Basic HTML Version
The Care Quality Commission has released a new strategy
,
Raising standards,
putting people first – our strategy for 2013–2016
,
and it could have major
implications for the substance misuse sector
.
Recent reports from Mid Staffordshire, Winterbourne View and the Health
Select Committee have all been critical of CQC and its operations. Internally,
CQC has commissioned two reports which have also set challenges, such as
the restoring of ‘star ratings’ and an overhaul of its methodology. So what are
the changes we should look out for?
CQC now seems to have ended its generic approach to regulation. The
commission says that there will be new ‘fundamental’ care standards,
differentiated by sector, with specialist teams to inspect hospitals and social care
services. The health secretary, Jeremy Hunt, has announced that CQC will also
reintroduce ‘performance ratings’ so that the general public will have good
information on which to base their choices of services. CQC also says that it will
inspect services according to risks posed to people who use the service – an
‘about turn’, after recently committing themselves to annual inspections.
Other significant changes will be the appointment of a chief inspector for
hospitals, as well as chief inspectors of social care and primary care. CQC has
been quite open about its priorities, saying that ‘the changes will come into
effect in NHS hospitals and mental health trusts first, because we recognise
that there is an urgent need for more effective inspection and regulation of
these services.’ It goes on to say that ‘we will extend and adapt our
approaches to other sectors in 2014 and 2015.’
The immediate questions for the substance misuse sector regarding this
‘direction of travel’ are:
• How specialised will the inspection approach be,
ie
will substance
misuse be seen as a ‘stand alone’ sector?
• The substance misuse sector is comparatively small, so how can it
be heard in the consultation process on the new standards and the
new methodologies?
• Will there be an opportunity to contribute to the training of
inspectors in the particular knowledge and skills necessary to
inspect the substance misuse sector?
• What will the performance ratings look like, and will they reflect
how excellence is perceived in the substance misuse sector?
My view is that the ‘big players’ in the sector and the representative bodies need
to ensure that they are in communication with CQC at an early stage so that
their voice is heard. There is also no harm in single providers making
representations to be included in the consultation process, because CQC says that
it is committed to working with partners in the health and social care system.
Another interesting strand to the CQC strategy is the desire to listen to people
who use services. CQC says that it will focus on gathering the views of people in
the most vulnerable circumstances. There is also a specific point under the
heading of ‘Involving people in our work’, which says that: ‘We will set up a panel
of people who use services to inform all aspects of our work and improve how we
gather the views of the people who use services.’ CQC also says that it ‘will
improve how we involve small and diverse community groups in our work.’
These seem to me to be great opportunities for service user representative
groups to get in touch directly with CQC and raise issues on behalf of people who
use substance misuse services. And remember this includes many community
services which are registered with CQC as well as residential services.
The next and most immediate question is: what can we expect in the coming year?
The public statements of CQC are that it will be ‘business as usual’ for the
social care sector. This means that the approach outlined in
Improving the way
we regulate
, (a document published in February 2012), still applies. This means
that you will be inspected on at least five outcomes, one from each of the
chapter headings in the ‘Essential standards’. The intention of CQC was to
cover all 16 outcomes in a three-year period, so it is likely that the outcomes
inspected will be different this time around.
A reading of inspection reports shows that CQC tended to look at the
following outcomes most often during the last round of inspections in 2012-13:
• Respecting and involving people who use services – 1
• Care and welfare – 4
• Safeguarding – 7
• Supporting workers (supervision and training) – 14
• Monitoring of quality – 16
So for the forthcoming year, as providers, you need to look at your last
inspection report and check if these outcomes have been inspected. If any
haven’t, then make sure you are up to speed and prepared for them. If they
were inspected, then you need to look and see what CQC might prioritise next.
In its documents CQC says that it will inspect according to information
received, so if there have been any safeguarding issues raised or complaints
passed onto CQC then these outcomes will be the first to be inspected. Also,
CQC says that it tailors its inspections according to the services you provide, so
the next priority may be other key components of the treatment you deliver.
My suggestion is that the following might be high on CQC’s priorities if they
haven’t been inspected already:
• Consent – outcome 2
• Medicine management – outcome 9
• Staffing – outcome 13
• Complaints – outcome 17
There has also been a growing tendency for CQC to ask about any people in
your services who might temporarily lose capacity to make decisions where
the requirements of the Mental Capacity Act 2005 become relevant.
The preparing of evidence for your inspection is important and needs to be
Staying
ahead of
THE INSP
16 |
drinkanddrugsnews
| May 2013
Regulation |
Care Quality Commission
www.drinkanddrugsnews.com
The Care Quality
Commission is once again
changing the way it inspects
and rates substance
misuse services. Make
sure you are prepared,
says
David Finney