‘What good looks like’ – Public leaflets, what to expect from a good care service

CQC have launched a new suite of leaflets to help the public better understand what they can expect from a good care service. These have been co-produced with staff, the public and with providers. They describe what good care looks like across the five key questions and there are five versions covering: hospitals, care homes, home-care, agencies, GP practices and dental practices.

The leaflets are available in various formats, including easy read, and providers are encouraged to use these as widely as possible. These are available in hard copy and as a download. Simply download from the CQC website  or contact them on 03000 616161 or to obtain copies.

  • Unplanned closures of care homes

There is recognition that all statutory bodies (LA, CCG, CQC) and providers need to work better together in partnership, to improve the closure and ‘crisis’ move process; and lessen impact on people affected who rely on services. There are various reasons for closures from flood and fire, to market exits and decommissioning of services.

Between 2011 and 2015, guidance was produced internally by CQC, ADASS/LGA and NHS England for their own organisations but lack of clarity, understanding of roles of partners in closure situations remained, therefore there has been a stakeholder symposium to plan a better way forward.

Between February and April, principles and guidance have been developed in co-production with commissioners, providers and CQC. This is one document and aligns the key elements of guidance about closures and clarifies roles and responsibilities. This document is in draft form at present and will be released once signed off, in June 2016. However, time will be taken, in May, to test the guidance in a scenario exercise to identify gaps and strengthen the guidance.

Please remember, ARC England is there to represent you at the trade association meetings! We regularly attend, so do let us know of any inspection issues or concerns and we will feed these directly to the meetings and get back to you!

Lisa Lenton, ARC England Director